Mobile C-arm cone-beam CT for guidance of spine surgery: Image quality, radiation dose, and integration with interventional guidance

Energy Technology Data Exchange (ETDEWEB)

Schafer, S.; Nithiananthan, S.; Mirota, D. J.; Uneri, A.; Stayman, J. W.; Zbijewski, W.; Schmidgunst, C.; Kleinszig, G.; Khanna, A. J.; Siewerdsen, J. H. [Department of Biomedical Engineering, Johns Hopkins University, Baltimore, Maryland 21202 (United States); Department of Computer Science, Johns Hopkins University, Baltimore, Maryland 21218 (United States); Department of Biomedical Engineering, Johns Hopkins University, Baltimore, Maryland 21202 (United States); Siemens Healthcare XP Division, Erlangen (Germany); Department of Orthopaedic Surgery, Johns Hopkins University, Baltimore, Maryland 21239 (United States); Department of Biomedical Engineering, Johns Hopkins University, Baltimore, Maryland 21202 and Department of Computer Science, Johns Hopkins University, Baltimore, Maryland 21218 (United States)

2011-08-15

Purpose: A flat-panel detector based mobile isocentric C-arm for cone-beam CT (CBCT) has been developed to allow intraoperative 3D imaging with sub-millimeter spatial resolution and soft-tissue visibility. Image quality and radiation dose were evaluated in spinal surgery, commonly relying on lower-performance image intensifier based mobile C-arms. Scan protocols were developed for task-specific imaging at minimum dose, in-room exposure was evaluated, and integration of the imaging system with a surgical guidance system was demonstrated in preclinical studies of minimally invasive spine surgery. Methods: Radiation dose was assessed as a function of kilovolt (peak) (80-120 kVp) and milliampere second using thoracic and lumbar spine dosimetry phantoms. In-room radiation exposure was measured throughout the operating room for various CBCT scan protocols. Image quality was assessed using tissue-equivalent inserts in chest and abdomen phantoms to evaluate bone and soft-tissue contrast-to-noise ratio as a function of dose, and task-specific protocols (i.e., visualization of bone or soft-tissues) were defined. Results were applied in preclinical studies using a cadaveric torso simulating minimally invasive, transpedicular surgery. Results: Task-specific CBCT protocols identified include: thoracic bone visualization (100 kVp; 60 mAs; 1.8 mGy); lumbar bone visualization (100 kVp; 130 mAs; 3.2 mGy); thoracic soft-tissue visualization (100 kVp; 230 mAs; 4.3 mGy); and lumbar soft-tissue visualization (120 kVp; 460 mAs; 10.6 mGy) - each at (0.3 x 0.3 x 0.9 mm{sup 3}) voxel size. Alternative lower-dose, lower-resolution soft-tissue visualization protocols were identified (100 kVp; 230 mAs; 5.1 mGy) for the lumbar region at (0.3 x 0.3 x 1.5 mm{sup 3}) voxel size. Half-scan orbit of the C-arm (x-ray tube traversing under the table) was dosimetrically advantageous (prepatient attenuation) with a nonuniform dose distribution ({approx}2 x higher at the entrance side than at isocenter

Clinical application of percutaneous needling lung abscess drairnage under CT guidance

International Nuclear Information System (INIS)

Hu Xiaokun; Wang Mingyou; Li Chenjun; Lv Dongfang; Li Xiaodong; Yu Zhaocun

2004-01-01

Objective: To discuss the clinical application of drainage for lung abscess by needle puncture under CT guidance. Methods: 18 cases of lung abscess were drainaged by needle puncture under CT guidance, including direct aspiration by puncture needle 1-3 times (n=8) and retaining drainage tube continuously (n=10). Results: 17 cases with this procedure were succeeded possessing success rate of 94.7%(17/18). The patients were followed up for 11-35 days with symptom relieving better obviously and the focus shrinkage or disappeared (n=16), the curative rate reached 88.9%(16/18). The main complication was pneumothorax with capacities of 30%(n=1). Conclusions: The curative course of lung abscess can be shortened greatly by percutaneous needling drainage under CT guidance with mild trauma. The procedure is simple with high successful rate and less complication. (authors)

SU-E-J-24: Image-Guidance Using Cone-Beam CT for Stereotactic Body Radiotherapy (SBRT) of Lung Cancer Patients: Bony Alignment or Soft Tissue Alignment?

Science.gov (United States)

Wang, L; Turaka, A; Meyer, J; Spoka, D; Jin, L; Fan, J; Ma, C

2012-06-01

To assess the reliability of soft tissue alignment by comparing pre- and post-treatment cone-beam CT (CBCT) for image guidance in stereotactic body radiotherapy (SBRT) of lung cancers. Our lung SBRT procedures require all patients undergo 4D CT scan in order to obtain patient-specific target motion information through reconstructed 4D data using the maximum-intensity projection (MIP) algorithm. The internal target volume (ITV) was outlined directly from the MIP images and a 3-5 mm margin expansion was then applied to the ITV to create the PTV. Conformal treatment planning was performed on the helical images, to which the MIP images were fused. Prior to each treatment, CBCT was used for image guidance by comparing with the simulation CT and for patient relocalization based on the bony anatomy. Any displacement of the patient bony structure would be considered as setup errors and would be corrected by couch shifts. Theoretically, as the PTV definition included target internal motion, no further shifts other than setup corrections should be made. However, it is our practice to have treating physicians further check target localization within the PTV. Whenever the shifts based on the soft-tissue alignment (that is, target alignment) exceeded a certain value (e.g. 5 mm), a post-treatment CBCT was carried out to ensure that the tissue alignment is reliable by comparing between pre- and post-treatment CBCT. Pre- and post-CBCT has been performed for 7 patients so far who had shifts beyond 5 mm despite bony alignment. For all patients, post CBCT confirmed that the visualized target position was kept in the same position as before treatment after adjusting for soft-tissue alignment. For the patient population studied, it is shown that soft-tissue alignment is necessary and reliable in the lung SBRT for individual cases. © 2012 American Association of Physicists in Medicine.

Tailoring four-dimensional cone-beam CT acquisition settings for fiducial marker-based image guidance in radiation therapy.

Science.gov (United States)

Jin, Peng; van Wieringen, Niek; Hulshof, Maarten C C M; Bel, Arjan; Alderliesten, Tanja

2018-04-01

Use of four-dimensional cone-beam CT (4D-CBCT) and fiducial markers for image guidance during radiation therapy (RT) of mobile tumors is challenging due to the trade-off among image quality, imaging dose, and scanning time. This study aimed to investigate different 4D-CBCT acquisition settings for good visibility of fiducial markers in 4D-CBCT. Using these 4D-CBCTs, the feasibility of marker-based 4D registration for RT setup verification and manual respiration-induced motion quantification was investigated. For this, we applied a dynamic phantom with three different breathing motion amplitudes and included two patients with implanted markers. Irrespective of the motion amplitude, for a medium field of view (FOV), marker visibility was improved by reducing the imaging dose per projection and increasing the number of projection images; however, the scanning time was 4 to 8 min. For a small FOV, the total imaging dose and the scanning time were reduced (62.5% of the dose using a medium FOV, 2.5 min) without losing marker visibility. However, the body contour could be missing for a small FOV, which is not preferred in RT. The marker-based 4D setup verification was feasible for both the phantom and patient data. Moreover, manual marker motion quantification can achieve a high accuracy with a mean error of [Formula: see text].

Lumbar sympathectomy under CT guidance: therapeutic option in critical limb ischaemia

International Nuclear Information System (INIS)

Pieri, Stefano; Agresti, Paolo; Di Cesare, Fabio; Ricci, Guiseppe

2005-01-01

Purpose: Lumbar sympathectomy is a complementary therapeutic option for patients with severe peripheral vascular occlusive disease presenting rest pain or gangrene and not eligible for surgical revascularisation. Traditional surgical sympathectomy was widely used in the past. However, due to its invasive character, it has increasingly been replaced by percutaneous techniques and, in some recent cases, by laparoscopic procedures. Percutaneous lumbar sympathectomy is a safe, cost-effective and widely available treatment option. We report our experience on 19 patients subjected to percutaneous sympathectomy under CT guidance. Materials and methods: Between 1998 and 2000, 19 patients underwent percutaneous sympathectomy under CT guidance. All patients had severe vascular disease of the lower extremities (Fontaine stage IV), with rest pain and gangrene. They were not eligible for surgical revascularization. Phenol was injected at the level of L2 and L4 using two 22 G needles (15 cm long). Signs of interrupted sympathetic activity usually occur 2'-15' after the procedure with warmth and flushing and dryness of the lower extremities. Results: Percutaneous sympathectomy under CT guidance is a simple, safe and well-tolerated procedure with a low rate of complications. Of the 19 patients, 9 (47.3%) showed clinical improvement, whereas 5 experienced a worsening of ischaemia in the month immediately following the procedure. Discussion: Results suggest that percutaneous lumbar sympathectomy causes a sympathetic blockade in patients with advanced vascular disease of the limb. CT guidance ensures a high level of precision in drug dosing, thus lowering the risk of complications. Although the results are demoralizing. the impossibility of achieving surgical revascularisation in advanced peripheral arteriosclerosis enhances the role of Ct-guided percutaneous sympathectomy in relieving rest pain and healing ulcers in order to postpone the amputation [it

C-arm cone-beam CT combined with a new electromagnetic navigation system for guidance of percutaneous needle biopsies. Initial clinical experience

Energy Technology Data Exchange (ETDEWEB)

Kickuth, R.; Reichling, C.; Bley, T.; Hahn, D.; Ritter, C. [University Hospital of Wuerzburg (Germany). Inst. of Diagnostic and Interventional Radiology

2015-07-15

To evaluate the feasibility and efficacy of C-arm fluoroscopic cone-beam computed tomography (CACT) in combination with a new electromagnetic tracking (EMT) system for needle guidance during percutaneous biopsies. 53 patients were referred for biopsy of thoracic (n = 19) and abdominal (n = 34) lesions. CT-like images of the anatomical region of interest (ROI) were generated using a flat panel-based angiographic system. These images were transmitted to an EMT system. A coaxial puncture needle with a sensor in its tip was connected with the navigation system and tracked into an electromagnetic field created via a field generator. Data generated within this field were merged with the CACT images. On a monitor both the anatomical ROI and needle tip position were displayed to enable precise needle insertion into the target. Through the coaxial needle, biopsy specimens for the histologic evaluation were extracted. Number of representative biopsy samples, number of core biopsies/patient, total procedure time, dose-area product, fluoroscopic time, and complications were recorded. 53 CACT/EMT-guided biopsy procedures were performed, 48 of which (91 %) yielded representative tissue samples. Four core biopsies were obtained from each patient. 40 (75 %) lesions were malignant and 13 (25 %) lesions were benign. The total procedure time was 9 ± 5 min (range, 3 - 23 min), fluoroscopic time was 0.8 ± 0.4 min (range, 0.4 - 2 min). The mean dose-area product (cGy cm{sup 2}) was 7373 (range, 895 - 26 904). The rate of complications (1 pneumothorax, 2 hemoptyses) was 6 %. CACT combined with EMT appears to be a feasible and effective technique for the guidance of percutaneous biopsies with a low rate of therapeutically relevant complications.

C-arm cone-beam CT combined with a new electromagnetic navigation system for guidance of percutaneous needle biopsies. Initial clinical experience

International Nuclear Information System (INIS)

Kickuth, R.; Reichling, C.; Bley, T.; Hahn, D.; Ritter, C.

2015-01-01

To evaluate the feasibility and efficacy of C-arm fluoroscopic cone-beam computed tomography (CACT) in combination with a new electromagnetic tracking (EMT) system for needle guidance during percutaneous biopsies. 53 patients were referred for biopsy of thoracic (n = 19) and abdominal (n = 34) lesions. CT-like images of the anatomical region of interest (ROI) were generated using a flat panel-based angiographic system. These images were transmitted to an EMT system. A coaxial puncture needle with a sensor in its tip was connected with the navigation system and tracked into an electromagnetic field created via a field generator. Data generated within this field were merged with the CACT images. On a monitor both the anatomical ROI and needle tip position were displayed to enable precise needle insertion into the target. Through the coaxial needle, biopsy specimens for the histologic evaluation were extracted. Number of representative biopsy samples, number of core biopsies/patient, total procedure time, dose-area product, fluoroscopic time, and complications were recorded. 53 CACT/EMT-guided biopsy procedures were performed, 48 of which (91 %) yielded representative tissue samples. Four core biopsies were obtained from each patient. 40 (75 %) lesions were malignant and 13 (25 %) lesions were benign. The total procedure time was 9 ± 5 min (range, 3 - 23 min), fluoroscopic time was 0.8 ± 0.4 min (range, 0.4 - 2 min). The mean dose-area product (cGy cm 2 ) was 7373 (range, 895 - 26 904). The rate of complications (1 pneumothorax, 2 hemoptyses) was 6 %. CACT combined with EMT appears to be a feasible and effective technique for the guidance of percutaneous biopsies with a low rate of therapeutically relevant complications.

Foreign body extraction from soft tissue by using CT and fluoroscopic guidance: a new technique

Energy Technology Data Exchange (ETDEWEB)

Amoretti, Nicolas; Marcy, Pierre-Yves; Lesbats-Jacquot, Virginie; Fonquerne, Marie-Eve; Maratos, Yvonne [Centre Hospitalier Universitaire de Nice, Radiology Department, Nice (France); Hauger, Olivier [Hopital Pellegrin, Unite d' Imagerie Osteo-articulaire, CHU de Bordeaux (France); Hovorka, Istvan; Boileau, Pascal [Centre Hopitalier Universitaire de Nice, Orthopaedic Department, Nice (France)

2010-01-15

We report on a new minimally invasive technique for the retrieval of a surgical pin fragment after accidental migration into the soft tissue of the shoulder in two patients. The technique is performed under local anaesthesia and uses combined CT and fluoroscopic guidance. The materials used were simple, combining a bone biopsy needle and an endoscopy clamp. Pin displacement was confirmed under fluoroscopic guidance and the clamp was used to withdraw the pin to the cutaneous entry point under CT (step-by-step) guidance. The CT slices provide perfect visualisation of the vascular or nervous structures as well as perfect positioning of the extremity of the trocar relative to the material to be removed. This intervention avoids a second surgical intervention with a longer incision and avoided repeated general anaesthesia. (orig.)

C-arm CT for planning and guidance of extrahepatic embolizations

International Nuclear Information System (INIS)

Wacker, F.K.; Meissner, O.A.; Meyer, B.C.

2009-01-01

Interventional radiological vascular embolizations are complex procedures that require exact imaging of the target region to facilitate safe and effective treatment. The purpose of this paper is to present the technique and feasibility of flat detector C-arm computed tomography (C-arm CT) for control and guidance of extrahepatic abdominal embolization procedures. C-arm CT images can provide important information on both vascular and cross-sectional anatomy of the target region, help in determining therapy endpoints and provide follow-up during and immediately after the abdominal interventions.The cases presented demonstrate that C-arm CT images are beneficial for abdominal embolization procedures and facilitate precise treatment. (orig.) [de

Hypofractionated radiotherapy for lung tumors with online cone beam CT guidance and active breathing control

Science.gov (United States)

2010-01-01

Background To study the set-up errors, PTV margin and toxicity of cone beam CT (CBCT) guided hypofractionated radiotherapy with active breathing control (ABC) for patients with non-small cell lung cancer (NSCLC) or metastatic tumors in lung. Methods 32 tumors in 20 patients were treated. Based on the location of tumor, dose per fraction given to tumor was divided into three groups: 12 Gy, 8 Gy and 6 Gy. ABC is applied for every patient. During each treatment, patients receive CBCT scan for online set-up correction. The pre- and post-correction setup errors between fractions, the interfractional and intrafractional, set-up errors, PTV margin as well as toxicity are analyzed. Results The pre-correction systematic and random errors in the left-right (LR), superior-inferior (SI), anterior-posterior (AP) directions were 3.7 mm and 5.3 mm, 3.1 mm and 2.1 mm, 3.7 mm and 2.8 mm, respectively, while the post-correction residual errors were 0.6 mm and 0.8 mm, 0.8 mm and 0.8 mm, 1.2 mm and 1.3 mm, respectively. There was an obvious intrafractional shift of tumor position. The pre-correction PTV margin was 9.5 mm in LR, 14.1 mm in SI and 8.2 mm in AP direction. After CBCT guided online correction, the PTV margin was markedly reduced in all three directions. The post-correction margins ranged 1.5 to 2.1 mm. The treatment was well tolerated by patients, of whom there were 4 (20%) grade1-2 acute pneumonitis, 3 (15%) grade1 acute esophagitis, 2 (10%) grade1 late pneumonitis and 1 (5%) grade 1 late esophagitis. Conclusion The positioning errors for lung SBRT using ABC were significant. Online correction with CBCT image guidance should be applied to reduce setup errors and PTV margin, which may reduce radiotherapy toxicity of tissues when ABC was used. PMID:20187962

Hypofractionated radiotherapy for lung tumors with online cone beam CT guidance and active breathing control

Directory of Open Access Journals (Sweden)

Wang Xin

2010-02-01

Full Text Available Abstract Background To study the set-up errors, PTV margin and toxicity of cone beam CT (CBCT guided hypofractionated radiotherapy with active breathing control (ABC for patients with non-small cell lung cancer (NSCLC or metastatic tumors in lung. Methods 32 tumors in 20 patients were treated. Based on the location of tumor, dose per fraction given to tumor was divided into three groups: 12 Gy, 8 Gy and 6 Gy. ABC is applied for every patient. During each treatment, patients receive CBCT scan for online set-up correction. The pre- and post-correction setup errors between fractions, the interfractional and intrafractional, set-up errors, PTV margin as well as toxicity are analyzed. Results The pre-correction systematic and random errors in the left-right (LR, superior-inferior (SI, anterior-posterior (AP directions were 3.7 mm and 5.3 mm, 3.1 mm and 2.1 mm, 3.7 mm and 2.8 mm, respectively, while the post-correction residual errors were 0.6 mm and 0.8 mm, 0.8 mm and 0.8 mm, 1.2 mm and 1.3 mm, respectively. There was an obvious intrafractional shift of tumor position. The pre-correction PTV margin was 9.5 mm in LR, 14.1 mm in SI and 8.2 mm in AP direction. After CBCT guided online correction, the PTV margin was markedly reduced in all three directions. The post-correction margins ranged 1.5 to 2.1 mm. The treatment was well tolerated by patients, of whom there were 4 (20% grade1-2 acute pneumonitis, 3 (15% grade1 acute esophagitis, 2 (10% grade1 late pneumonitis and 1 (5% grade 1 late esophagitis. Conclusion The positioning errors for lung SBRT using ABC were significant. Online correction with CBCT image guidance should be applied to reduce setup errors and PTV margin, which may reduce radiotherapy toxicity of tissues when ABC was used.

Hypofractionated radiotherapy for lung tumors with online cone beam CT guidance and active breathing control

International Nuclear Information System (INIS)

Shen, Yali; Zhang, Hong; Wang, Jin; Zhong, Renming; Jiang, Xiaoqing; Xu, Qinfeng; Wang, Xin; Bai, Sen; Xu, Feng

2010-01-01

To study the set-up errors, PTV margin and toxicity of cone beam CT (CBCT) guided hypofractionated radiotherapy with active breathing control (ABC) for patients with non-small cell lung cancer (NSCLC) or metastatic tumors in lung. 32 tumors in 20 patients were treated. Based on the location of tumor, dose per fraction given to tumor was divided into three groups: 12 Gy, 8 Gy and 6 Gy. ABC is applied for every patient. During each treatment, patients receive CBCT scan for online set-up correction. The pre- and post-correction setup errors between fractions, the interfractional and intrafractional, set-up errors, PTV margin as well as toxicity are analyzed. The pre-correction systematic and random errors in the left-right (LR), superior-inferior (SI), anterior-posterior (AP) directions were 3.7 mm and 5.3 mm, 3.1 mm and 2.1 mm, 3.7 mm and 2.8 mm, respectively, while the post-correction residual errors were 0.6 mm and 0.8 mm, 0.8 mm and 0.8 mm, 1.2 mm and 1.3 mm, respectively. There was an obvious intrafractional shift of tumor position. The pre-correction PTV margin was 9.5 mm in LR, 14.1 mm in SI and 8.2 mm in AP direction. After CBCT guided online correction, the PTV margin was markedly reduced in all three directions. The post-correction margins ranged 1.5 to 2.1 mm. The treatment was well tolerated by patients, of whom there were 4 (20%) grade1-2 acute pneumonitis, 3 (15%) grade1 acute esophagitis, 2 (10%) grade1 late pneumonitis and 1 (5%) grade 1 late esophagitis. The positioning errors for lung SBRT using ABC were significant. Online correction with CBCT image guidance should be applied to reduce setup errors and PTV margin, which may reduce radiotherapy toxicity of tissues when ABC was used

Real-time CT-video registration for continuous endoscopic guidance

Science.gov (United States)

Merritt, Scott A.; Rai, Lav; Higgins, William E.

2006-03-01

Previous research has shown that CT-image-based guidance could be useful for the bronchoscopic assessment of lung cancer. This research drew upon the registration of bronchoscopic video images to CT-based endoluminal renderings of the airway tree. The proposed methods either were restricted to discrete single-frame registration, which took several seconds to complete, or required non-real-time buffering and processing of video sequences. We have devised a fast 2D/3D image registration method that performs single-frame CT-Video registration in under 1/15th of a second. This allows the method to be used for real-time registration at full video frame rates without significantly altering the physician's behavior. The method achieves its speed through a gradient-based optimization method that allows most of the computation to be performed off-line. During live registration, the optimization iteratively steps toward the locally optimal viewpoint at which a CT-based endoluminal view is most similar to a current bronchoscopic video frame. After an initial registration to begin the process (generally done in the trachea for bronchoscopy), subsequent registrations are performed in real-time on each incoming video frame. As each new bronchoscopic video frame becomes available, the current optimization is initialized using the previous frame's optimization result, allowing continuous guidance to proceed without manual re-initialization. Tests were performed using both synthetic and pre-recorded bronchoscopic video. The results show that the method is robust to initialization errors, that registration accuracy is high, and that continuous registration can proceed on real-time video at >15 frames per sec. with minimal user-intervention.

Low-dose dual-energy cone-beam CT using a total-variation minimization algorithm

International Nuclear Information System (INIS)

Min, Jong Hwan

2011-02-01

Dual-energy cone-beam CT is an important imaging modality in diagnostic applications, and may also find its use in other application such as therapeutic image guidance. Despite of its clinical values, relatively high radiation dose of dual-energy scan may pose a challenge to its wide use. In this work, we investigated a low-dose, pre-reconstruction type of dual-energy cone-beam CT (CBCT) using a total-variation minimization algorithm for image reconstruction. An empirical dual-energy calibration method was used to prepare material-specific projection data. Raw data at high and low tube voltages are converted into a set of basis functions which can be linearly combined to produce material-specific data using the coefficients obtained through the calibration process. From much fewer views than are conventionally used, material specific images are reconstructed by use of the total-variation minimization algorithm. An experimental study was performed to demonstrate the feasibility of the proposed method using a micro-CT system. We have reconstructed images of the phantoms from only 90 projections acquired at tube voltages of 40 kVp and 90 kVp each. Aluminum-only and acryl-only images were successfully decomposed. We evaluated the quality of the reconstructed images by use of contrast-to-noise ratio and detectability. A low-dose dual-energy CBCT can be realized via the proposed method by greatly reducing the number of projections

Single-slice rebinning method for helical cone-beam CT

International Nuclear Information System (INIS)

Noo, F.; Defrise, M.; Clackdoyle, R.

1999-01-01

In this paper, we present reconstruction results from helical cone-beam CT data, obtained using a simple and fast algorithm, which we call the CB-SSRB algorithm. This algorithm combines the single-slice rebinning method of PET imaging with the weighting schemes of spiral CT algorithms. The reconstruction is approximate but can be performed using 2D multislice fan-beam filtered backprojection. The quality of the results is surprisingly good, and far exceeds what one might expect, even when the pitch of the helix is large. In particular, with this algorithm comparable quality is obtained using helical cone-beam data with a normalized pitch of 10 to that obtained using standard spiral CT reconstruction with a normalized pitch of 2. (author)

Point spread function modeling and image restoration for cone-beam CT

International Nuclear Information System (INIS)

Zhang Hua; Shi Yikai; Huang Kuidong; Xu Zhe

2015-01-01

X-ray cone-beam computed tomography (CT) has such notable features as high efficiency and precision, and is widely used in the fields of medical imaging and industrial non-destructive testing, but the inherent imaging degradation reduces the quality of CT images. Aimed at the problems of projection image degradation and restoration in cone-beam CT, a point spread function (PSF) modeling method is proposed first. The general PSF model of cone-beam CT is established, and based on it, the PSF under arbitrary scanning conditions can be calculated directly for projection image restoration without the additional measurement, which greatly improved the application convenience of cone-beam CT. Secondly, a projection image restoration algorithm based on pre-filtering and pre-segmentation is proposed, which can make the edge contours in projection images and slice images clearer after restoration, and control the noise in the equivalent level to the original images. Finally, the experiments verified the feasibility and effectiveness of the proposed methods. (authors)

Prototype heel effect compensation filter for cone-beam CT

International Nuclear Information System (INIS)

Mori, Shinichiro; Endo, Masahiro; Nishizawa, Kanae; Ohno, Mari; Miyazaki, Hiroaki; Tsujita, Kazuhiko; Saito, Yasuo

2005-01-01

The prototype cone-beam CT (CBCT) has a larger beam width than the conventional multi-detector row CT (MDCT). This causes a non-uniform angular distribution of the x-ray beam intensity known as the heel effect. Scan conditions for CBCT tube current are adjusted on the anode side to obtain an acceptable clinical image quality. However, as the dose is greater on the cathode side than on the anode side, the signal-to-noise ratio on the cathode side is excessively high, resulting in an unnecessary dose amount. To compensate for the heel effect, we developed a heel effect compensation (HEC) filter. The HEC filter rendered the dose distribution uniform and reduced the dose by an average of 25% for free air and by 20% for CTDI phantoms compared to doses with the conventional filter. In addition, its effect in rendering the effective energy uniform resulted in an improvement in image quality. This new HEC filter may be useful in cone-beam CT studies. (note)

Deep inspiration breath-hold radiotherapy for lung cancer: impact on image quality and registration uncertainty in cone beam CT image guidance

DEFF Research Database (Denmark)

Josipovic, Mirjana; Persson, Gitte F; Bangsgaard, Jens Peter

2016-01-01

OBJECTIVE: We investigated the impact of deep inspiration breath-hold (DIBH) and tumour baseline shifts on image quality and registration uncertainty in image-guided DIBH radiotherapy (RT) for locally advanced lung cancer. METHODS: Patients treated with daily cone beam CT (CBCT)-guided free...

Effects of physical guidance on short-term learning of walking on a narrow beam

OpenAIRE

Domingo, Antoinette; Ferris, Daniel P.

2009-01-01

Physical guidance is often used in rehabilitation when teaching patients to re-learn movements. However, the effects of guidance on motor learning of complex skills, such as walking balance, are not clear. We tested four groups of healthy subjects that practiced walking on a narrow (1.27 cm) or wide (2.5 cm) treadmill-mounted balance beam, with or without physical guidance. Assistance was given by springs attached to a hip belt that applied restoring forces towards beam center. Subjects were ...

Volume CT with a flat-panel detector on a mobile, isocentric C-arm: Pre-clinical investigation in guidance of minimally invasive surgery

International Nuclear Information System (INIS)

Siewerdsen, J.H.; Moseley, D.J.; Burch, S.; Bisland, S.K.; Bogaards, A.; Wilson, B.C.; Jaffray, D.A.

2005-01-01

A mobile isocentric C-arm (Siemens PowerMobil) has been modified in our laboratory to include a large area flat-panel detector (in place of the x-ray image intensifier), providing multi-mode fluoroscopy and cone-beam computed tomography (CT) imaging capability. This platform represents a promising technology for minimally invasive, image-guided surgical procedures where precision in the placement of interventional tools with respect to bony and soft-tissue structures is critical. The image quality and performance in surgical guidance was investigated in pre-clinical evaluation in image-guided spinal surgery. The control, acquisition, and reconstruction system are described. The reproducibility of geometric calibration, essential to achieving high three-dimensional (3D) image quality, is tested over extended time scales (7 months) and across a broad range in C-arm angulation (up to 45 deg.), quantifying the effect of improper calibration on spatial resolution, soft-tissue visibility, and image artifacts. Phantom studies were performed to investigate the precision of 3D localization (viz., fiber optic probes within a vertebral body) and effect of lateral projection truncation (limited field of view) on soft-tissue detectability in image reconstructions. Pre-clinical investigation was undertaken in a specific spinal procedure (photodynamic therapy of spinal metastases) in five animal subjects (pigs). In each procedure, placement of fiber optic catheters in two vertebrae (L1 and L2) was guided by fluoroscopy and cone-beam CT. Experience across five procedures is reported, focusing on 3D image quality, the effects of respiratory motion, limited field of view, reconstruction filter, and imaging dose. Overall, the intraoperative cone-beam CT images were sufficient for guidance of needles and catheters with respect to bony anatomy and improved surgical performance and confidence through 3D visualization and verification of transpedicular trajectories and tool placement

Laser Guidance in C-Arm Cone-Beam CT-Guided Radiofrequency Ablation of Osteoid Osteoma Reduces Fluoroscopy Time

Energy Technology Data Exchange (ETDEWEB)

Kroes, Maarten W., E-mail: Maarten.Kroes@radboudumc.nl; Busser, Wendy M. H.; Hoogeveen, Yvonne L.; Lange, Frank de; Schultze Kool, Leo J. [Radboud University Medical Center, Department of Radiology and Nuclear Medicine (Netherlands)

2017-05-15

PurposeTo assess whether laser guidance can reduce fluoroscopy and procedure time of cone-beam computed tomography (CBCT)-guided radiofrequency (RF) ablations of osteoid osteoma compared to freehand CBCT guidance.Materials and Methods32 RF ablations were retrospectively analyzed, 17 laser-guided and 15 procedures using the freehand technique. Subgroup selection of 18 ablations in the hip–pelvic region with a similar degree of difficulty was used for a direct comparison. Data are presented as median (ranges).ResultsComparison of all 32 ablations resulted in fluoroscopy times of 365 s (193–878 s) for freehand and 186 s (75–587 s) for laser-guided procedures (p = 0.004). Corresponding procedure times were 56 min (35–97 min) and 52 min (30–85 min) (p = 0.355). The subgroup showed comparable target sizes, needle path lengths, and number of scans between groups. Fluoroscopy times were lower for laser-guided procedures, 215 s (75–413 s), compared to 384 s (193–878 s) for freehand (p = 0.012). Procedure times were comparable between groups, 51 min (30–72 min) for laser guidance and 58 min (35–79 min) for freehand (p = 0.172).ConclusionAdding laser guidance to CBCT-guided osteoid osteoma RF ablations significantly reduced fluoroscopy time without increasing procedure time.Level of EvidenceLevel 4, case series.

Cone-beam CT in paediatric dentistry. DIMITRA project position statement

International Nuclear Information System (INIS)

Oenning, Anne Caroline; Jacobs, Reinhilde; Pauwels, Ruben; Stratis, Andreas; Hedesiu, Mihaela; Salmon, Benjamin

2018-01-01

DIMITRA (dentomaxillofacial paediatric imaging: an investigation towards low-dose radiation induced risks) is a European multicenter and multidisciplinary project focused on optimizing cone-beam CT exposures for children and adolescents. With increasing use of cone-beam CT for dentomaxillofacial diagnostics, concern arises regarding radiation risks associated with this imaging modality, especially for children. Research evidence concerning cone-beam CT indications in children remains limited, while reports mention inconsistent recommendations for dose reduction. Furthermore, there is no paper using the combined and integrated information on the required indication-oriented image quality and the related patient dose levels. In this paper, therefore, the authors initiate an integrated approach based on current evidence regarding image quality and dose, together with the expertise of DIMITRA's members searching for a state of the art. The aim of this DIMITRA position statement is to provide indication-oriented and patient-specific recommendations regarding the main cone-beam CT applications in the pediatric field. The authors will review this position statement document when results regarding multidisciplinary approaches evolve, in a period of 5 years or earlier. (orig.)

The noise power spectrum in CT with direct fan beam reconstruction

International Nuclear Information System (INIS)

Baek, Jongduk; Pelc, Norbert J.

2010-01-01

The noise power spectrum (NPS) is a useful metric for understanding the noise content in images. To examine some unique properties of the NPS of fan beam CT, the authors derived an analytical expression for the NPS of fan beam CT and validated it with computer simulations. The nonstationary noise behavior of fan beam CT was examined by analyzing local regions and the entire field-of-view (FOV). This was performed for cases with uniform as well as nonuniform noise across the detector cells and across views. The simulated NPS from the entire FOV and local regions showed good agreement with the analytically derived NPS. The analysis shows that whereas the NPS of a large FOV in parallel beam CT (using a ramp filter) is proportional to frequency, the NPS with direct fan beam FBP reconstruction shows a high frequency roll off. Even in small regions, the fan beam NPS can show a sharp transition (discontinuity) at high frequencies. These effects are due to the variable magnification and therefore are more pronounced as the fan angle increases. For cases with nonuniform noise, the NPS can show the directional dependence and additional effects.

Fast kilovoltage/megavoltage (kVMV) breathhold cone-beam CT for image-guided radiotherapy of lung cancer

International Nuclear Information System (INIS)

Wertz, Hansjoerg; Stsepankou, Dzmitry; Blessing, Manuel; Boda-Heggemann, Judit; Hesser, Juergen; Lohr, Frank; Wenz, Frederik; Rossi, Michael; Gros, Uwe; Knox, Chris; Brown, Kevin; Walter, Cornelia

2010-01-01

Long image acquisition times of 60-120 s for cone-beam CT (CBCT) limit the number of patients with lung cancer who can undergo volume image guidance under breathhold. We developed a low-dose dual-energy kilovoltage-megavoltage-cone-beam CT (kVMV-CBCT) based on a clinical treatment unit reducing imaging time to ≤15 s. Simultaneous kVMV-imaging was achieved by dedicated synchronization hardware controlling the output of the linear accelerator (linac) based on detector panel readout signals, preventing imaging artifacts from interference of the linac's MV-irradiation and panel readouts. Optimization was performed to minimize the imaging dose. Single MV-projections, reconstructed MV-CBCT images and images of simultaneous 90 0 kV- and 90 0 MV-CBCT (180 0 kVMV-CBCT) were acquired with different parameters. Image quality and imaging dose were evaluated and compared to kV-imaging. Hardware-based kVMV synchronization resulted in artifact-free projections. A combined 180 0 kVMV-CBCT scan with a total MV-dose of 5 monitor units was acquired in 15 s and with sufficient image quality. The resolution was 5-6 line pairs cm -1 (Catphan phantom). The combined kVMV-scan dose was equivalent to a kV-radiation scan dose of ∼33 mGy. kVMV-CBCT based on a standard linac is promising and can provide ultra-fast online volume image guidance with low imaging dose and sufficient image quality for fast and accurate patient positioning for patients with lung cancer under breathhold.

Tumor Localization Using Cone-Beam CT Reduces Setup Margins in Conventionally Fractionated Radiotherapy for Lung Tumors

International Nuclear Information System (INIS)

Yeung, Anamaria R.; Li, Jonathan G.; Shi Wenyin; Newlin, Heather E.; Chvetsov, Alexei; Liu, Chihray; Palta, Jatinder R.; Olivier, Kenneth

2009-01-01

Purpose: To determine whether setup margins can be reduced using cone-beam computed tomography (CBCT) to localize tumor in conventionally fractionated radiotherapy for lung tumors. Methods and Materials: A total of 22 lung cancer patients were treated with curative intent with conventionally fractionated radiotherapy using daily image guidance with CBCT. Of these, 13 lung cancer patients had sufficient CBCT scans for analysis (389 CBCT scans). The patients underwent treatment simulation in the BodyFix immobilization system using four-dimensional CT to account for respiratory motion. Daily alignment was first done according to skin tattoos, followed by CBCT. All 389 CBCT scans were retrospectively registered to the planning CT scans using automated soft-tissue and bony registration; the resulting couch shifts in three dimensions were recorded. Results: The daily alignment to skin tattoos with no image guidance resulted in systematic (Σ) and random (σ) errors of 3.2-5.6 mm and 2.0-3.5 mm, respectively. The margin required to account for the setup error introduced by aligning to skin tattoos with no image guidance was approximately 1-1.6 cm. The difference in the couch shifts obtained from the bone and soft-tissue registration resulted in systematic (Σ) and random (σ) errors of 1.5-4.1 mm and 1.8-5.3 mm, respectively. The margin required to account for the setup error introduced using bony anatomy as a surrogate for the target, instead of localizing the target itself, was 0.5-1.4 cm. Conclusion: Using daily CBCT soft-tissue registration to localize the tumor in conventionally fractionated radiotherapy reduced the required setup margin by up to approximately 1.5 cm compared with both no image guidance and image guidance using bony anatomy as a surrogate for the target.

Comparison of CT numbers between cone-beam CT and multi-detector CT

International Nuclear Information System (INIS)

Kim, Dong Soo; Han, Won Jeong; Kim, Eun Kyung

2010-01-01

To compare the CT numbers on 3 cone-beam CT (CBCT) images with those on multi-detector CT (MDCT) image using CT phantom and to develop linear regressive equations using CT numbers to material density for all the CT scanner each. Mini CT phantom comprised of five 1 inch thick cylindrical models with 1.125 inches diameter of materials with different densities (polyethylene, polystyrene, plastic water, nylon and acrylic) was used. It was scanned in 3 CBCTs (i-CAT, Alphard VEGA, Implagraphy SC) and 1 MDCT (Somatom Emotion). The images were saved as DICOM format and CT numbers were measured using OnDemand 3D. CT numbers obtained from CBCTs and MDCT images were compared and linear regression analysis was performed for the density, ρ(g/cm 3 ), as the dependent variable in terms of the CT numbers obtained from CBCTs and MDCT images. CT numbers on i-CAT and Implagraphy CBCT images were smaller than those on Somatom Emotion MDCT image (p<0.05). Linear relationship on a range of materials used for this study were ρ=0.001 H+1.07 with R2 value of 0.999 for Somatom Emotion, ρ=0.002 H+1.09 with R2 value of 0.991 for Alphard VEGA, ρ=0.001 H+1.43 with R2 value of 0.980 for i-CAT and ρ=0.001 H+1.30 with R2 value of 0.975 for Implagraphy. CT numbers on i-CAT and Implagraphy CBCT images were not same as those on Somatom Emotion MDCT image. The linear regressive equations to determine the density from the CT numbers with very high correlation coefficient were obtained on three CBCT and MDCT scan.

Comparison of CT numbers between cone-beam CT and multi-detector CT

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Kim, Dong Soo; Han, Won Jeong; Kim, Eun Kyung [Department of Oral and Maxillofacial Radiology, School of Dentistry, Dankook University, Cheonan (Korea, Republic of)

2010-06-15

To compare the CT numbers on 3 cone-beam CT (CBCT) images with those on multi-detector CT (MDCT) image using CT phantom and to develop linear regressive equations using CT numbers to material density for all the CT scanner each. Mini CT phantom comprised of five 1 inch thick cylindrical models with 1.125 inches diameter of materials with different densities (polyethylene, polystyrene, plastic water, nylon and acrylic) was used. It was scanned in 3 CBCTs (i-CAT, Alphard VEGA, Implagraphy SC) and 1 MDCT (Somatom Emotion). The images were saved as DICOM format and CT numbers were measured using OnDemand 3D. CT numbers obtained from CBCTs and MDCT images were compared and linear regression analysis was performed for the density, {rho}(g/cm{sup 3}), as the dependent variable in terms of the CT numbers obtained from CBCTs and MDCT images. CT numbers on i-CAT and Implagraphy CBCT images were smaller than those on Somatom Emotion MDCT image (p<0.05). Linear relationship on a range of materials used for this study were {rho}=0.001 H+1.07 with R2 value of 0.999 for Somatom Emotion, {rho}=0.002 H+1.09 with R2 value of 0.991 for Alphard VEGA, {rho}=0.001 H+1.43 with R2 value of 0.980 for i-CAT and {rho}=0.001 H+1.30 with R2 value of 0.975 for Implagraphy. CT numbers on i-CAT and Implagraphy CBCT images were not same as those on Somatom Emotion MDCT image. The linear regressive equations to determine the density from the CT numbers with very high correlation coefficient were obtained on three CBCT and MDCT scan.

CT thermometry for cone-beam CT guided ablation

Science.gov (United States)

DeStefano, Zachary; Abi-Jaoudeh, Nadine; Li, Ming; Wood, Bradford J.; Summers, Ronald M.; Yao, Jianhua

2016-03-01

Monitoring temperature during a cone-beam CT (CBCT) guided ablation procedure is important for prevention of over-treatment and under-treatment. In order to accomplish ideal temperature monitoring, a thermometry map must be generated. Previously, this was attempted using CBCT scans of a pig shoulder undergoing ablation.1 We are extending this work by using CBCT scans of real patients and incorporating more processing steps. We register the scans before comparing them due to the movement and deformation of organs. We then automatically locate the needle tip and the ablation zone. We employ a robust change metric due to image noise and artifacts. This change metric takes windows around each pixel and uses an equation inspired by Time Delay Analysis to calculate the error between windows with the assumption that there is an ideal spatial offset. Once the change map is generated, we correlate change data with measured temperature data at the key points in the region. This allows us to transform our change map into a thermal map. This thermal map is then able to provide an estimate as to the size and temperature of the ablation zone. We evaluated our procedure on a data set of 12 patients who had a total of 24 ablation procedures performed. We were able to generate reasonable thermal maps with varying degrees of accuracy. The average error ranged from 2.7 to 16.2 degrees Celsius. In addition to providing estimates of the size of the ablation zone for surgical guidance, 3D visualizations of the ablation zone and needle are also produced.

Development of a cone-beam CT system for radiological technologist education

International Nuclear Information System (INIS)

Teramoto, Atsushi; Ohara, Ken; Ozaki, Kaho; Miyashita, Mariko; Ohno, Tomoyuki; Tsuzaka, Masatoshi; Fujita, Hiroshi

2011-01-01

For radiological technologists, it is very important to understand the principle of computed tomography (CT) and CT artifacts derived from mechanical and electrical failure. In this study, a CT system for educating radiological technologists was developed. The system consisted of a cone-beam CT scanner and educational software. The cone-beam CT scanner has a simple structure, using a micro-focus X-ray tube and an indirect-conversion flat panel detector. For the educational software, we developed various educational functions of image reconstruction and reconstruction parameters as well as CT artifacts. In the experiments, the capabilities of the system were evaluated using an acrylic phantom. We verified that the system produced the expected results. (author)

Study on broad beam heavy ion CT

International Nuclear Information System (INIS)

Ohno, Yumiko; Kohno, Toshiyuki; Sasaki, Hitomi; Nanbu, S.; Kanai, Tatsuaki

2003-01-01

To achieve the heavy ion radiotherapy more precisely, it is important to know the distribution of the electron density in a human body, which is highly related to the range of charged particles. From a heavy ion CT image, we can directly obtain the 2-D distribution of the electron density in a sample. For this purpose, we have developed a broad beam heavy ion CT system. The electron density was obtained using some kinds of solutions targets. Also the dependence of the spatial resolution on the target size and the kinds of beams was estimated in this work using cylinders targets of 40, 60 and 80 mm in diameter, each of them has a hole of 10 mm in diameter at the center of it. (author)

An analytical simulation technique for cone-beam CT and pinhole SPECT

International Nuclear Information System (INIS)

Zhang Xuezhu; Qi Yujin

2011-01-01

This study was aimed at developing an efficient simulation technique with an ordinary PC. The work involved derivation of mathematical operators, analytic phantom generations, and effective analytical projectors developing for cone-beam CT and pinhole SPECT imaging. The computer simulations based on the analytical projectors were developed by ray-tracing method for cone-beam CT and voxel-driven method for pinhole SPECT of degrading blurring. The 3D Shepp-Logan, Jaszczak and Defrise phantoms were used for simulation evaluations and image reconstructions. The reconstructed phantom images were of good accuracy with the phantoms. The results showed that the analytical simulation technique is an efficient tool for studying cone-beam CT and pinhole SPECT imaging. (authors)

Percutaneous Transhepatic Drainage of Inaccessible Abdominal Abscesses Following Abdominal Surgery Under Real-Time CT-Fluoroscopic Guidance

International Nuclear Information System (INIS)

Yamakado, Koichiro; Takaki, Haruyuki; Nakatsuka, Atsuhiro; Kashima, Masataka; Uraki, Junji; Yamanaka, Takashi; Takeda, Kan

2010-01-01

This study evaluated the safety, feasibility, and clinical utility of transhepatic drainage of inaccessible abdominal abscesses retrospectively under real-time computed tomographic (CT) guidance. For abdominal abscesses, 12 consecutive patients received percutaneous transhepatic drainage. Abscesses were considered inaccessible using the usual access route because they were surrounded by the liver and other organs. The maximum diameters of abscesses were 4.6-9.5 cm (mean, 6.7 ± 1.4 cm). An 8-Fr catheter was advanced into the abscess cavity through the liver parenchyma using real-time CT fluoroscopic guidance. Safety, feasibility, procedure time, and clinical utility were evaluated. Drainage catheters were placed with no complications in abscess cavities through the liver parenchyma in all patients. The mean procedure time was 18.8 ± 9.2 min (range, 12-41 min). All abscesses were drained. They shrank immediately after catheter placement. In conclusions, this transhepatic approach under real-time CT fluoroscopic guidance is a safe, feasible, and useful technique for use of drainage of inaccessible abdominal abscesses.

Accuracy of image guidance using free-breathing cone-beam computed tomography for stereotactic lung radiotherapy.

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Kamomae, Takeshi; Monzen, Hajime; Nakayama, Shinichi; Mizote, Rika; Oonishi, Yuuichi; Kaneshige, Soichiro; Sakamoto, Takashi

2015-01-01

Movement of the target object during cone-beam computed tomography (CBCT) leads to motion blurring artifacts. The accuracy of manual image matching in image-guided radiotherapy depends on the image quality. We aimed to assess the accuracy of target position localization using free-breathing CBCT during stereotactic lung radiotherapy. The Vero4DRT linear accelerator device was used for the examinations. Reference point discrepancies between the MV X-ray beam and the CBCT system were calculated using a phantom device with a centrally mounted steel ball. The precision of manual image matching between the CBCT and the averaged intensity (AI) images restructured from four-dimensional CT (4DCT) was estimated with a respiratory motion phantom, as determined in evaluations by five independent operators. Reference point discrepancies between the MV X-ray beam and the CBCT image-guidance systems, categorized as left-right (LR), anterior-posterior (AP), and superior-inferior (SI), were 0.33 ± 0.09, 0.16 ± 0.07, and 0.05 ± 0.04 mm, respectively. The LR, AP, and SI values for residual errors from manual image matching were -0.03 ± 0.22, 0.07 ± 0.25, and -0.79 ± 0.68 mm, respectively. The accuracy of target position localization using the Vero4DRT system in our center was 1.07 ± 1.23 mm (2 SD). This study experimentally demonstrated the sufficient level of geometric accuracy using the free-breathing CBCT and the image-guidance system mounted on the Vero4DRT. However, the inter-observer variation and systematic localization error of image matching substantially affected the overall geometric accuracy. Therefore, when using the free-breathing CBCT images, careful consideration of image matching is especially important.

A characteristic of angiographic cone-beam CT

International Nuclear Information System (INIS)

Takase, Tadashi; Take, Toshio; Nakazawa, Yasuo; Kinouchi, Katsunori

2009-01-01

Angiographic cone-beam CT, called DynaCT by SIEMENS, is a 3D imaging tool reconstructed from projection data by a rotational C-arm with a flat panel detector. It can visualize low-contrast objects such as soft tissue or small vessels as well as high-contrast structures such as enhanced vessels or bone. We need to understand its image characteristics and dose distribution during 200 degree rotation around a patient. In this research, we evaluated fundamental characteristics and dose effectiveness for optimized clinical images. DynaCT, including soft tissue information and isochronal voxel data along the z-axis, could provide enough CT-like image quality for interventional radiology (IVR) use. In addition, evaluation of accumulated dose distribution helped us to predict and avoid the occurrence of radiodermatitis. Thus, DynaCT is useful as a support and navigation tool for IVR. (author)

The percutaneous interventional therapy of lung abscess and pyothorax under the CT guidance

International Nuclear Information System (INIS)

Gao Xinghan; Zhu Zhenfang; Lv Fanzhen; Yan Dejun; Su Baomin

2003-01-01

Objective: To study the indication, the procedure, the necessity and feasibility of the percutaneous interventional therapy of lung abscess and pyothorax under the CT guidance. Methods: The group included 18 patients who received percutaneous interventional therapy of lung abscess and pyothorax. Results: 13 patients were cured by a single procedure, 3 patients received twice intervention. Triple therapies were done in 2 patients. 2 cases out of 18 were eventually diagnosed as peripheral lung cancer. The body temperature and the WBC count returned to normal range after the procedures. 16 patients completely recovered in 1-5 weeks after the therapies. Conclusion: The interventional therapy under CT guidance not only helps the diagnosis and differential diagnosis of chronic or acute lung abscess and pyothorax, but also shortens the course of treatment and avoids the open surgery. It is a safe, simple and convenient method

Improved precision of interstitial brain tumor irradiation using the BRW CT stereotaxic guidance system

International Nuclear Information System (INIS)

Sapozink, M.D.; Moeller, J.M.; McDonald, P.N.; Heilbrun, M.P.

1987-01-01

A technique is described which enables precise temporary interstitial volume implantation of brain tumors using a CT stereotaxic guidance system. This technique has the advantages of designing irregular isodose distributions during the preplanning stage. Although the preplanning stage can be time-consuming, this is performed while the patient is in the hospital room and CT scanner time, anesthesia time, and operating room time is minimized for individual patients

Effects of physical guidance on short-term learning of walking on a narrow beam

Science.gov (United States)

Domingo, Antoinette; Ferris, Daniel P.

2009-01-01

Physical guidance is often used in rehabilitation when teaching patients to re-learn movements. However, the effects of guidance on motor learning of complex skills, such as walking balance, are not clear. We tested four groups of healthy subjects that practiced walking on a narrow (1.27 cm) or wide (2.5 cm) treadmill-mounted balance beam, with or without physical guidance. Assistance was given by springs attached to a hip belt that applied restoring forces towards beam center. Subjects were evaluated while walking unassisted before and after training by calculating the number of times subjects stepped off of the beam per minute of successful walking on the beam (Failures per Minute). Subjects in Unassisted groups had greater performance improvements in walking balance from pre to post compared to subjects in Assisted groups. During training, Unassisted groups had more Failures per Minute than Assisted groups. Performance improvements were smaller in Narrow Beam groups than in Wide Beam groups. The Unassisted-Wide and Assisted-Narrow groups had similar Failures per Minute during training, but the Unassisted-Wide group had much greater performance gains after training. These results suggest that physical assistance can hinder motor learning of walking balance, assistance appears less detrimental for more difficult tasks, and task-specific dynamics are important to learning independent of error experience. PMID:19674900

Effects of physical guidance on short-term learning of walking on a narrow beam.

Science.gov (United States)

Domingo, Antoinette; Ferris, Daniel P

2009-11-01

Physical guidance is often used in rehabilitation when teaching patients to re-learn movements. However, the effects of guidance on motor learning of complex skills, such as walking balance, are not clear. We tested four groups of healthy subjects that practiced walking on a narrow (1.27 cm) or wide (2.5 cm) treadmill-mounted balance beam, with or without physical guidance. Assistance was given by springs attached to a hip belt that applied restoring forces towards beam center. Subjects were evaluated while walking unassisted before and after training by calculating the number of times subjects stepped off of the beam per minute of successful walking on the beam (Failures per Minute). Subjects in Unassisted groups had greater performance improvements in walking balance from pre to post compared to subjects in Assisted groups. During training, Unassisted groups had more Failures per Minute than Assisted groups. Performance improvements were smaller in Narrow Beam groups than in Wide Beam groups. The Unassisted-Wide and Assisted-Narrow groups had similar Failures per Minute during training, but the Unassisted-Wide group had much greater performance gains after training. These results suggest that physical assistance can hinder motor learning of walking balance, assistance appears less detrimental for more difficult tasks, and task-specific dynamics are important to learning independent of error experience.

Identification of dental root canals and their medial line from micro-CT and cone-beam CT records

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Benyó Balázs

2012-10-01

Full Text Available Abstract Background Shape of the dental root canal is highly patient specific. Automated identification methods of the medial line of dental root canals and the reproduction of their 3D shape can be beneficial for planning endodontic interventions as severely curved root canals or multi-rooted teeth may pose treatment challenges. Accurate shape information of the root canals may also be used by manufacturers of endodontic instruments in order to make more efficient clinical tools. Method Novel image processing procedures dedicated to the automated detection of the medial axis of the root canal from dental micro-CT and cone-beam CT records are developed. For micro-CT, the 3D model of the root canal is built up from several hundred parallel cross sections, using image enhancement, histogram based fuzzy c-means clustering, center point detection in the segmented slice, three dimensional inner surface reconstruction, and potential field driven curve skeleton extraction in three dimensions. Cone-beam CT records are processed with image enhancement filters and fuzzy chain based regional segmentation, followed by the reconstruction of the root canal surface and detecting its skeleton via a mesh contraction algorithm. Results The proposed medial line identification and root canal detection algorithms are validated on clinical data sets. 25 micro-CT and 36 cone-beam-CT records are used in the validation procedure. The overall success rate of the automatic dental root canal identification was about 92% in both procedures. The algorithms proved to be accurate enough for endodontic therapy planning. Conclusions Accurate medial line identification and shape detection algorithms of dental root canal have been developed. Different procedures are defined for micro-CT and cone-beam CT records. The automated execution of the subsequent processing steps allows easy application of the algorithms in the dental care. The output data of the image processing procedures

Partial volume and aliasing artefacts in helical cone-beam CT

International Nuclear Information System (INIS)

Zou Yu; Sidky, Emil Y; Pan, Xiaochuan

2004-01-01

A generalization of the quasi-exact algorithms of Kudo et al (2000 IEEE Trans. Med. Imaging 19 902-21) is developed that allows for data acquisition in a 'practical' frame for clinical diagnostic helical, cone-beam computed tomography (CT). The algorithm is investigated using data that model nonlinear partial volume averaging. This investigation leads to an understanding of aliasing artefacts in helical, cone-beam CT image reconstruction. An ad hoc scheme is proposed to mitigate artefacts due to the nonlinear partial volume and aliasing artefacts

Benign Prostatic Hyperplasia: Cone-Beam CT in Conjunction with DSA for Identifying Prostatic Arterial Anatomy.

Science.gov (United States)

Wang, Mao Qiang; Duan, Feng; Yuan, Kai; Zhang, Guo Dong; Yan, Jieyu; Wang, Yan

2017-01-01

Purpose To describe findings in prostatic arteries (PAs) at digital subtraction angiography (DSA) and cone-beam computed tomography (CT) that allow identification of benign prostatic hyperplasia and to determine the value added with the use of cone-beam CT. Materials and Methods This retrospective single-institution study was approved by the institutional review board, and the requirement for written informed consent was waived. From February 2009 to December 2014, a total of 148 patients (mean age ± standard deviation, 70.5 years ± 14.5) underwent DSA of the internal iliac arteries and cone-beam CT with a flat-detector angiographic system before they underwent prostate artery embolization. Both the DSA and cone-beam CT images were evaluated by two interventional radiologists to determine the number of independent PAs and their origins and anastomoses with adjacent arteries. The exact McNemar test was used to compare the detection rate of the PAs and the anastomoses with DSA and with cone-beam CT. Results The PA anatomy was evaluated successfully by means of cone-beam CT in conjunction with DSA in all patients. Of the 296 pelvic sides, 274 (92.6%) had only one PA. The most frequent PA origin was the common gluteal-pudendal trunk with the superior vesicular artery in 118 (37.1%), followed by the anterior division of the internal iliac artery in 99 (31.1%), and the internal pudendal artery in 77 (24.2%) pelvic sides. In 67 (22.6%) pelvic sides, anastomoses to adjacent arteries were documented. The numbers of PA origins and anastomoses, respectively, that could be identified were significantly higher with cone-beam CT (301 of 318 [94.7%] and 65 of 67 [97.0%]) than with DSA (237 [74.5%] and 39 [58.2%], P < .05). Cone-beam CT provided essential information that was not available with DSA in 90 of 148 (60.8%) patients. Conclusion Cone-beam CT is a useful adjunctive technique to DSA for identification of the PA anatomy and provides information to help treatment planning

Investigation of bulk electron densities for dose calculations on cone-beam CT images

International Nuclear Information System (INIS)

Lambert, J.; Parker, J.; Gupta, S.; Hatton, J.; Tang, C.; Capp, A.; Denham, J.W.; Wright, P.

2010-01-01

Full text: If cone-beam CT images are to be used for dose calculations, then the images must be able to provide accurate electron density information. Twelve patients underwent twice weekly cone-beam CT scans in addition to the planning CT scan. A standardised 5-field treatment plan was applied to 169 of the CBCT images. Doses were calculated using the original electron density values in the CBCT and with bulk electron densities applied. Bone was assigned a density of 288 HU, and all other tissue was assigned to be water equivalent (0 HU). The doses were compared to the dose calculated on the original planning CT image. Using the original HU values in the cone-beam images, the average dose del i vered by the plans from all 12 patients was I. I % lower than the intended 200 cOy delivered on the original CT plans (standard devia tion 0.7%, maximum difference -2.93%). When bulk electron densities were applied to the cone-beam images, the average dose was 0.3% lower than the original CT plans (standard deviation 0.8%, maximum difference -2.22%). Compared to using the original HU values, applying bulk electron densities to the CBCT images improved the dose calculations by almost I %. Some variation due to natural changes in anatomy should be expected. The application of bulk elec tron densities to cone beam CT images has the potential to improve the accuracy of dose calculations due to inaccurate H U values. Acknowledgements This work was partially funded by Cancer Council NSW Grant Number RG 07-06.

A new cone-beam X-ray CT system with a reduced size planar detector

International Nuclear Information System (INIS)

Li Liang; Chen Zhiqiang; Zhang Li; Xing Yuxiang; Kang Kejun

2006-01-01

In a traditional cone-beam CT system, the cost of product and computation is very high. The authors propose a transversely truncated cone-beam X-ray CT system with a reduced size detector positioned off-center, in which X-ray beams only cover half of the object. The reduced detector size cuts the cost and the X-ray dose of the CT system. The existing CT reconstruction algorithms are not directly applicable in this new CT system. Hence, the authors develop a BPF-type direct backprojection algorithm. Different from the traditional rebinding methods, our algorithm directly backprojects the pretreated projection data without rebinding. This makes the algorithm compact and computationally more efficient. Finally, some numerical simulations and practical experiments are done to validate the proposed algorithm. (authors)

Percutaneous Cryoablation of Small Hepatocellular Carcinoma with US Guidance and CT Monitoring: Initial Experience

International Nuclear Information System (INIS)

Orlacchio, Antonio; Bazzocchi, Gabriele; Pastorelli, Daniela; Bolacchi, Francesca; Angelico, Mario; Almerighi, Cristiana; Masala, Salvatore; Simonetti, Giovanni

2008-01-01

The purpose of this study was to retrospectively determine the safety and effectiveness of percutaneous cryoablation, monitored with computed tomography (CT) and ultrasonographic (US) guidance, for the treatment of hepatocellular carcinoma (HCC). Four patients with small HCCs underwent one percutaneous cryoablation treatment session monitored with CT and US guidance. All patients underwent pretreatment blood chemistry testing and imaging evaluation. We treated lesions with simultaneous insertion of multiple 17-G cryoprobes (two or three) and defined technical success when the extension of a visible iceball was beyond 5 mm from the tumor margin. Intralesional enhancement or tumoral size increase was defined as local progression compared with that on images obtained immediately after ablation. We evaluated complications and follow-up (at 1, 3, and 6 months). All patients survived without short- or long-term complications. Cryoablation was technically successful in all patients at the end of the procedure. During follow-up two patients developed disease recurrence. One patient developed local tumor progression on the margin of the lesion; the other, a new HCC. In the case of local tumor progression a new elevation of α-fetoprotein (αFP) levels occurred at first follow-up control. In the other case levels of αFP remained stable during the first 3 months after the procedure, then demonstrated a progressive increase in αFP levels beginning at the fourth month, without tumor evidence during CT control at 3 months. We conclude that percutaneous cryotherapy with US guidance and CT monitoring is a feasible, safe, and effective for treatment of HCC. If local ablative procedures of hepatic lesions are to be performed, percutaneous cryoablation, not laparotomic, should be discussed as an alternative therapeutic measure. Longer follow-up should provide proof of the effectiveness of this technique

A One-Step Cone-Beam CT-Enabled Planning-to-Treatment Model for Palliative Radiotherapy-From Development to Implementation

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Wong, Rebecca K.S., E-mail: rebecca.wong@rmp.uhn.on.ca [Radiation Medicine Program, Princess Margaret Hospital, Toronto, Ontario (Canada); Department of Radiation Oncology, University of Toronto, Toronto, Ontario (Canada); Letourneau, Daniel; Varma, Anita [Radiation Medicine Program, Princess Margaret Hospital, Toronto, Ontario (Canada); Department of Radiation Oncology, University of Toronto, Toronto, Ontario (Canada); Bissonnette, Jean Pierre; Fitzpatrick, David; Grabarz, Daniel; Elder, Christine [Radiation Medicine Program, Princess Margaret Hospital, Toronto, Ontario (Canada); Martin, Melanie; Bezjak, Andrea [Radiation Medicine Program, Princess Margaret Hospital, Toronto, Ontario (Canada); Department of Radiation Oncology, University of Toronto, Toronto, Ontario (Canada); Panzarella, Tony [Department of Biostatistics, Princess Margaret Hospital, Toronto, Ontario (Canada); Gospodarowicz, Mary [Radiation Medicine Program, Princess Margaret Hospital, Toronto, Ontario (Canada); Department of Radiation Oncology, University of Toronto, Toronto, Ontario (Canada); Jaffray, David A. [Radiation Medicine Program, Princess Margaret Hospital, Toronto, Ontario (Canada); Department of Radiation Oncology, University of Toronto, Toronto, Ontario (Canada); Department of Medical Biophysics, University of Toronto, Toronto, Ontario (Canada)

2012-11-01

Purpose: To develop a cone-beam computed tomography (CT)-enabled one-step simulation-to-treatment process for the treatment of bone metastases. Methods and Materials: A three-phase prospective study was conducted. Patients requiring palliative radiotherapy to the spine, mediastinum, or abdomen/pelvis suitable for treatment with simple beam geometry ({<=}2 beams) were accrued. Phase A established the accuracy of cone-beam CT images for the purpose of gross tumor target volume (GTV) definition. Phase B evaluated the feasibility of implementing the cone-beam CT-enabled planning process at the treatment unit. Phase C evaluated the online cone-beam CT-enabled process for the planning and treatment of patients requiring radiotherapy for bone metastases. Results: Eighty-four patients participated in this study. Phase A (n = 9) established the adequacy of cone-beam CT images for target definition. Phase B (n = 45) established the quality of treatment plans to be adequate for clinical implementation for bone metastases. When the process was applied clinically in bone metastases (Phase C), the degree of overlap between planning computed tomography (PCT) and cone-beam CT for GTV and between PCT and cone-beam CT for treatment field was 82% {+-} 11% and 97% {+-} 4%, respectively. The oncologist's decision to accept the plan under a time-pressured environment remained of high quality, with the cone-beam CT-generated treatment plan delivering at least 90% of the prescribed dose to 100% {+-} 0% of the cone-beam CT planning target volume (PTV). With the assumption that the PCT PTV is the gold-standard target, the cone-beam CT-generated treatment plan delivered at least 90% and at least 95% of dose to 98% {+-} 2% and 97% {+-} 5% of the PCT PTV, respectively. The mean time for the online planning and treatment process was 32.7 {+-} 4.0 minutes. Patient satisfaction was high, with a trend for superior satisfaction with the cone-beam CT-enabled process. Conclusions: The cone-beam

Evaluation of the OSC-TV iterative reconstruction algorithm for cone-beam optical CT.

Science.gov (United States)

Matenine, Dmitri; Mascolo-Fortin, Julia; Goussard, Yves; Després, Philippe

2015-11-01

The present work evaluates an iterative reconstruction approach, namely, the ordered subsets convex (OSC) algorithm with regularization via total variation (TV) minimization in the field of cone-beam optical computed tomography (optical CT). One of the uses of optical CT is gel-based 3D dosimetry for radiation therapy, where it is employed to map dose distributions in radiosensitive gels. Model-based iterative reconstruction may improve optical CT image quality and contribute to a wider use of optical CT in clinical gel dosimetry. This algorithm was evaluated using experimental data acquired by a cone-beam optical CT system, as well as complementary numerical simulations. A fast GPU implementation of OSC-TV was used to achieve reconstruction times comparable to those of conventional filtered backprojection. Images obtained via OSC-TV were compared with the corresponding filtered backprojections. Spatial resolution and uniformity phantoms were scanned and respective reconstructions were subject to evaluation of the modulation transfer function, image uniformity, and accuracy. The artifacts due to refraction and total signal loss from opaque objects were also studied. The cone-beam optical CT data reconstructions showed that OSC-TV outperforms filtered backprojection in terms of image quality, thanks to a model-based simulation of the photon attenuation process. It was shown to significantly improve the image spatial resolution and reduce image noise. The accuracy of the estimation of linear attenuation coefficients remained similar to that obtained via filtered backprojection. Certain image artifacts due to opaque objects were reduced. Nevertheless, the common artifact due to the gel container walls could not be eliminated. The use of iterative reconstruction improves cone-beam optical CT image quality in many ways. The comparisons between OSC-TV and filtered backprojection presented in this paper demonstrate that OSC-TV can potentially improve the rendering of

C-arm Cone Beam Computed Tomography: A New Tool in the Interventional Suite.

Science.gov (United States)

Raj, Santhosh; Irani, Farah Gillan; Tay, Kiang Hiong; Tan, Bien Soo

2013-11-01

C-arm Cone Beam CT (CBCT) is a technology that is being integrated into many of the newer angiography systems in the interventional suite. Due to its ability to provide cross sectional imaging, it has opened a myriad of opportunities for creating new clinical applications. We review the technical aspects, current reported clinical applications and potential benefits of this technology. Searches were made via PubMed using the string "CBCT", "Cone Beam CT", "Cone Beam Computed Tomography" and "C-arm Cone Beam Computed Tomography". All relevant articles in the results were reviewed. CBCT clinical applications have been reported in both vascular and non-vascular interventions. They encompass many aspects of a procedure including preprocedural planning, intraprocedural guidance and postprocedural assessment. As a result, they have allowed the interventionalist to be safer and more accurate in performing image guided procedures. There are however several technical limitations. The quality of images produced is not comparable to conventional computed tomography (CT). Radiation doses are also difficult to quantify when compared to CT and fluoroscopy. CBCT technology in the interventional suite has contributed significant benefits to the patient despite its current limitations. It is a tool that will evolve and potentially become an integral part of imaging guidance for intervention.

Cone beam CT findings of retromolar canals: Report of cases and literature review

Energy Technology Data Exchange (ETDEWEB)

Han, Sang Sun [Dept. of Dental Hygiene, Eulji University, Seongnam (Korea, Republic of); Park, Chang Seo [Dept. of Oral and Maxillofacial Radiology, College of Dentistry, Yonsei University, Seoul (Korea, Republic of)

2013-12-15

A retromolar canal is an anatomical variation in the mandible. As it includes the neurovascular bundle, local anesthetic insufficiency can occur, and an injury of the retromolar canal during dental surgery in the mandible may result in excessive bleeding, paresthesia, and traumatic neuroma. Using imaging analysis software, we evaluated the cone-beam computed tomography (CT) images of two Korean patients who presented with retromolar canals. Retromolar canals were detectable on the sagittal and cross-sectional images of cone-beam CT, but not on the panoramic radiographs of the patients. Therefore, the clinician should pay particular attention to the identification of retromolar canals by preoperative radiographic examination, and additional cone beam CT scanning would be recommended.

Cone beam CT findings of retromolar canals: Report of cases and literature review

International Nuclear Information System (INIS)

Han, Sang Sun; Park, Chang Seo

2013-01-01

A retromolar canal is an anatomical variation in the mandible. As it includes the neurovascular bundle, local anesthetic insufficiency can occur, and an injury of the retromolar canal during dental surgery in the mandible may result in excessive bleeding, paresthesia, and traumatic neuroma. Using imaging analysis software, we evaluated the cone-beam computed tomography (CT) images of two Korean patients who presented with retromolar canals. Retromolar canals were detectable on the sagittal and cross-sectional images of cone-beam CT, but not on the panoramic radiographs of the patients. Therefore, the clinician should pay particular attention to the identification of retromolar canals by preoperative radiographic examination, and additional cone beam CT scanning would be recommended.

Clinical implementation of intraoperative cone-beam CT in head and neck surgery

Science.gov (United States)

Daly, M. J.; Chan, H.; Nithiananthan, S.; Qiu, J.; Barker, E.; Bachar, G.; Dixon, B. J.; Irish, J. C.; Siewerdsen, J. H.

2011-03-01

A prototype mobile C-arm for cone-beam CT (CBCT) has been translated to a prospective clinical trial in head and neck surgery. The flat-panel CBCT C-arm was developed in collaboration with Siemens Healthcare, and demonstrates both sub-mm spatial resolution and soft-tissue visibility at low radiation dose (e.g., software based on the open-source Image-Guided Surgery Toolkit (IGSTK). The CBCT C-arm has been successfully deployed in 15 head and neck cases and streamlined into the surgical environment using human factors engineering methods and expert feedback from surgeons, nurses, and anesthetists. Intraoperative imaging is implemented in a manner that maintains operating field sterility, reduces image artifacts (e.g., carbon fiber OR table) and minimizes radiation exposure. Image reviews conducted with surgical staff indicate bony detail and soft-tissue visualization sufficient for intraoperative guidance, with additional artifact management (e.g., metal, scatter) promising further improvements. Clinical trial deployment suggests a role for intraoperative CBCT in guiding complex head and neck surgical tasks, including planning mandible and maxilla resection margins, guiding subcranial and endonasal approaches to skull base tumours, and verifying maxillofacial reconstruction alignment. Ongoing translational research into complimentary image-guidance subsystems include novel methods for real-time tool tracking, fusion of endoscopic video and CBCT, and deformable registration of preoperative volumes and planning contours with intraoperative CBCT.

Minimizing image noise in on-board CT reconstruction using both kilovoltage and megavoltage beam projections

International Nuclear Information System (INIS)

Zhang Junan; Yin Fangfang

2007-01-01

We studied a recently proposed aggregated CT reconstruction technique which combines the complementary advantages of kilovoltage (kV) and megavoltage (MV) x-ray imaging. Various phantoms were imaged to study the effects of beam orientations and geometry of the imaging object on image quality of reconstructed CT. It was shown that the quality of aggregated CT was correlated with both kV and MV beam orientations and the degree of this correlation depended upon the geometry of the imaging object. The results indicated that the optimal orientations were those when kV beams pass through the thinner portion and MV beams pass through the thicker portion of the imaging object. A special preprocessing procedure was also developed to perform contrast conversions between kV and MV information prior to image reconstruction. The performance of two reconstruction methods, one filtered backprojection method and one iterative method, were compared. The effects of projection number, beam truncation, and contrast conversion on the CT image quality were investigated

The contribution of the medical physicist in the field of Cone Beam (CT) in dental and maxillofacial for quality assurance and patient dosimetry

International Nuclear Information System (INIS)

Begnozzi, L.

2014-01-01

The guideline RP n. 172 of the European Commission has recently published (http://ec.europa.eu/energy/nuclear/radiation_protection/medical/publications_en.htm) in order to provide guidance to ensure the safety and effectiveness within the scope of Cone Beam CT for Dental and Maxillofacial Radiology in compliance with the criteria of justification, optimization and limitation of doses. The document should be a useful reference and help to the professional categories and must help to optimize the use of ionizing radiation in dental imaging.

Study of residual stresses in CT test specimens welded by electron beam

Science.gov (United States)

Papushkin, I. V.; Kaisheva, D.; Bokuchava, G. D.; Angelov, V.; Petrov, P.

2018-03-01

The paper reports result of residual stress distribution studies in CT specimens reconstituted by electron beam welding (EBW). The main aim of the study is evaluation of the applicability of the welding technique for CT specimens’ reconstitution. Thus, the temperature distribution during electron beam welding of a CT specimen was calculated using Green’s functions and the residual stress distribution was determined experimentally using neutron diffraction. Time-of-flight neutron diffraction experiments were performed on a Fourier stress diffractometer at the IBR-2 fast pulsed reactor in FLNP JINR (Dubna, Russia). The neutron diffraction data estimates yielded a maximal stress level of ±180 MPa in the welded joint.

MO-DE-210-07: Investigation of Treatment Interferences of a Novel Robotic Ultrasound Radiotherapy Guidance System with Clinical VMAT Plans for Liver SBRT Patients

Energy Technology Data Exchange (ETDEWEB)

Gong, R [Stanford University, Palo Alto, CA (United States); Bruder, R; Schweikard, A [University of Luebeck, Luebeck, Schleswig-Holstein (Germany); Schlosser, J [SoniTrack Systems Inc., Mountain View, CA (United States); Hristov, D [Stanford University Cancer Center, Palo Alto, CA (United States)

2015-06-15

Purpose: To evaluate the proportion of liver SBRT cases in which robotic ultrasound image guidance concurrent with beam delivery can be deployed without interfering with clinically used VMAT beam configurations. Methods: A simulation environment incorporating LINAC, couch, planning CT, and robotic ultrasound guidance hardware was developed. Virtual placement of the robotic ultrasound hardware was guided by a target visibility map rendered on the CT surface. The map was computed on GPU by using the planning CT to simulate ultrasound propagation and attenuation along rays connecting skin surface points to a rasterized imaging target. The visibility map was validated in a prostate phantom experiment by capturing live ultrasound images of the prostate from different phantom locations. In 20 liver SBRT patients treated with VMAT, the simulation environment was used to place the robotic hardware and ultrasound probe at imaging locations indicated on the visibility map. Imaging targets were either entire PTV (range 5.9–679.5 ml) or entire GTV (range 0.9–343.4 ml). Presence or absence of mechanical collisions with LINAC, couch, and patient body as well as interferences with treated beams were recorded. Results: For PTV targets, robotic ultrasound guidance without mechanical collision was possible in 80% of the cases and guidance without beam interference was possible in 60% of the cases. For the smaller GTV targets, these proportions were 95% and 85% correspondingly. GTV size (1/20), elongated shape (1/20), and depth (1/20) were the main factors limiting the availability of non-interfering imaging positions. Conclusion: This study indicates that for VMAT liver SBRT, robotic ultrasound tracking of a relevant internal target would be possible in 85% of cases while using treatment plans currently deployed in the clinic. With beam re-planning in accordance with the presence of robotic ultrasound guidance, intra-fractional ultrasound guidance may be an option for 95% of the

MO-DE-210-07: Investigation of Treatment Interferences of a Novel Robotic Ultrasound Radiotherapy Guidance System with Clinical VMAT Plans for Liver SBRT Patients

International Nuclear Information System (INIS)

Gong, R; Bruder, R; Schweikard, A; Schlosser, J; Hristov, D

2015-01-01

Purpose: To evaluate the proportion of liver SBRT cases in which robotic ultrasound image guidance concurrent with beam delivery can be deployed without interfering with clinically used VMAT beam configurations. Methods: A simulation environment incorporating LINAC, couch, planning CT, and robotic ultrasound guidance hardware was developed. Virtual placement of the robotic ultrasound hardware was guided by a target visibility map rendered on the CT surface. The map was computed on GPU by using the planning CT to simulate ultrasound propagation and attenuation along rays connecting skin surface points to a rasterized imaging target. The visibility map was validated in a prostate phantom experiment by capturing live ultrasound images of the prostate from different phantom locations. In 20 liver SBRT patients treated with VMAT, the simulation environment was used to place the robotic hardware and ultrasound probe at imaging locations indicated on the visibility map. Imaging targets were either entire PTV (range 5.9–679.5 ml) or entire GTV (range 0.9–343.4 ml). Presence or absence of mechanical collisions with LINAC, couch, and patient body as well as interferences with treated beams were recorded. Results: For PTV targets, robotic ultrasound guidance without mechanical collision was possible in 80% of the cases and guidance without beam interference was possible in 60% of the cases. For the smaller GTV targets, these proportions were 95% and 85% correspondingly. GTV size (1/20), elongated shape (1/20), and depth (1/20) were the main factors limiting the availability of non-interfering imaging positions. Conclusion: This study indicates that for VMAT liver SBRT, robotic ultrasound tracking of a relevant internal target would be possible in 85% of cases while using treatment plans currently deployed in the clinic. With beam re-planning in accordance with the presence of robotic ultrasound guidance, intra-fractional ultrasound guidance may be an option for 95% of the

Automated planning of breast radiotherapy using cone beam CT imaging

International Nuclear Information System (INIS)

Amit, Guy; Purdie, Thomas G.

2015-01-01

Purpose: Develop and clinically validate a methodology for using cone beam computed tomography (CBCT) imaging in an automated treatment planning framework for breast IMRT. Methods: A technique for intensity correction of CBCT images was developed and evaluated. The technique is based on histogram matching of CBCT image sets, using information from “similar” planning CT image sets from a database of paired CBCT and CT image sets (n = 38). Automated treatment plans were generated for a testing subset (n = 15) on the planning CT and the corrected CBCT. The plans generated on the corrected CBCT were compared to the CT-based plans in terms of beam parameters, dosimetric indices, and dose distributions. Results: The corrected CBCT images showed considerable similarity to their corresponding planning CTs (average mutual information 1.0±0.1, average sum of absolute differences 185 ± 38). The automated CBCT-based plans were clinically acceptable, as well as equivalent to the CT-based plans with average gantry angle difference of 0.99°±1.1°, target volume overlap index (Dice) of 0.89±0.04 although with slightly higher maximum target doses (4482±90 vs 4560±84, P < 0.05). Gamma index analysis (3%, 3 mm) showed that the CBCT-based plans had the same dose distribution as plans calculated with the same beams on the registered planning CTs (average gamma index 0.12±0.04, gamma <1 in 99.4%±0.3%). Conclusions: The proposed method demonstrates the potential for a clinically feasible and efficient online adaptive breast IMRT planning method based on CBCT imaging, integrating automation

Balloon pulmonary angioplasty: applicability of C-Arm CT for procedure guidance

Energy Technology Data Exchange (ETDEWEB)

Hinrichs, Jan B. [Department for Diagnostic and Interventional Radiology, Member of the German Center for Lung Research (DZL), Hannover Medical School, Hannover (Germany); Institute for Diagnostic and Interventional Radiology, Hannover Medical School, Hannover (Germany); Renne, Julius; Wacker, Frank K.; Meyer, Bernhard C. [Department for Diagnostic and Interventional Radiology, Member of the German Center for Lung Research (DZL), Hannover Medical School, Hannover (Germany); Hoeper, Marius M.; Olsson, Karen M. [Clinic for Pneumology, Member of the German Center for Lung Research (DZL), Hannover Medical School, Hannover (Germany)

2016-11-15

To investigate the feasibility of and compare two C-Arm CT (CACT) guidance methods during balloon pulmonary angioplasty (BPA). Forty-two BPAs [27 CTEPH patients (nine males, 70 ± 14y)] targeting 143 pulmonary arteries were included. Twenty-two BPAs were guided by contrast-enhanced CACT acquired immediately before BPA (G3D). In another 20 BPAs (G2D), two orthogonal fluoroscopy images of the chest where acquired to compute a registration of a previously acquired CACT. Volume rendering-based graphic representations (VRT guidance) were generated indicating the origin and course of the vessels. Based on VRT guidance, the intervention was planned. Procedure durations and radiation exposure data were compared between the two groups (Wilcoxon test). The overall intervention time was approximately 2 h in both groups (p = 0.31). BPA was successfully performed in G3D 91 % and G2D 94 %. No significant difference was found concerning the mean dose area product (DAP) related to fluoroscopy (p = 0.38), while DAP related to DSA was slightly higher in G3D (p = 0.048). Overall, DAP was significantly higher in G3D (p = 0.002). The use of CACT for procedure guidance in patients undergoing BPA is feasible and accurate. Image fusion of a pre-acquired CACT can be used to decrease radiation exposure due to multiple BPA sessions. (orig.)

Segmentation-free empirical beam hardening correction for CT

Energy Technology Data Exchange (ETDEWEB)

Schüller, Sören; Sawall, Stefan [German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, Heidelberg 69120 (Germany); Stannigel, Kai; Hülsbusch, Markus; Ulrici, Johannes; Hell, Erich [Sirona Dental Systems GmbH, Fabrikstraße 31, 64625 Bensheim (Germany); Kachelrieß, Marc, E-mail: marc.kachelriess@dkfz.de [German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120 Heidelberg (Germany)

2015-02-15

Purpose: The polychromatic nature of the x-ray beams and their effects on the reconstructed image are often disregarded during standard image reconstruction. This leads to cupping and beam hardening artifacts inside the reconstructed volume. To correct for a general cupping, methods like water precorrection exist. They correct the hardening of the spectrum during the penetration of the measured object only for the major tissue class. In contrast, more complex artifacts like streaks between dense objects need other techniques of correction. If using only the information of one single energy scan, there are two types of corrections. The first one is a physical approach. Thereby, artifacts can be reproduced and corrected within the original reconstruction by using assumptions in a polychromatic forward projector. These assumptions could be the used spectrum, the detector response, the physical attenuation and scatter properties of the intersected materials. A second method is an empirical approach, which does not rely on much prior knowledge. This so-called empirical beam hardening correction (EBHC) and the previously mentioned physical-based technique are both relying on a segmentation of the present tissues inside the patient. The difficulty thereby is that beam hardening by itself, scatter, and other effects, which diminish the image quality also disturb the correct tissue classification and thereby reduce the accuracy of the two known classes of correction techniques. The herein proposed method works similar to the empirical beam hardening correction but does not require a tissue segmentation and therefore shows improvements on image data, which are highly degraded by noise and artifacts. Furthermore, the new algorithm is designed in a way that no additional calibration or parameter fitting is needed. Methods: To overcome the segmentation of tissues, the authors propose a histogram deformation of their primary reconstructed CT image. This step is essential for the

Segmentation-free empirical beam hardening correction for CT.

Science.gov (United States)

Schüller, Sören; Sawall, Stefan; Stannigel, Kai; Hülsbusch, Markus; Ulrici, Johannes; Hell, Erich; Kachelrieß, Marc

2015-02-01

The polychromatic nature of the x-ray beams and their effects on the reconstructed image are often disregarded during standard image reconstruction. This leads to cupping and beam hardening artifacts inside the reconstructed volume. To correct for a general cupping, methods like water precorrection exist. They correct the hardening of the spectrum during the penetration of the measured object only for the major tissue class. In contrast, more complex artifacts like streaks between dense objects need other techniques of correction. If using only the information of one single energy scan, there are two types of corrections. The first one is a physical approach. Thereby, artifacts can be reproduced and corrected within the original reconstruction by using assumptions in a polychromatic forward projector. These assumptions could be the used spectrum, the detector response, the physical attenuation and scatter properties of the intersected materials. A second method is an empirical approach, which does not rely on much prior knowledge. This so-called empirical beam hardening correction (EBHC) and the previously mentioned physical-based technique are both relying on a segmentation of the present tissues inside the patient. The difficulty thereby is that beam hardening by itself, scatter, and other effects, which diminish the image quality also disturb the correct tissue classification and thereby reduce the accuracy of the two known classes of correction techniques. The herein proposed method works similar to the empirical beam hardening correction but does not require a tissue segmentation and therefore shows improvements on image data, which are highly degraded by noise and artifacts. Furthermore, the new algorithm is designed in a way that no additional calibration or parameter fitting is needed. To overcome the segmentation of tissues, the authors propose a histogram deformation of their primary reconstructed CT image. This step is essential for the proposed

Characterization of CT beams using Compton spectrometry; Caracterização de feixes de TC utilizando Espectrometria Compton

Energy Technology Data Exchange (ETDEWEB)

Terini, Ricardo A.; Nerssissian, Denise Y.; Campelo, Maria Carolina S.; Yoshimura, Elisabeth M., E-mail: rterini@if.usp.br [Universidade de São Paulo (LDRFM/USP), SP (Brazil). Lab. de Dosimetria das Radiações e Física Médica

2017-07-01

Obtaining the energy spectra of computed tomography (CT) X-ray beams is essential, helping to obtain parameters that characterize beam quality and equipment performance. However, CT photon fluxes are too high to have the spectra measured directly with common photon counting detectors. In this work, a Compton spectrometer was designed, with Al-Pb-Al collimators and shields, as well as a cadmium telluride (CdTe) detector to get the spectrum of CT beams, from the measurement of the spectrum of a beam scattered at 90 deg by a polymethyl-methacrylate (PMMA) rod. A MatLab® computer code was developed, using the Waller-Hartree formalism, to reconstruct the spectrum of the incident beam, from the measured scattered beam spectrum. Tests at IF-USP Laboratory of Radiation Dosimetry and Medical Physics with standard CT beams showed that the reconstructed spectrum is alike the directly measured beam. Shielding influence and scatterer thickness were investigated. The system was tested in measurements on a GE 690 CT scanner, showing practical positioning on the exam table, and alignment with CT lasers refined by scan projection radiography. Spectra obtained with the properly shielded system presented values of half-value layer (HVL) compatible with those measured in QC tests and kVp values with accuracy to evaluate the scanner voltage calibration. (author)

TU-H-207A-03: CT Hounsfield Unit Accuracy: Effect of Beam Hardening On Phantom and Clinical Whole-Body CT Images

Energy Technology Data Exchange (ETDEWEB)

Ai, H; Wendt, R [The University of Texas MD Anderson Cancer Center, Houston, TX (United States)

2016-06-15

Purpose: To assess the effect of beam hardening on measured CT HU values. Methods: An anthropomorphic knee phantom was scanned with the CT component of a GE Discovery 690 PET/CT scanner (120kVp, 300mAs, 40?0.625mm collimation, pitch=0.984, FOV=500mm, matrix=512?512) with four different scan setups, each of which induces different degrees of beam hardening by introducing additional attenuation media into the field of view. Homogeneous voxels representing “soft tissue” and “bone” were segmented by HU thresholding followed by a 3D morphological erosion operation which removes the non-homogenous voxels located on the interface of thresholded tissue mask. HU values of segmented “soft tissue” and “bone” were compared.Additionally, whole-body CT data with coverage from the skull apex to the end of toes were retrospectively retrieved from seven PET/CT exams to evaluate the effect of beam hardening in vivo. Homogeneous bone voxels were segmented with the same method previously described. Total In-Slice Attenuation (TISA) for each CT slice, defined as the summation of HU values over all voxels within a CT slice, was calculated for all slices of the seven whole-body CT datasets and evaluated against the mean HU values of homogeneous bone voxels within that slice. Results: HU values measured from the phantom showed that while “soft tissue” HU values were unaffected, added attenuation within the FOV caused noticeable decreases in the measured HU values of “bone” voxels. A linear relationship was observed between bone HU and TISA for slices of the torso and legs, but not of the skull. Conclusion: Beam hardening effect is not an issue of concern for voxels with HU in the soft tissue range, but should not be neglected for bone voxels. A linear relationship exists between bone HU and the associated TISA in non-skull CT slices, which can be exploited to develop a correction strategy.

Image-Guided Radiotherapy via Daily Online Cone-Beam CT Substantially Reduces Margin Requirements for Stereotactic Lung Radiotherapy

International Nuclear Information System (INIS)

Grills, Inga S.; Hugo, Geoffrey; Kestin, Larry L.; Galerani, Ana Paula; Chao, K. Kenneth; Wloch, Jennifer; Yan Di

2008-01-01

Purpose: To determine treatment accuracy and margins for stereotactic lung radiotherapy with and without cone-beam CT (CBCT) image guidance. Methods and Materials: Acquired for the study were 308 CBCT of 24 patients with solitary peripheral lung tumors treated with stereotactic radiotherapy. Patients were immobilized in a stereotactic body frame (SBF) or alpha-cradle and treated with image guidance using daily CBCT. Four (T1) or five (T2/metastatic) 12-Gy fractions were prescribed to the planning target volume (PTV) edge. The PTV margin was ≥5 mm depending on a pretreatment estimate of tumor excursion. Initial daily setup was according to SBF coordinates or tattoos for alpha-cradle cases. A CBCT was performed and registered to the planning CT using soft tissue registration of the target. The initial setup error/precorrection position, was recorded for the superior-inferior, anterior-posterior, and medial-lateral directions. The couch was adjusted to correct the tumor positional error. A second CBCT verified tumor position after correction. Patients were treated in the corrected position after the residual errors were ≤2 mm. A final CBCT after treatment assessed intrafraction tumor displacement. Results: The precorrection systematic (Σ) and random errors (σ) for the population ranged from 2-3 mm for SBF and 2-6 mm for alpha-cradle patients; postcorrection errors ranged from 0.4-1.0 mm. Calculated population margins were 9 to 13 mm (SBF) and 10-14 mm (cradle) precorrection, 1-2 mm (SBF), and 2-3 mm (cradle) postcorrection, and 2-4 mm (SBF) and 2-5 mm (cradle) posttreatment. Conclusions: Setup for stereotactic lung radiotherapy using a SBF or alpha-cradle alone is suboptimal. CBCT image guidance significantly improves target positioning and substantially reduces required target margins and normal tissue irradiation

Relationships between cone beam CT value and physical density in image guided radiation therapy

International Nuclear Information System (INIS)

Jiang Xiaoqin; Bai Sen; Zhong Renming; Tang Zhiquan; Jiang Qinfeng; Li Tao

2007-01-01

Objective: To evaluate the main factors affecting the relationship between physical density and CT value in cone-beam computed tomography(CBCT) for imaging guided radiation therapy(IGRT) by comparing the CT value in the image from cone-beam scanner and from fan-beam (FBCT) scanner of a reference phantom. Methods: A taking-park reference phantom with a set of tissue equivalent inserts was scanned at different energies different fields of view (FOV) for IGRT-CBCT and FBCT. The CT value of every insert was measured and compared. Results: The position of inserts in phantom, the size of phantom, the FOV of scanner and different energies had more effect on the relationships between physical density and the CT value from IGRT-CBCT than those from the normal FBCT. The higher the energy was, the less effect of the position of inserts in phantom, the size of phantom and the FOV of scanner on CT value, and the poorer density contrast was observed. Conclusion: At present, the CT value of IGRT-CBCT is not in the true HU value since the manufacturer has not corrected its number. Therefore, we are not able to use the CT value of CBCT for dose calculation in TPS. (authors)

Scatter correction, intermediate view estimation and dose characterization in megavoltage cone-beam CT imaging

Science.gov (United States)

Sramek, Benjamin Koerner

The ability to deliver conformal dose distributions in radiation therapy through intensity modulation and the potential for tumor dose escalation to improve treatment outcome has necessitated an increase in localization accuracy of inter- and intra-fractional patient geometry. Megavoltage cone-beam CT imaging using the treatment beam and onboard electronic portal imaging device is one option currently being studied for implementation in image-guided radiation therapy. However, routine clinical use is predicated upon continued improvements in image quality and patient dose delivered during acquisition. The formal statement of hypothesis for this investigation was that the conformity of planned to delivered dose distributions in image-guided radiation therapy could be further enhanced through the application of kilovoltage scatter correction and intermediate view estimation techniques to megavoltage cone-beam CT imaging, and that normalized dose measurements could be acquired and inter-compared between multiple imaging geometries. The specific aims of this investigation were to: (1) incorporate the Feldkamp, Davis and Kress filtered backprojection algorithm into a program to reconstruct a voxelized linear attenuation coefficient dataset from a set of acquired megavoltage cone-beam CT projections, (2) characterize the effects on megavoltage cone-beam CT image quality resulting from the application of Intermediate View Interpolation and Intermediate View Reprojection techniques to limited-projection datasets, (3) incorporate the Scatter and Primary Estimation from Collimator Shadows (SPECS) algorithm into megavoltage cone-beam CT image reconstruction and determine the set of SPECS parameters which maximize image quality and quantitative accuracy, and (4) evaluate the normalized axial dose distributions received during megavoltage cone-beam CT image acquisition using radiochromic film and thermoluminescent dosimeter measurements in anthropomorphic pelvic and head and

Nursing care for patients receiving perccutaneous biopsy of the pancreas under CT-guidance

International Nuclear Information System (INIS)

Li Yongli; Wang Zhenfang

2010-01-01

Objective: To discuss the application of nursing care in CT-guided percutaneous biopsy of the pancreas. Methods: The perioperative nursing measures were carried out in 21 patients receiving percutaneous biopsy of the pancreas under CT-guidance. Active, effective and comprehensive nursing procedures were adopted to closely cooperate with the whole process of percutaneous biopsy as far as possible. Results: All the patients could actively cooperate with the physician during the whole process of percutaneous biopsy and the surgery was successfully completed in all patients. The technical success rate with only single puncture was 100%. No obvious complications occurred after the procedure. Conclusion: In order to ensure that the patient will be able to cooperate with the CT-guided percutaneous biopsy of the pancreas, that the operation time can be shortened and that the postoperative complications can be avoided, perioperative nursing care is indispensable. (authors)

Advanced single-slice rebinning for tilted spiral cone-beam CT

International Nuclear Information System (INIS)

Kachelriess, Marc; Fuchs, Theo; Schaller, Stefan; Kalender, Willi A.

2001-01-01

Future medical CT scanners and today's micro CT scanners demand cone-beam reconstruction algorithms that are capable of reconstructing data acquired from a tilted spiral trajectory where the vector of rotation is not necessarily parallel to the vector of table increment. For the medical CT scanner this case of nonparallel object motion is met for nonzero gantry tilt: the table moves into a direction that is not perpendicular to the plane of rotation. Since this is not a special application of medical CT but rather a daily routine in head exams, there is a strong need for corresponding reconstruction algorithms. In contrast to medical CT, where the special case of nonperpendicular motion is used on purpose, micro CT scanners cannot avoid aberrations of the rotational axis and the table increment vector due to alignment problems. Especially for those micro CT scanners that have the lifting stage mounted on the rotation table (in contrast to setups where the lifting stage holds the rotation table), this kind of misalignment is equivalent to a gantry tilt. We therefore generalize the advanced single-slice rebinning algorithm (ASSR), which is considered a very promising approach for medical cone-beam reconstruction due to its high image quality and its high reconstruction speed [Med. Phys. 27, 754-772 (2000)], to the case of tilted gantries. We evaluate this extended ASSR approach (which we will denote as ASSR + , for convenience) in comparison to the original ASSR algorithm using simulated phantom data for reconstruction. For the case of nonparallel object motion ASSR + shows significant improvements over ASSR, however, its computational complexity is slightly increased due to the broken symmetry of the spiral trajectory

Small metal soft tissue foreign body extraction by using 3D CT guidance: A reliable method

International Nuclear Information System (INIS)

Tao, Kai; Xu, Sen; Liu, Xiao-yan; Liang, Jiu-long; Qiu, Tao; Tan, Jia-nan; Che, Jian-hua; Wang, Zi-hua

2012-01-01

Objective: To introduce a useful and accurate technique for the locating and removal of small metal foreign bodies in the soft tissues. Methods: Eight patients presented with suspected small metal foreign bodies retained in the soft tissues of various body districts. Under local anesthesia, 3–6 pieces of 5 ml syringe needles or 1 ml syringe needles were induced through three different planes around the entry point of the foreign bodies. Using these finders, the small metal FBs were confirmed under 3D CT guidance. Based on the CT findings, the soft tissues were dissected along the path of the closest needle and the FBs were easily found and removed according to the relation with the closest needle finder. Results: Eight metal foreign bodies (3 slices, 3 nails, 1 fish hook, 1 needlepoint) were successfully removed under 3D CT guidance in all patients. The procedures took between 35 min and 50 min and the operation times took between 15 min and 25 min. No complications arose after the treatment. Conclusion: 3D CT-guided technique is a good alternative for the removal of small metal foreign body retained in the soft tissues as it is relatively accurate, reliable, quick, carries a low risk of complications and can be a first-choice procedure for the extraction of small metal foreign body.

Motion tolerant iterative reconstruction algorithm for cone-beam helical CT imaging

Energy Technology Data Exchange (ETDEWEB)

Takahashi, Hisashi; Goto, Taiga; Hirokawa, Koichi; Miyazaki, Osamu [Hitachi Medical Corporation, Chiba-ken (Japan). CT System Div.

2011-07-01

We have developed a new advanced iterative reconstruction algorithm for cone-beam helical CT. The features of this algorithm are: (a) it uses separable paraboloidal surrogate (SPS) technique as a foundation for reconstruction to reduce noise and cone-beam artifact, (b) it uses a view weight in the back-projection process to reduce motion artifact. To confirm the improvement of our proposed algorithm over other existing algorithm, such as Feldkamp-Davis-Kress (FDK) or SPS algorithm, we compared the motion artifact reduction, image noise reduction (standard deviation of CT number), and cone-beam artifact reduction on simulated and clinical data set. Our results demonstrate that the proposed algorithm dramatically reduces motion artifacts compared with the SPS algorithm, and decreases image noise compared with the FDK algorithm. In addition, the proposed algorithm potentially improves time resolution of iterative reconstruction. (orig.)

Cone-beam CT angiography of the thorax. An experimental study

International Nuclear Information System (INIS)

Yoshida, Katsuya; Shimada, Kazuhiro; Tadokoro, Hiroyuki

1999-01-01

The authors recently developed a cone-beam computed tomography (CT) scanner and this report presents their evaluation of its potential for thoracic vascular imaging. An X-ray tube and a video-fluoroscopic system were rotated around the objects and 360 projected images were collected in a 12-s scan. Each image was digitized and a 3 dimensional (D) image (256 x 256 x 256 voxel volume with a voxel dimension of 0.9 x 0.9 x 0.9 mm) was reconstructed. Two different 3D-CT angiographies were investigated in 2 pigs: right atriography and thoracic aortography. Each pig was anesthetized, mechanically ventilated and positioned within the scanner. Contrast agent was infused through the right atrium or the aortic root at a rate of 3 ml/s during the scan. The right atriography scan clearly delineated the anatomy of the pulmonary artery, heart chambers and thoracic aorta. The thoracic aortography scan also clearly delineated the aortic anatomy including the internal thoracic and intercostal arteries. In conclusion, cone-beam CT angiography is potentially useful for thoracic vascular imaging. (author)

Poster — Thur Eve — 06: Dose assessment of cone beam CT imaging protocols as part of SPECT/CT examinations

Energy Technology Data Exchange (ETDEWEB)

Tonkopi, E; Ross, AA [Department of Diagnostic Imaging, Queen Elizabeth II Health Sciences Centre, CDHA (Canada); Department of Radiology, Dalhousie University (Canada)

2014-08-15

Purpose: To assess radiation dose from the cone beam CT (CBCT) component of SPECT/CT studies and to compare with other CT examinations performed in our institution. Methods: We used an anthropomorphic chest phantom and the 6 cc ion chamber to measure entrance breast dose for several CBCT and diagnostic CT acquisition protocols. The CBCT effective dose was calculated with ImPACT software; the CT effective dose was evaluated from the DLP value and conversion factor, dependent on the anatomic region. The RADAR medical procedure radiation dose calculator was used to assess the nuclear medicine component of exam dose. Results: The entrance dose to the breast measured with the anthropomorphic phantom was 0.48 mGy and 9.41 mGy for cardiac and chest CBCT scans; and 4.59 mGy for diagnostic thoracic CT. The effective doses were 0.2 mSv, 3.2 mSv and 2.8 mSv respectively. For a small patient represented by the anthropomorphic phantom, the dose from the diagnostic CT was lower than from the CBCT scan, as a result of the exposure reduction options available on modern CT scanners. The CBCT protocols used the same fixed scanning techniques. The diagnostic CT dose based on the patient data was 35% higher than the phantom dose. For most SPECT/CT studies the dose from the CBCT component was comparable with the dose from the radiopharmaceutical. Conclusions: The patient radiation dose from the cone beam CT scan can be higher than that from a diagnostic CT and should be taken into consideration in evaluating total SPECT/CT patient dose.

Organ doses can be estimated from the computed tomography (CT) dose index for cone-beam CT on radiotherapy equipment.

Science.gov (United States)

Martin, Colin J; Abuhaimed, Abdullah; Sankaralingam, Marimuthu; Metwaly, Mohamed; Gentle, David J

2016-06-01

Cone beam computed tomography (CBCT) systems are fitted to radiotherapy linear accelerators and used for patient positioning prior to treatment by image guided radiotherapy (IGRT). Radiotherapists' and radiographers' knowledge of doses to organs from CBCT imaging is limited. The weighted CT dose index for a reference beam of width 20 mm (CTDIw,ref) is displayed on Varian CBCT imaging equipment known as an On-Board Imager (OBI) linked to the Truebeam linear accelerator. This has the potential to provide an indication of organ doses. This knowledge would be helpful for guidance of radiotherapy clinicians preparing treatments. Monte Carlo simulations of imaging protocols for head, thorax and pelvic scans have been performed using EGSnrc/BEAMnrc, EGSnrc/DOSXYZnrc, and ICRP reference computational male and female phantoms to derive the mean absorbed doses to organs and tissues, which have been compared with values for the CTDIw,ref displayed on the CBCT scanner console. Substantial variations in dose were observed between male and female phantoms. Nevertheless, the CTDIw,ref gave doses within  ±21% for the stomach and liver in thorax scans and 2  ×  CTDIw,ref can be used as a measure of doses to breast, lung and oesophagus. The CTDIw,ref could provide indications of doses to the brain for head scans, and the colon for pelvic scans. It is proposed that knowledge of the link between CTDIw for CBCT should be promoted and included in the training of radiotherapy staff.

Bone quality evaluation at dental implant site using multislice CT, micro-CT, and cone beam CT.

Science.gov (United States)

Parsa, Azin; Ibrahim, Norliza; Hassan, Bassam; van der Stelt, Paul; Wismeijer, Daniel

2015-01-01

The first purpose of this study was to analyze the correlation between bone volume fraction (BV/TV) and calibrated radiographic bone density Hounsfield units (HU) in human jaws, derived from micro-CT and multislice computed tomography (MSCT), respectively. The second aim was to assess the accuracy of cone beam computed tomography (CBCT) in evaluating trabecular bone density and microstructure using MSCT and micro-CT, respectively, as reference gold standards. Twenty partially edentulous human mandibular cadavers were scanned by three types of CT modalities: MSCT (Philips, Best, the Netherlands), CBCT (3D Accuitomo 170, J Morita, Kyoto, Japan), and micro-CT (SkyScan 1173, Kontich, Belgium). Image analysis was performed using Amira (v4.1, Visage Imaging Inc., Carlsbad, CA, USA), 3Diagnosis (v5.3.1, 3diemme, Cantu, Italy), Geomagic (studio(®) 2012, Morrisville, NC, USA), and CTAn (v1.11, SkyScan). MSCT, CBCT, and micro-CT scans of each mandible were matched to select the exact region of interest (ROI). MSCT HU, micro-CT BV/TV, and CBCT gray value and bone volume fraction of each ROI were derived. Statistical analysis was performed to assess the correlations between corresponding measurement parameters. Strong correlations were observed between CBCT and MSCT density (r = 0.89) and between CBCT and micro-CT BV/TV measurements (r = 0.82). Excellent correlation was observed between MSCT HU and micro-CT BV/TV (r = 0.91). However, significant differences were found between all comparisons pairs (P micro-CT BV/TV (P = 0.147). An excellent correlation exists between bone volume fraction and bone density as assessed on micro-CT and MSCT, respectively. This suggests that bone density measurements could be used to estimate bone microstructural parameters. A strong correlation also was found between CBCT gray values and BV/TV and their gold standards, suggesting the potential of this modality in bone quality assessment at implant site. © 2013 John Wiley & Sons A/S. Published by

Integration of PET-CT and cone-beam CT for image-guided radiotherapy with high image quality and registration accuracy

Science.gov (United States)

Wu, T.-H.; Liang, C.-H.; Wu, J.-K.; Lien, C.-Y.; Yang, B.-H.; Huang, Y.-H.; Lee, J. J. S.

2009-07-01

Hybrid positron emission tomography-computed tomography (PET-CT) system enhances better differentiation of tissue uptake of 18F-fluorodeoxyglucose (18F-FDG) and provides much more diagnostic value in the non-small-cell lung cancer and nasopharyngeal carcinoma (NPC). In PET-CT, high quality CT images not only offer diagnostic value on anatomic delineation of the tissues but also shorten the acquisition time for attenuation correction (AC) compared with PET-alone imaging. The linear accelerators equipped with the X-ray cone-beam computed tomography (CBCT) imaging system for image-guided radiotherapy (IGRT) provides excellent verification on position setup error. The purposes of our study were to optimize the CT acquisition protocols of PET-CT and to integrate the PET-CT and CBCT for IGRT. The CT imaging parameters were modified in PET-CT for increasing the image quality in order to enhance the diagnostic value on tumour delineation. Reproducibility and registration accuracy via bone co-registration algorithm between the PET-CT and CBCT were evaluated by using a head phantom to simulate a head and neck treatment condition. Dose measurement in computed tomography dose index (CTDI) was also estimated. Optimization of the CT acquisition protocols of PET-CT was feasible in this study. Co-registration accuracy between CBCT and PET-CT on axial and helical modes was in the range of 1.06 to 2.08 and 0.99 to 2.05 mm, respectively. In our result, it revealed that the accuracy of the co-registration with CBCT on helical mode was more accurate than that on axial mode. Radiation doses in CTDI were 4.76 to 18.5 mGy and 4.83 to 18.79 mGy on axial and helical modes, respectively. Registration between PET-CT and CBCT is a state-of-the-art registration technology which could provide much information on diagnosis and accurate tumour contouring on radiotherapy while implementing radiotherapy procedures. This novelty technology of PET-CT and cone-beam CT integration for IGRT may have a

Integration of PET-CT and cone-beam CT for image-guided radiotherapy with high image quality and registration accuracy

International Nuclear Information System (INIS)

Wu, T-H; Liang, C-H; Wu, J-K; Lien, C-Y; Yang, B-H; Lee, J J S; Huang, Y-H

2009-01-01

Hybrid positron emission tomography-computed tomography (PET-CT) system enhances better differentiation of tissue uptake of 18 F-fluorodeoxyglucose ( 18 F-FDG) and provides much more diagnostic value in the non-small-cell lung cancer and nasopharyngeal carcinoma (NPC). In PET-CT, high quality CT images not only offer diagnostic value on anatomic delineation of the tissues but also shorten the acquisition time for attenuation correction (AC) compared with PET-alone imaging. The linear accelerators equipped with the X-ray cone-beam computed tomography (CBCT) imaging system for image-guided radiotherapy (IGRT) provides excellent verification on position setup error. The purposes of our study were to optimize the CT acquisition protocols of PET-CT and to integrate the PET-CT and CBCT for IGRT. The CT imaging parameters were modified in PET-CT for increasing the image quality in order to enhance the diagnostic value on tumour delineation. Reproducibility and registration accuracy via bone co-registration algorithm between the PET-CT and CBCT were evaluated by using a head phantom to simulate a head and neck treatment condition. Dose measurement in computed tomography dose index (CTDI) was also estimated. Optimization of the CT acquisition protocols of PET-CT was feasible in this study. Co-registration accuracy between CBCT and PET-CT on axial and helical modes was in the range of 1.06 to 2.08 and 0.99 to 2.05 mm, respectively. In our result, it revealed that the accuracy of the co-registration with CBCT on helical mode was more accurate than that on axial mode. Radiation doses in CTDI were 4.76 to 18.5 mGy and 4.83 to 18.79 mGy on axial and helical modes, respectively. Registration between PET-CT and CBCT is a state-of-the-art registration technology which could provide much information on diagnosis and accurate tumour contouring on radiotherapy while implementing radiotherapy procedures. This novelty technology of PET-CT and cone-beam CT integration for IGRT may have a

Predicting factors for conversion from fluoroscopy guided Percutaneous transthoracic needle biopsy to cone-beam CT guided Percutaneous transthoracic needle biopsy

International Nuclear Information System (INIS)

Lee, Kang Ji; Han, Young Min; Jin, Gong Yong; Song, Ji Soo

2015-01-01

To evaluate the predicting factors for conversion from fluoroscopy guided percutaneous transthoracic needle biopsy (PTNB) to cone-beam CT guided PTNB. From January 2011 to December 2012, we retrospectively identified 38 patients who underwent cone-beam CT guided PTNB with solid pulmonary lesions, and 76 patients who underwent fluoroscopy guided PTNB were matched to the patients who underwent cone-beam CT guided PTNB for age, sex, and lesion location. We evaluated predicting factors such as, long-axis diameter, short-axis diameter, anterior-posterior diameter, and CT attenuation value of the solid pulmonary lesion affecting conversion from fluoroscopy guided PTNB to cone-beam CT guided PTNB. Pearson χ 2 test, Fisher exact test, and independent t test were used in statistical analyses; in addition, we also used receiver operating characteristics curve to find the proper cut-off values affecting the conversion to cone-beam CT guided PTNB. Short-axis, long-axis, anterior-posterior diameter and CT attenuation value of the solid pulmonary lesion in patients who underwent fluoroscopy guided PTNB were 2.70 ± 1.57 cm, 3.40 ± 1.92 cm, 3.06 ± 1.81 cm, and 35.67 ± 15.70 Hounsfield unit (HU), respectively. Short-axis, long-axis, anterior-posterior diameter and CT attenuation value of the solid pulmonary lesion in patients who underwent cone-beam CT guided PTNB were 1.60 ± 1.30 cm, 2.20 ± 1.45 cm, 1.91 ± 1.99 cm, and 18.32 ± 23.11 HU, respectively. Short-axis, long-axis, anterior-posterior diameter, and CT attenuation value showed a significantly different mean value between the 2 groups (p = 0.001, p < 0.001, p = 0.003, p < 0.001, respectively). Odd ratios of CT attenuation value and short-axis diameter of the solid pulmonary lesion were 0.952 and 0.618, respectively. Proper cut-off values affecting the conversion to cone-beam CT guided PTNB were 1.65 cm (sensitivity 68.4%, specificity 71.1%) in short-axis diameter and 29.50 HU (sensitivity 65.8%, specificity 65.8%) in

Efficacy of percutaneous sclerotherapy through pig tail drainage tube for giant hepatic and renal cysts under CT guidance

International Nuclear Information System (INIS)

Huang Xiaoming; Huang Yongbin; Geng Lei; Zhang Haitao

2008-01-01

Objective: To evaluate the safety and efficacy of percutaneous sclerotherapy through pig tail drainage tube for giant hepatic and renal cysts under CT guidance. Methods: Seventeen cases of giant hepatic and renal cyst were percutaneously implanted with 7 F pig tail drainage tube under CT guidance, together with daily injection of dehydrated ethanol or acetic acid. The drainage tube should be clamped after injection of sclerosing agent for cystic fluid 500 ml, immediate reopening of the drainage tube should be taken sright after the sclerotherapy. The withdrawal of drainage tube should be taken after resclerotherapy for all patients with < 10 ml of 24 h. drainage volume, including average of 40 d for hepatic cyst and 10 d for renal cyst. Results: 6 months after scletotherapy, all patients showed under US examination and 'healed' for all 17 cases, with successful rate up to 100%. No complication of bleeding, infection and cardioencephalovascular events occurred. Conclusion: CT guided pereutaneous sclerotherapy through pig tail drainage tube for giant hepatic and renal cysts is simple, safe and satisfactory efficacy. (authors)

Cone-beam CT with a flat-panel detector: From image science to image-guided surgery

International Nuclear Information System (INIS)

Siewerdsen, Jeffrey H.

2011-01-01

The development of large-area flat-panel X-ray detectors (FPDs) has spurred investigation in a spectrum of advanced medical imaging applications, including tomosynthesis and cone-beam CT (CBCT). Recent research has extended image quality metrics and theoretical models to such applications, providing a quantitative foundation for the assessment of imaging performance as well as a general framework for the design, optimization, and translation of such technologies to new applications. For example, cascaded systems models of the Fourier domain metrics, such as noise-equivalent quanta (NEQ), have been extended to these modalities to describe the propagation of signal and noise through the image acquisition and reconstruction chain and to quantify the factors that govern spatial resolution, image noise, and detectability. Moreover, such models have demonstrated basic agreement with human observer performance for a broad range of imaging conditions and imaging tasks. These developments in image science have formed a foundation for the knowledgeable development and translation of CBCT to new applications in image-guided interventions-for example, CBCT implemented on a mobile surgical C-arm for intraoperative 3D imaging. The ability to acquire high-quality 3D images on demand during surgical intervention overcomes conventional limitations of surgical guidance in the context of preoperative images alone. A prototype mobile C-arm developed in academic-industry partnership demonstrates CBCT with low radiation dose, sub-mm spatial resolution, and soft-tissue visibility potentially approaching that of diagnostic CT. Integration of the 3D imaging system with real-time tracking, deformable registration, endoscopic video, and 3D visualization offers a promising addition to the surgical arsenal in interventions ranging from head-and-neck/skull base surgery to spine, orthopaedic, thoracic, and abdominal surgeries. Cadaver studies show the potential for significant boosts in surgical

Cone-beam CT with a flat-panel detector: From image science to image-guided surgery

Energy Technology Data Exchange (ETDEWEB)

Siewerdsen, Jeffrey H., E-mail: jeff.siewerdsen@jhu.edu [Department of Biomedical Engineering, Johns Hopkins University, Traylor Building, Room 718, 720 Rutland Avenue, Baltimore, MD 21205 (United States)

2011-08-21

The development of large-area flat-panel X-ray detectors (FPDs) has spurred investigation in a spectrum of advanced medical imaging applications, including tomosynthesis and cone-beam CT (CBCT). Recent research has extended image quality metrics and theoretical models to such applications, providing a quantitative foundation for the assessment of imaging performance as well as a general framework for the design, optimization, and translation of such technologies to new applications. For example, cascaded systems models of the Fourier domain metrics, such as noise-equivalent quanta (NEQ), have been extended to these modalities to describe the propagation of signal and noise through the image acquisition and reconstruction chain and to quantify the factors that govern spatial resolution, image noise, and detectability. Moreover, such models have demonstrated basic agreement with human observer performance for a broad range of imaging conditions and imaging tasks. These developments in image science have formed a foundation for the knowledgeable development and translation of CBCT to new applications in image-guided interventions-for example, CBCT implemented on a mobile surgical C-arm for intraoperative 3D imaging. The ability to acquire high-quality 3D images on demand during surgical intervention overcomes conventional limitations of surgical guidance in the context of preoperative images alone. A prototype mobile C-arm developed in academic-industry partnership demonstrates CBCT with low radiation dose, sub-mm spatial resolution, and soft-tissue visibility potentially approaching that of diagnostic CT. Integration of the 3D imaging system with real-time tracking, deformable registration, endoscopic video, and 3D visualization offers a promising addition to the surgical arsenal in interventions ranging from head-and-neck/skull base surgery to spine, orthopaedic, thoracic, and abdominal surgeries. Cadaver studies show the potential for significant boosts in surgical

Four-dimensional cone beam CT with adaptive gantry rotation and adaptive data sampling

International Nuclear Information System (INIS)

Lu Jun; Guerrero, Thomas M.; Munro, Peter; Jeung, Andrew; Chi, P.-C. M.; Balter, Peter; Zhu, X. Ronald; Mohan, Radhe; Pan Tinsu

2007-01-01

We have developed a new four-dimensional cone beam CT (4D-CBCT) on a Varian image-guided radiation therapy system, which has radiation therapy treatment and cone beam CT imaging capabilities. We adapted the speed of gantry rotation time of the CBCT to the average breath cycle of the patient to maintain the same level of image quality and adjusted the data sampling frequency to keep a similar level of radiation exposure to the patient. Our design utilized the real-time positioning and monitoring system to record the respiratory signal of the patient during the acquisition of the CBCT data. We used the full-fan bowtie filter during data acquisition, acquired the projection data over 200 deg of gantry rotation, and reconstructed the images with a half-scan cone beam reconstruction. The scan time for a 200-deg gantry rotation per patient ranged from 3.3 to 6.6 min for the average breath cycle of 3-6 s. The radiation dose of the 4D-CBCT was about 1-2 times the radiation dose of the 4D-CT on a multislice CT scanner. We evaluated the 4D-CBCT in scanning, data processing and image quality with phantom studies. We demonstrated the clinical applicability of the 4D-CBCT and compared the 4D-CBCT and the 4D-CT scans in four patient studies. The contrast-to-noise ratio of the 4D-CT was 2.8-3.5 times of the contrast-to-noise ratio of the 4D-CBCT in the four patient studies

A One-Step Cone-Beam CT-Enabled Planning-to-Treatment Model for Palliative Radiotherapy-From Development to Implementation

International Nuclear Information System (INIS)

Wong, Rebecca K.S.; Letourneau, Daniel; Varma, Anita; Bissonnette, Jean Pierre; Fitzpatrick, David; Grabarz, Daniel; Elder, Christine; Martin, Melanie; Bezjak, Andrea; Panzarella, Tony; Gospodarowicz, Mary; Jaffray, David A.

2012-01-01

Purpose: To develop a cone-beam computed tomography (CT)–enabled one-step simulation-to-treatment process for the treatment of bone metastases. Methods and Materials: A three-phase prospective study was conducted. Patients requiring palliative radiotherapy to the spine, mediastinum, or abdomen/pelvis suitable for treatment with simple beam geometry (≤2 beams) were accrued. Phase A established the accuracy of cone-beam CT images for the purpose of gross tumor target volume (GTV) definition. Phase B evaluated the feasibility of implementing the cone-beam CT–enabled planning process at the treatment unit. Phase C evaluated the online cone-beam CT–enabled process for the planning and treatment of patients requiring radiotherapy for bone metastases. Results: Eighty-four patients participated in this study. Phase A (n = 9) established the adequacy of cone-beam CT images for target definition. Phase B (n = 45) established the quality of treatment plans to be adequate for clinical implementation for bone metastases. When the process was applied clinically in bone metastases (Phase C), the degree of overlap between planning computed tomography (PCT) and cone-beam CT for GTV and between PCT and cone-beam CT for treatment field was 82% ± 11% and 97% ± 4%, respectively. The oncologist’s decision to accept the plan under a time-pressured environment remained of high quality, with the cone-beam CT–generated treatment plan delivering at least 90% of the prescribed dose to 100% ± 0% of the cone-beam CT planning target volume (PTV). With the assumption that the PCT PTV is the gold-standard target, the cone-beam CT–generated treatment plan delivered at least 90% and at least 95% of dose to 98% ± 2% and 97% ± 5% of the PCT PTV, respectively. The mean time for the online planning and treatment process was 32.7 ± 4.0 minutes. Patient satisfaction was high, with a trend for superior satisfaction with the cone-beam CT–enabled process. Conclusions: The cone-beam CT�

Cone-beam computed tomography for lung cancer - validation with CT and monitoring tumour response during chemo-radiation therapy.

Science.gov (United States)

Michienzi, Alissa; Kron, Tomas; Callahan, Jason; Plumridge, Nikki; Ball, David; Everitt, Sarah

2017-04-01

Cone-beam computed tomography (CBCT) is a valuable image-guidance tool in radiation therapy (RT). This study was initiated to assess the accuracy of CBCT for quantifying non-small cell lung cancer (NSCLC) tumour volumes compared to the anatomical 'gold standard', CT. Tumour regression or progression on CBCT was also analysed. Patients with Stage I-III NSCLC, prescribed 60 Gy in 30 fractions RT with concurrent platinum-based chemotherapy, routine CBCT and enrolled in a prospective study of serial PET/CT (baseline, weeks two and four) were eligible. Time-matched CBCT and CT gross tumour volumes (GTVs) were manually delineated by a single observer on MIM software, and were analysed descriptively and using Pearson's correlation coefficient (r) and linear regression (R 2 ). Of 94 CT/CBCT pairs, 30 patients were eligible for inclusion. The mean (± SD) CT GTV vs CBCT GTV on the four time-matched pairs were 95 (±182) vs 98.8 (±160.3), 73.6 (±132.4) vs 70.7 (±96.6), 54.7 (±92.9) vs 61.0 (±98.8) and 61.3 (±53.3) vs 62.1 (±47.9) respectively. Pearson's correlation coefficient (r) was 0.98 (95% CI 0.97-0.99, ρ < 0.001). The mean (±SD) CT/CBCT Dice's similarity coefficient was 0.66 (±0.16). Of 289 CBCT scans, tumours in 27 (90%) patients regressed by a mean (±SD) rate of 1.5% (±0.75) per fraction. The mean (±SD) GTV regression was 43.1% (±23.1) from the first to final CBCT. Primary lung tumour volumes observed on CBCT and time-matched CT are highly correlated (although not identical), thereby validating observations of GTV regression on CBCT in NSCLC. © 2016 The Royal Australian and New Zealand College of Radiologists.

Cone-beam volume CT mammographic imaging: feasibility study

Science.gov (United States)

Chen, Biao; Ning, Ruola

2001-06-01

X-ray projection mammography, using a film/screen combination or digital techniques, has proven to be the most effective imaging modality for early detection of breast cancer currently available. However, the inherent superimposition of structures makes small carcinoma (a few millimeters in size) difficult to detect in the occultation case or in dense breasts, resulting in a high false positive biopsy rate. The cone-beam x-ray projection based volume imaging using flat panel detectors (FPDs) makes it possible to obtain three-dimensional breast images. This may benefit diagnosis of the structure and pattern of the lesion while eliminating hard compression of the breast. This paper presents a novel cone-beam volume CT mammographic imaging protocol based on the above techniques. Through computer simulation, the key issues of the system and imaging techniques, including the x-ray imaging geometry and corresponding reconstruction algorithms, x-ray characteristics of breast tissues, x-ray setting techniques, the absorbed dose estimation and the quantitative effect of x-ray scattering on image quality, are addressed. The preliminary simulation results support the proposed cone-beam volume CT mammographic imaging modality in respect to feasibility and practicability for mammography. The absorbed dose level is comparable to that of current two-view mammography and would not be a prominent problem for this imaging protocol. Compared to traditional mammography, the proposed imaging protocol with isotropic spatial resolution will potentially provide significantly better low contrast detectability of breast tumors and more accurate location of breast lesions.

Comparing Effective Doses During Image-Guided Core Needle Biopsies with Computed Tomography Versus C-Arm Cone Beam CT Using Adult and Pediatric Phantoms.

Science.gov (United States)

Ben-Shlomo, A; Cohen, D; Bruckheimer, E; Bachar, G N; Konstantinovsky, R; Birk, E; Atar, E

2016-05-01

To compare the effective doses of needle biopsies based on dose measurements and simulations using adult and pediatric phantoms, between cone beam c-arm CT (CBCT) and CT. Effective doses were calculated and compared based on measurements and Monte Carlo simulations of CT- and CBCT-guided biopsy procedures of the lungs, liver, and kidney using pediatric and adult phantoms. The effective doses for pediatric and adult phantoms, using our standard protocols for upper, middle and lower lungs, liver, and kidney biopsies, were significantly lower under CBCT guidance than CT. The average effective dose for a 5-year old for these five biopsies was 0.36 ± 0.05 mSv with the standard CBCT exposure protocols and 2.13 ± 0.26 mSv with CT. The adult average effective dose for the five biopsies was 1.63 ± 0.22 mSv with the standard CBCT protocols and 8.22 ± 1.02 mSv using CT. The CT effective dose was higher than CBCT protocols for child and adult phantoms by 803 and 590% for upper lung, 639 and 525% for mid-lung, and 461 and 251% for lower lung, respectively. Similarly, the effective dose was higher by 691 and 762% for liver and 513 and 608% for kidney biopsies. Based on measurements and simulations with pediatric and adult phantoms, radiation effective doses during image-guided needle biopsies of the lung, liver, and kidney are significantly lower with CBCT than with CT.

Region-of-interest reconstruction for a cone-beam dental CT with a circular trajectory

International Nuclear Information System (INIS)

Hu, Zhanli; Zou, Jing; Gui, Jianbao; Zheng, Hairong; Xia, Dan

2013-01-01

Dental CT is the most appropriate and accurate device for preoperative evaluation of dental implantation. It can demonstrate the quantity of bone in three dimensions (3D), the location of important adjacent anatomic structures and the quality of available bone with minimal geometric distortion. Nevertheless, with the rapid increase of dental CT examinations, we are facing the problem of dose reduction without loss of image quality. In this work, backprojection-filtration (BPF) and Feldkamp–Davis–Kress (FDK) algorithm was applied to reconstruct the 3D full image and region-of-interest (ROI) image from complete and truncated circular cone-beam data respectively by computer-simulation. In addition, the BPF algorithm was evaluated based on the 3D ROI-image reconstruction from real data, which was acquired from our developed circular cone-beam prototype dental CT system. The results demonstrated that the ROI-image quality reconstructed from truncated data using the BPF algorithm was comparable to that reconstructed from complete data. The FDK algorithm, however, created artifacts while reconstructing ROI-image. Thus it can be seen, for circular cone-beam dental CT, reducing scanning angular range of the BPF algorithm used for ROI-image reconstruction are helpful for reducing the radiation dose and scanning time. Finally, an analytical method was developed for estimation of the ROI projection area on the detector before CT scanning, which would help doctors to roughly estimate the total radiation dose before the CT examination. -- Highlights: ► BPF algorithm was applied by using dental CT for the first time. ► A method was developed for estimation of projection region before CT scanning. ► Roughly predict the total radiation dose before CT scans. ► Potential reduce imaging radiation dose, scatter, and scanning time

Fast shading correction for cone beam CT in radiation therapy via sparse sampling on planning CT.

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Shi, Linxi; Tsui, Tiffany; Wei, Jikun; Zhu, Lei

2017-05-01

The image quality of cone beam computed tomography (CBCT) is limited by severe shading artifacts, hindering its quantitative applications in radiation therapy. In this work, we propose an image-domain shading correction method using planning CT (pCT) as prior information which is highly adaptive to clinical environment. We propose to perform shading correction via sparse sampling on pCT. The method starts with a coarse mapping between the first-pass CBCT images obtained from the Varian TrueBeam system and the pCT. The scatter correction method embedded in the Varian commercial software removes some image errors but the CBCT images still contain severe shading artifacts. The difference images between the mapped pCT and the CBCT are considered as shading errors, but only sparse shading samples are selected for correction using empirical constraints to avoid carrying over false information from pCT. A Fourier-Transform-based technique, referred to as local filtration, is proposed to efficiently process the sparse data for effective shading correction. The performance of the proposed method is evaluated on one anthropomorphic pelvis phantom and 17 patients, who were scheduled for radiation therapy. (The codes of the proposed method and sample data can be downloaded from https://sites.google.com/view/linxicbct) RESULTS: The proposed shading correction substantially improves the CBCT image quality on both the phantom and the patients to a level close to that of the pCT images. On the phantom, the spatial nonuniformity (SNU) difference between CBCT and pCT is reduced from 74 to 1 HU. The root of mean square difference of SNU between CBCT and pCT is reduced from 83 to 10 HU on the pelvis patients, and from 101 to 12 HU on the thorax patients. The robustness of the proposed shading correction is fully investigated with simulated registration errors between CBCT and pCT on the phantom and mis-registration on patients. The sparse sampling scheme of our method successfully

Cone-beam computed tomography for lung cancer – validation with CT and monitoring tumour response during chemo-radiation therapy

International Nuclear Information System (INIS)

Michienzi, Alissa; Kron, Tomas; Callahan, Jason; Plumridge, Nikki; Ball, David; Everitt, Sarah

2017-01-01

Cone-beam computed tomography (CBCT) is a valuable image-guidance tool in radiation therapy (RT). This study was initiated to assess the accuracy of CBCT for quantifying non-small cell lung cancer (NSCLC) tumour volumes compared to the anatomical ‘gold standard’, CT. Tumour regression or progression on CBCT was also analysed. Patients with Stage I-III NSCLC, prescribed 60 Gy in 30 fractions RT with concurrent platinum-based chemotherapy, routine CBCT and enrolled in a prospective study of serial PET/CT (baseline, weeks two and four) were eligible. Time-matched CBCT and CT gross tumour volumes (GTVs) were manually delineated by a single observer on MIM software, and were analysed descriptively and using Pearson's correlation coefficient (r) and linear regression (R 2 ). Of 94 CT/CBCT pairs, 30 patients were eligible for inclusion. The mean (± SD) CT GTV vs CBCT GTV on the four time-matched pairs were 95 (±182) vs 98.8 (±160.3), 73.6 (±132.4) vs 70.7 (±96.6), 54.7 (±92.9) vs 61.0 (±98.8) and 61.3 (±53.3) vs 62.1 (±47.9) respectively. Pearson's correlation coefficient (r) was 0.98 (95% CI 0.97–0.99, ρ < 0.001). The mean (±SD) CT/CBCT Dice's similarity coefficient was 0.66 (±0.16). Of 289 CBCT scans, tumours in 27 (90%) patients regressed by a mean (±SD) rate of 1.5% (±0.75) per fraction. The mean (±SD) GTV regression was 43.1% (±23.1) from the first to final CBCT. Primary lung tumour volumes observed on CBCT and time-matched CT are highly correlated (although not identical), thereby validating observations of GTV regression on CBCT in NSCLC.

An index of beam hardening artifact for two-dimensional cone-beam CT tomographic images: establishment and preliminary evaluation

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Yuan, Fusong; Lv, Peijun; Yang, Huifang; Wang, Yong; Sun, Yuchun

2015-07-01

Objectives: Based on the pixel gray value measurements, establish a beam-hardening artifacts index of the cone-beam CT tomographic image, and preliminarily evaluate its applicability. Methods: The 5mm-diameter metal ball and resin ball were fixed on the light-cured resin base plate respectively, while four vitro molars were fixed above and below the ball, on the left and right respectively, which have 10mm distance with the metal ball. Then, cone beam CT was used to scan the fixed base plate twice. The same layer tomographic images were selected from the two data and imported into the Photoshop software. The circle boundary was built through the determination of the center and radius of the circle, according to the artifact-free images section. Grayscale measurement tools were used to measure the internal boundary gray value G0, gray value G1 and G2 of 1mm and 20mm artifacts outside the circular boundary, the length L1 of the arc with artifacts in the circular boundary, the circumference L2. Hardening artifacts index was set A = (G1 / G0) * 0.5 + (G2 / G1) * 0.4 + (L2 / L1) * 0.1. Then, the A values of metal and resin materials were calculated respectively. Results: The A value of cobalt-chromium alloy material is 1, and resin material is 0. Conclusion: The A value reflects comprehensively the three factors of hardening artifacts influencing normal oral tissue image sharpness of cone beam CT. The three factors include relative gray value, the decay rate and range of artifacts.

Inter- and intrafractional localisation errors in cone-beam CT guided stereotactic radiation therapy of tumours in the liver and lung

International Nuclear Information System (INIS)

Worm, Esben S.; Hansen, Anders T.; Petersen, Joergen B.; Muren, Ludvig P.; Praestegaard, Lars H.; Hoeyer, Morten

2010-01-01

Background. Localisation errors in cone-beam CT (CBCT) guided stereotactic body radiation therapy (SBRT) were evaluated and compared to positioning using the external coordinates of a stereotactic body frame (SBF) alone. Possible correlations to patient- or treatment-specific factors such as body mass index (BMI), planning time, treatment delivery time, and distance between tumour and spinal cord were explored to determine whether they influenced on the benefit of image-guidance. Material and methods. A total of 34 patients received SBRT (3 fractions) for tumours in the liver (15 patients) or the lung (19 patients). Immobilisation and positioning was obtained with a SBF. Pre- and post-treatment CBCT scans were registered with the bony anatomy of the planning CT to find inter- and intrafractional patient positioning errors (PPE). For lung tumour patients, matching was also performed on the tumours to find the tumour positioning errors (TPE) and baseline shifts relative to bony anatomy. Results. The mean inter- and intrafractional 3D vector PPE was 4.5 ± 2.7 mm (average ± SD) and 1.5 ± 0.6 mm, respectively, for the combined group of patients. For lung tumours, the interfractional misalignment was 5.6 ± 1.8 mm. The baseline shift was 3.9 ± 2.0 mm. Intrafractional TPE and baseline shifts were 2.1 ± 0.7 mm and 1.9 ± 0.6 mm, respectively. The magnitude of interfractional baseline shift was closely correlated with the distance between the tumour and the spinal cord. Intrafractional errors were independent of patient BMI, age or gender. Conclusion. Image-guidance reduced setup errors considerably. The study demonstrated the benefit of CBCT-guidance regardless of patient specific factors such as BMI, age or gender. Protection of the spinal cord was facilitated by the correlation between the tumour position relative to the spinal cord and the magnitude of baseline shift.

In vivo verification of proton beam path by using post-treatment PET/CT imaging.

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Hsi, Wen C; Indelicato, Daniel J; Vargas, Carlos; Duvvuri, Srividya; Li, Zuofeng; Palta, Jatinder

2009-09-01

The purpose of this study is to establish the in vivo verification of proton beam path by using proton-activated positron emission distributions. A total of 50 PET/CT imaging studies were performed on ten prostate cancer patients immediately after daily proton therapy treatment through a single lateral portal. The PET/CT and planning CT were registered by matching the pelvic bones, and the beam path of delivered protons was defined in vivo by the positron emission distribution seen only within the pelvic bones, referred to as the PET-defined beam path. Because of the patient position correction at each fraction, the marker-defined beam path, determined by the centroid of implanted markers seen in the posttreatment (post-Tx) CT, is used for the planned beam path. The angular variation and discordance between the PET- and marker-defined paths were derived to investigate the intrafraction prostate motion. For studies with large discordance, the relative location between the centroid and pelvic bones seen in the post-Tx CT was examined. The PET/CT studies are categorized for distinguishing the prostate motion that occurred before or after beam delivery. The post-PET CT was acquired after PET imaging to investigate prostate motion due to physiological changes during the extended PET acquisition. The less than 2 degrees of angular variation indicates that the patient roll was minimal within the immobilization device. Thirty of the 50 studies with small discordance, referred as good cases, show a consistent alignment between the field edges and the positron emission distributions from the entrance to the distal edge. For those good cases, average displacements are 0.6 and 1.3 mm along the anterior-posterior (D(AP)) and superior-inferior (D(SI)) directions, respectively, with 1.6 mm standard deviations in both directions. For the remaining 20 studies demonstrating a large discordance (more than 6 mm in either D(AP) or D(SI)), 13 studies, referred as motion-after-Tx cases

In vivo verification of proton beam path by using post-treatment PET/CT imaging

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Hsi, Wen C.; Indelicato, Daniel J.; Vargas, Carlos; Duvvuri, Srividya; Li Zuofeng; Palta, Jatinder [Proton Therapy Institute, University of Florida, Jacksonville, Florida 32206 (United States); Boca Radiation Oncology Associates, Boca Raton, Florida 33431 (United States); Proton Therapy Institute, University of Florida, Jacksonville, Florida 32206 (United States); Department of Radiation Oncology, University of Florida, Gainesville, Florida 32610 (United States)

2009-09-15

Purpose: The purpose of this study is to establish the in vivo verification of proton beam path by using proton-activated positron emission distributions. Methods: A total of 50 PET/CT imaging studies were performed on ten prostate cancer patients immediately after daily proton therapy treatment through a single lateral portal. The PET/CT and planning CT were registered by matching the pelvic bones, and the beam path of delivered protons was defined in vivo by the positron emission distribution seen only within the pelvic bones, referred to as the PET-defined beam path. Because of the patient position correction at each fraction, the marker-defined beam path, determined by the centroid of implanted markers seen in the post-treatment (post-Tx) CT, is used for the planned beam path. The angular variation and discordance between the PET- and marker-defined paths were derived to investigate the intrafraction prostate motion. For studies with large discordance, the relative location between the centroid and pelvic bones seen in the post-Tx CT was examined. The PET/CT studies are categorized for distinguishing the prostate motion that occurred before or after beam delivery. The post-PET CT was acquired after PET imaging to investigate prostate motion due to physiological changes during the extended PET acquisition. Results: The less than 2 deg. of angular variation indicates that the patient roll was minimal within the immobilization device. Thirty of the 50 studies with small discordance, referred as good cases, show a consistent alignment between the field edges and the positron emission distributions from the entrance to the distal edge. For those good cases, average displacements are 0.6 and 1.3 mm along the anterior-posterior (D{sub AP}) and superior-inferior (D{sub SI}) directions, respectively, with 1.6 mm standard deviations in both directions. For the remaining 20 studies demonstrating a large discordance (more than 6 mm in either D{sub AP} or D{sub SI}), 13

Image-Guided Radiotherapy for Liver Cancer Using Respiratory-Correlated Computed Tomography and Cone-Beam Computed Tomography

International Nuclear Information System (INIS)

Guckenberger, Matthias; Sweeney, Reinhart A.; Wilbert, Juergen; Krieger, Thomas; Richter, Anne; Baier, Kurt; Mueller, Gerd; Sauer, Otto; Flentje, Michael

2008-01-01

Purpose: To evaluate a novel four-dimensional (4D) image-guided radiotherapy (IGRT) technique in stereotactic body RT for liver tumors. Methods and Materials: For 11 patients with 13 intrahepatic tumors, a respiratory-correlated 4D computed tomography (CT) scan was acquired at treatment planning. The target was defined using CT series reconstructed at end-inhalation and end-exhalation. The liver was delineated on these two CT series and served as a reference for image guidance. A cone-beam CT scan was acquired after patient positioning; the blurred diaphragm dome was interpreted as a probability density function showing the motion range of the liver. Manual contour matching of the liver structures from the planning 4D CT scan with the cone-beam CT scan was performed. Inter- and intrafractional uncertainties of target position and motion range were evaluated, and interobserver variability of the 4D-IGRT technique was tested. Results: The workflow of 4D-IGRT was successfully practiced in all patients. The absolute error in the liver position and error in relation to the bony anatomy was 8 ± 4 mm and 5 ± 2 mm (three-dimensional vector), respectively. Margins of 4-6 mm were calculated for compensation of the intrafractional drifts of the liver. The motion range of the diaphragm dome was reproducible within 5 mm for 11 of 13 lesions, and the interobserver variability of the 4D-IGRT technique was small (standard deviation, 1.5 mm). In 4 patients, the position of the intrahepatic lesion was directly verified using a mobile in-room CT scanner after application of intravenous contrast. Conclusion: The results of our study have shown that 4D image guidance using liver contour matching between respiratory-correlated CT and cone-beam CT scans increased the accuracy compared with stereotactic positioning and compared with IGRT without consideration of breathing motion

A combination-weighted Feldkamp-based reconstruction algorithm for cone-beam CT

International Nuclear Information System (INIS)

Mori, Shinichiro; Endo, Masahiro; Komatsu, Shuhei; Kandatsu, Susumu; Yashiro, Tomoyasu; Baba, Masayuki

2006-01-01

The combination-weighted Feldkamp algorithm (CW-FDK) was developed and tested in a phantom in order to reduce cone-beam artefacts and enhance cranio-caudal reconstruction coverage in an attempt to improve image quality when utilizing cone-beam computed tomography (CBCT). Using a 256-slice cone-beam CT (256CBCT), image quality (CT-number uniformity and geometrical accuracy) was quantitatively evaluated in phantom and clinical studies, and the results were compared to those obtained with the original Feldkamp algorithm. A clinical study was done in lung cancer patients under breath holding and free breathing. Image quality for the original Feldkamp algorithm is degraded at the edge of the scan region due to the missing volume, commensurate with the cranio-caudal distance between the reconstruction and central planes. The CW-FDK extended the reconstruction coverage to equal the scan coverage and improved reconstruction accuracy, unaffected by the cranio-caudal distance. The extended reconstruction coverage with good image quality provided by the CW-FDK will be clinically investigated for improving diagnostic and radiotherapy applications. In addition, this algorithm can also be adapted for use in relatively wide cone-angle CBCT such as with a flat-panel detector CBCT

Potential of image-guidance, gating and real-time tracking to improve accuracy in pulmonary stereotactic body radiotherapy

International Nuclear Information System (INIS)

Guckenberger, Matthias; Krieger, Thomas; Richter, Anne; Baier, Kurt; Wilbert, Juergen; Sweeney, Reinhart A.; Flentje, Michael

2009-01-01

Purpose: To evaluate the potential of image-guidance, gating and real-time tumor tracking to improve accuracy in pulmonary stereotactic body radiotherapy (SBRT). Materials and methods: Safety margins for compensation of inter- and intra-fractional uncertainties of the target position were calculated based on SBRT treatments of 43 patients with pre- and post-treatment cone-beam CT imaging. Safety margins for compensation of breathing motion were evaluated for 17 pulmonary tumors using respiratory correlated CT, model-based segmentation of 4D-CT images and voxel-based dose accumulation; the target in the mid-ventilation position was the reference. Results: Because of large inter-fractional base-line shifts of the tumor, stereotactic patient positioning and image-guidance based on the bony anatomy required safety margins of 12 mm and 9 mm, respectively. Four-dimensional image-guidance targeting the tumor itself and intra-fractional tumor tracking reduced margins to <5 mm and <3 mm, respectively. Additional safety margins are required to compensate for breathing motion. A quadratic relationship between tumor motion and margins for motion compensation was observed: safety margins of 2.4 mm and 6 mm were calculated for compensation of 10 mm and 20 mm motion amplitudes in cranio-caudal direction, respectively. Conclusion: Four-dimensional image-guidance with pre-treatment verification of the target position and online correction of errors reduced safety margins most effectively in pulmonary SBRT.

Development of a Method to Assess the Precision Of the z-axis X-ray Beam Collimation in a CT Scanner

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Kim, Yon-Min

2018-05-01

Generally X-ray equipment specifies the beam collimator for the accuracy measurement as a quality control item, but the computed tomography (CT) scanner with high dose has no collimator accuracy measurement item. If the radiation dose is to be reduced, an important step is to check if the beam precisely collimates at the body part for CT scan. However, few ways are available to assess how precisely the X-ray beam is collimated. In this regard, this paper provides a way to assess the precision of z-axis X-ray beam collimation in a CT scanner. After the image plate cassette had been exposed to the X-ray beam, the exposed width was automatically detected by using a computer program developed by the research team to calculate the difference between the exposed width and the imaged width (at isocenter). The result for the precision of z-axis X-ray beam collimation showed that the exposed width was 3.8 mm and the overexposure was high at 304% when a narrow beam of a 1.25 mm imaged width was used. In this study, the precision of the beam collimation of the CT scanner, which is frequently used for medical services, was measured in a convenient way by using the image plate (IP) cassette.

Geometric Parameters Estimation and Calibration in Cone-Beam Micro-CT

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Jintao Zhao

2015-09-01

Full Text Available The quality of Computed Tomography (CT images crucially depends on the precise knowledge of the scanner geometry. Therefore, it is necessary to estimate and calibrate the misalignments before image acquisition. In this paper, a Two-Piece-Ball (TPB phantom is used to estimate a set of parameters that describe the geometry of a cone-beam CT system. Only multiple projections of the TPB phantom at one position are required, which can avoid the rotation errors when acquiring multi-angle projections. Also, a corresponding algorithm is derived. The performance of the method is evaluated through simulation and experimental data. The results demonstrated that the proposed method is valid and easy to implement. Furthermore, the experimental results from the Micro-CT system demonstrate the ability to reduce artifacts and improve image quality through geometric parameter calibration.

Volume-of-change cone-beam CT for image-guided surgery

International Nuclear Information System (INIS)

Lee, Junghoon; Stayman, J Webster; Otake, Yoshito; Schafer, Sebastian; Zbijewski, Wojciech; Khanna, A Jay; Siewerdsen, Jeffrey H; Prince, Jerry L

2012-01-01

C-arm cone-beam CT (CBCT) can provide intraoperative 3D imaging capability for surgical guidance, but workflow and radiation dose are the significant barriers to broad utilization. One main reason is that each 3D image acquisition requires a complete scan with a full radiation dose to present a completely new 3D image every time. In this paper, we propose to utilize patient-specific CT or CBCT as prior knowledge to accurately reconstruct the aspects of the region that have changed by the surgical procedure from only a sparse set of x-rays. The proposed methods consist of a 3D–2D registration between the prior volume and a sparse set of intraoperative x-rays, creating digitally reconstructed radiographs (DRRs) from the registered prior volume, computing difference images by subtracting DRRs from the intraoperative x-rays, a penalized likelihood reconstruction of the volume of change (VOC) from the difference images, and finally a fusion of VOC reconstruction with the prior volume to visualize the entire surgical field. When the surgical changes are local and relatively small, the VOC reconstruction involves only a small volume size and a small number of projections, allowing less computation and lower radiation dose than is needed to reconstruct the entire surgical field. We applied this approach to sacroplasty phantom data obtained from a CBCT test bench and vertebroplasty data with a fresh cadaver acquired from a C-arm CBCT system with a flat-panel detector. The VOCs were reconstructed from a varying number of images (10–66 images) and compared to the CBCT ground truth using four different metrics (mean squared error, correlation coefficient, structural similarity index and perceptual difference model). The results show promising reconstruction quality with structural similarity to the ground truth close to 1 even when only 15–20 images were used, allowing dose reduction by the factor of 10–20. (paper)

Evaluation of tilted cone-beam CT orbits in the development of a dedicated hybrid mammotomograph

International Nuclear Information System (INIS)

Madhav, P; Crotty, D J; Tornai, M P; McKinley, R L

2009-01-01

A compact dedicated 3D breast SPECT-CT (mammotomography) system is currently under development. In its initial prototype, the cone-beam CT sub-system is restricted to a fixed-tilt circular rotation around the patient's pendant breast. This study evaluated stationary-tilt angles for the CT sub-system that will enable maximal volumetric sampling and viewing of the breast and chest wall. Images of geometric/anthropomorphic phantoms were acquired using various fixed-tilt circular and 3D sinusoidal trajectories. The iteratively reconstructed images showed more distortion and attenuation coefficient inaccuracy from tilted cone-beam orbits than from the complex trajectory. Additionally, line profiles illustrated cupping artifacts in planes distal to the central plane of the tilted cone-beam, otherwise not apparent for images acquired with complex trajectories. This indicates that undersampled cone-beam data may be an additional cause of cupping artifacts. High-frequency objects could be distinguished for all trajectories, but their shapes and locations were corrupted by out-of-plane frequency information. Although more acrylic balls were visualized with a fixed-tilt and nearly flat cone-beam at the posterior of the breast, 3D complex trajectories have less distortion and more complete sampling throughout the reconstruction volume. While complex trajectories would ideally be preferred, negatively fixed-tilt source-detector configuration demonstrates minimally distorted patient images.

Comparing Effective Doses During Image-Guided Core Needle Biopsies with Computed Tomography Versus C-Arm Cone Beam CT Using Adult and Pediatric Phantoms

International Nuclear Information System (INIS)

Ben-Shlomo, A.; Cohen, D.; Bruckheimer, E.; Bachar, G. N.; Konstantinovsky, R.; Birk, E.; Atar, E.

2016-01-01

PurposeTo compare the effective doses of needle biopsies based on dose measurements and simulations using adult and pediatric phantoms, between cone beam c-arm CT (CBCT) and CT.MethodEffective doses were calculated and compared based on measurements and Monte Carlo simulations of CT- and CBCT-guided biopsy procedures of the lungs, liver, and kidney using pediatric and adult phantoms.ResultsThe effective doses for pediatric and adult phantoms, using our standard protocols for upper, middle and lower lungs, liver, and kidney biopsies, were significantly lower under CBCT guidance than CT. The average effective dose for a 5-year old for these five biopsies was 0.36 ± 0.05 mSv with the standard CBCT exposure protocols and 2.13 ± 0.26 mSv with CT. The adult average effective dose for the five biopsies was 1.63 ± 0.22 mSv with the standard CBCT protocols and 8.22 ± 1.02 mSv using CT. The CT effective dose was higher than CBCT protocols for child and adult phantoms by 803 and 590 % for upper lung, 639 and 525 % for mid-lung, and 461 and 251 % for lower lung, respectively. Similarly, the effective dose was higher by 691 and 762 % for liver and 513 and 608 % for kidney biopsies.ConclusionsBased on measurements and simulations with pediatric and adult phantoms, radiation effective doses during image-guided needle biopsies of the lung, liver, and kidney are significantly lower with CBCT than with CT.

Comparing Effective Doses During Image-Guided Core Needle Biopsies with Computed Tomography Versus C-Arm Cone Beam CT Using Adult and Pediatric Phantoms

Energy Technology Data Exchange (ETDEWEB)

Ben-Shlomo, A. [Soreq NRC, Radiation Protection Domain (Israel); Cohen, D.; Bruckheimer, E. [Schneider Children’s Medical Center, Section of Pediatric Cardiology (Israel); Bachar, G. N.; Konstantinovsky, R. [Rabin Medical Center, Department of Diagnostic Radiology (Israel); Birk, E. [Schneider Children’s Medical Center, Section of Pediatric Cardiology (Israel); Atar, E., E-mail: elia@clalit.org.il [Rabin Medical Center, Department of Diagnostic Radiology (Israel)

2016-05-15

PurposeTo compare the effective doses of needle biopsies based on dose measurements and simulations using adult and pediatric phantoms, between cone beam c-arm CT (CBCT) and CT.MethodEffective doses were calculated and compared based on measurements and Monte Carlo simulations of CT- and CBCT-guided biopsy procedures of the lungs, liver, and kidney using pediatric and adult phantoms.ResultsThe effective doses for pediatric and adult phantoms, using our standard protocols for upper, middle and lower lungs, liver, and kidney biopsies, were significantly lower under CBCT guidance than CT. The average effective dose for a 5-year old for these five biopsies was 0.36 ± 0.05 mSv with the standard CBCT exposure protocols and 2.13 ± 0.26 mSv with CT. The adult average effective dose for the five biopsies was 1.63 ± 0.22 mSv with the standard CBCT protocols and 8.22 ± 1.02 mSv using CT. The CT effective dose was higher than CBCT protocols for child and adult phantoms by 803 and 590 % for upper lung, 639 and 525 % for mid-lung, and 461 and 251 % for lower lung, respectively. Similarly, the effective dose was higher by 691 and 762 % for liver and 513 and 608 % for kidney biopsies.ConclusionsBased on measurements and simulations with pediatric and adult phantoms, radiation effective doses during image-guided needle biopsies of the lung, liver, and kidney are significantly lower with CBCT than with CT.

Diagnostic accuracy of cone-beam CT in the assessment of mandibular invasion of lower gingival carcinoma: Comparison with conventional panoramic radiography

International Nuclear Information System (INIS)

Momin, Mohammad A.; Okochi, Kiyoshi; Watanabe, Hiroshi; Imaizumi, Akiko; Omura, Ken; Amagasa, Teruo; Okada, Norihiko; Ohbayashi, Naoto; Kurabayashi, Tohru

2009-01-01

Purpose: To evaluate the diagnostic accuracy of cone-beam CT in assessing mandibular invasion by lower gingival carcinoma and compare it with that of panoramic radiography. Patients and methods: Fifty patients with squamous cell carcinoma of the lower gingiva who were examined by both panoramic radiography and cone-beam CT before surgery were included in this study. Five radiologists used a 6-point rating scale to independently evaluate cone-beam CT and panoramic images for the presence or absence of alveolar bone and mandibular canal involvement by tumor. Using the histopathogical findings as the gold standard, we calculated and compared the area under the receiver operating characteristic curve (Az value) and the sensitivity and specificity of the two imaging modalities. Results: In evaluations of both alveolar bone and mandibular canal involvement, the mean Az value for cone-beam CT (0.918 and 0.977, respectively) was significantly higher than that for panoramic radiography (0.793 and 0.872, respectively). The mean sensitivity for cone-beam CT (89% and 99%, respectively) was significantly higher than that for panoramic radiography (73% and 56%, respectively). There was no significant difference in the mean specificity. While cone-beam CT could provide high-resolution three-dimensional images, the image quality around the alveolar crest was often hampered by severe dental artifacts and image noise, resulting in difficulties in detecting subtle alveolar invasion. Conclusion: Cone-beam CT was significantly superior to panoramic radiography in evaluating mandibular invasion by lower gingival carcinoma. Its diagnostic value in detecting subtle alveolar invasion, however, may be limited by severe dental artifacts and image noise.

Improved image quality of cone beam CT scans for radiotherapy image guidance using fiber-interspaced antiscatter grid.

Science.gov (United States)

Stankovic, Uros; van Herk, Marcel; Ploeger, Lennert S; Sonke, Jan-Jakob

2014-06-01

Medical linear accelerator mounted cone beam CT (CBCT) scanner provides useful soft tissue contrast for purposes of image guidance in radiotherapy. The presence of extensive scattered radiation has a negative effect on soft tissue visibility and uniformity of CBCT scans. Antiscatter grids (ASG) are used in the field of diagnostic radiography to mitigate the scatter. They usually do increase the contrast of the scan, but simultaneously increase the noise. Therefore, and considering other scatter mitigation mechanisms present in a CBCT scanner, the applicability of ASGs with aluminum interspacing for a wide range of imaging conditions has been inconclusive in previous studies. In recent years, grids using fiber interspacers have appeared, providing grids with higher scatter rejection while maintaining reasonable transmission of primary radiation. The purpose of this study was to evaluate the impact of one such grid on CBCT image quality. The grid used (Philips Medical Systems) had ratio of 21:1, frequency 36 lp/cm, and nominal selectivity of 11.9. It was mounted on the kV flat panel detector of an Elekta Synergy linear accelerator and tested in a phantom and a clinical study. Due to the flex of the linac and presence of gridline artifacts an angle dependent gain correction algorithm was devised to mitigate resulting artifacts. Scan reconstruction was performed using XVI4.5 augmented with inhouse developed image lag correction and Hounsfield unit calibration. To determine the necessary parameters for Hounsfield unit calibration and software scatter correction parameters, the Catphan 600 (The Phantom Laboratory) phantom was used. Image quality parameters were evaluated using CIRS CBCT Image Quality and Electron Density Phantom (CIRS) in two different geometries: one modeling head and neck and other pelvic region. Phantoms were acquired with and without the grid and reconstructed with and without software correction which was adapted for the different acquisition

Low-dose megavoltage cone-beam CT for radiation therapy

International Nuclear Information System (INIS)

Pouliot, Jean; Bani-Hashemi, Ali; Chen, Josephine; Svatos, Michelle; Ghelmansarai, Farhad; Mitschke, Matthias; Aubin, Michele; Xia Ping; Morin, Olivier; Bucci, Kara; Roach, Mack; Hernandez, Paco; Zheng Zirao; Hristov, Dimitre; Verhey, Lynn

2005-01-01

Purpose: The objective of this work was to demonstrate the feasibility of acquiring low-exposure megavoltage cone-beam CT (MV CBCT) three-dimensional (3D) image data of sufficient quality to register the CBCT images to kilovoltage planning CT images for patient alignment and dose verification purposes. Methods and materials: A standard clinical 6-MV Primus linear accelerator, operating in arc therapy mode, and an amorphous-silicon (a-Si) flat-panel electronic portal-imaging device (EPID) were employed. The dose-pulse rate of a 6-MV Primus accelerator beam was windowed to expose an a-Si flat panel by using only 0.02 to 0.08 monitor units (MUs) per image. A triggered image-acquisition mode was designed to produce a high signal-to-noise ratio without pulsing artifacts. Several data sets were acquired for an anthropomorphic head phantom and frozen sheep and pig cadaver heads, as well as for a head-and-neck cancer patient on intensity-modulated radiotherapy (IMRT). For each CBCT image, a set of 90 to 180 projection images incremented by 1 deg to 2 deg was acquired. The two-dimensional (2D) projection images were then synthesized into a 3D image by use of cone-beam CT reconstruction. The resulting MV CBCT image set was used to visualize the 3D bony anatomy and some soft-tissue details. The 3D image registration with the kV planning CT was performed either automatically by application of a maximization of mutual information (MMI) algorithm or manually by aligning multiple 2D slices. Results: Low-noise 3D MV CBCT images without pulsing artifacts were acquired with a total delivered dose that ranged from 5 to 15 cGy. Acquisition times, including image readout, were on the order of 90 seconds for 180 projection images taken through a continuous gantry rotation of 180 deg . The processing time of the data required an additional 90 seconds for the reconstruction of a 256 3 cube with 1.0-mm voxel size. Implanted gold markers (1 mm x 3 mm) were easily visible for all exposure

SimDoseCT: dose reporting software based on Monte Carlo simulation for a 320 detector-row cone-beam CT scanner and ICRP computational adult phantoms

Science.gov (United States)

Cros, Maria; Joemai, Raoul M. S.; Geleijns, Jacob; Molina, Diego; Salvadó, Marçal

2017-08-01

This study aims to develop and test software for assessing and reporting doses for standard patients undergoing computed tomography (CT) examinations in a 320 detector-row cone-beam scanner. The software, called SimDoseCT, is based on the Monte Carlo (MC) simulation code, which was developed to calculate organ doses and effective doses in ICRP anthropomorphic adult reference computational phantoms for acquisitions with the Aquilion ONE CT scanner (Toshiba). MC simulation was validated by comparing CTDI measurements within standard CT dose phantoms with results from simulation under the same conditions. SimDoseCT consists of a graphical user interface connected to a MySQL database, which contains the look-up-tables that were generated with MC simulations for volumetric acquisitions at different scan positions along the phantom using any tube voltage, bow tie filter, focal spot and nine different beam widths. Two different methods were developed to estimate organ doses and effective doses from acquisitions using other available beam widths in the scanner. A correction factor was used to estimate doses in helical acquisitions. Hence, the user can select any available protocol in the Aquilion ONE scanner for a standard adult male or female and obtain the dose results through the software interface. Agreement within 9% between CTDI measurements and simulations allowed the validation of the MC program. Additionally, the algorithm for dose reporting in SimDoseCT was validated by comparing dose results from this tool with those obtained from MC simulations for three volumetric acquisitions (head, thorax and abdomen). The comparison was repeated using eight different collimations and also for another collimation in a helical abdomen examination. The results showed differences of 0.1 mSv or less for absolute dose in most organs and also in the effective dose calculation. The software provides a suitable tool for dose assessment in standard adult patients undergoing CT

Real-time out-of-plane artifact subtraction tomosynthesis imaging using prior CT for scanning beam digital x-ray system

Energy Technology Data Exchange (ETDEWEB)

Wu, Meng, E-mail: mengwu@stanford.edu [Department of Electrical Engineering, Stanford University, Stanford, California 94305 (United States); Fahrig, Rebecca [Department of Radiology, Stanford University, Stanford, California 94305 (United States)

2014-11-01

Purpose: The scanning beam digital x-ray system (SBDX) is an inverse geometry fluoroscopic system with high dose efficiency and the ability to perform continuous real-time tomosynthesis in multiple planes. This system could be used for image guidance during lung nodule biopsy. However, the reconstructed images suffer from strong out-of-plane artifact due to the small tomographic angle of the system. Methods: The authors propose an out-of-plane artifact subtraction tomosynthesis (OPAST) algorithm that utilizes a prior CT volume to augment the run-time image processing. A blur-and-add (BAA) analytical model, derived from the project-to-backproject physical model, permits the generation of tomosynthesis images that are a good approximation to the shift-and-add (SAA) reconstructed image. A computationally practical algorithm is proposed to simulate images and out-of-plane artifacts from patient-specific prior CT volumes using the BAA model. A 3D image registration algorithm to align the simulated and reconstructed images is described. The accuracy of the BAA analytical model and the OPAST algorithm was evaluated using three lung cancer patients’ CT data. The OPAST and image registration algorithms were also tested with added nonrigid respiratory motions. Results: Image similarity measurements, including the correlation coefficient, mean squared error, and structural similarity index, indicated that the BAA model is very accurate in simulating the SAA images from the prior CT for the SBDX system. The shift-variant effect of the BAA model can be ignored when the shifts between SBDX images and CT volumes are within ±10 mm in the x and y directions. The nodule visibility and depth resolution are improved by subtracting simulated artifacts from the reconstructions. The image registration and OPAST are robust in the presence of added respiratory motions. The dominant artifacts in the subtraction images are caused by the mismatches between the real object and the prior CT

On-line image guidance for frameless stereotactic radiotherapy of lung malignancies by cone beam CT: Comparison between target localization and alignment on bony anatomy

International Nuclear Information System (INIS)

Masi, Laura; Casamassima, Franco; Menichelli, Claudia; Pasciuti, Katia; Doro, Raffaela; Polli, Caterina; D'imporzano, Elena; Bonucci, Ivano

2008-01-01

Introduction. Free-breathing stereotactic radiotherapy for lung malignancies requires reliable prediction of respiratory motion and accurate target localization. A protocol was adopted for reproducibility and reduction of respiratory motion and for target localization by CBCT image guidance. Tumor respiratory displacements and tumor positioning errors relative to bony anatomy alignment are analyzed. Materials and method. Image guided SRT was performed for 99 lung malignancies. Two groups of patients were considered: group A did not perform any breathing control; group B controlled visually their respiratory cycle and volumes on an Active Breathing Coordinator (ABC) monitor during the acquisition of simulation CT and CBCT, and treatment delivery. GTV on end inhale and exhale CT data sets were fused in an ITV and the extent of tumor motion evaluated between these 2 phases. A pre-treatment CBCT was acquired and aligned to the reference CT using bony anatomy; for tumor positioning the ITV contour on the reference CT was matched to the visible tumor on CBCT. Interobserver variability of tumor positioning was evaluated. ITV and CBCT tumor dimensions were compared. Results. 3D tumor breathing displacement (mean±SD) was significantly higher for group A (14.7±9.9 mm) than for group B (4.7±3.1 mm). The detected differences between tumor and bony structure alignment below 3 mm were 68% for group B and 45% for group A, reaching statistical significance. Interobserver variability was 1.7±1.1 mm (mean±SD). Dimensions of tumor image on CBCT were consistent with ITV dimensions for group B (max difference 14%). Conclusions. The adopted protocol seems effective in reducing respiratory internal movements and margin. Tumor positioning errors relative to bony anatomy are also reduced. However bony anatomy as a surrogate of the target may still lead to some relevant positioning errors. Target visualization on CBCT is essential for an accurate localization in lung SRT

Assessment of protocols in cone beam CT with symmetric and asymmetric beam using effective dose and Pka

International Nuclear Information System (INIS)

Batista, W. O.; Linhares de O, M. V.; Soares, M. R.; Maia, A. F.; Caldas, L. V. E.

2014-08-01

The cone beam CT is an emerging technology in dental radiology with significant differences the point of view of design technology between the various manufacturers on the world market. This study aims to evaluate and compare protocols with similar purposes in a cone beam CT scanner using TLDs and air kerma - area product (P ka ) as kerma index. Measurements were performed on two protocols used to obtain the image the maxilla-mandible in equipment Gendex GXCB 500: Protocol [GX1] extended diameter and asymmetric beam (14 cm x 8.5 cm - maxilla / mandible) and protocol [GX2] symmetrical beam (8.5 cm x 8.5 cm - maxillary / mandible). Was used LiF dosimeters (TLD 100) inserted into a female anthropomorphic phantom manufactured by Radiology Support Devices. For all protocols evaluated the value of P ka using a meter Diamentor E2 and PTW system Radcal Rapidose. The results obtained for Effective Dose / P ka these measurements were separated by protocol image. Protocol [GX1]: 44.5 μSv/478 mGy cm 2 ; protocol [GX2]: 54.8 μSv/507 mGy cm 2 . These values indicate that the relationship between the diameter of the image acquired in the protocol [GX1] and the diameter of the image in the protocol [GX2] is equal to 1.65, the Effective Dose for the first protocol has lower value at 18%. P ka values reveal very similar results between the two protocols, although, common sense leads to the interpretation that imaging protocols with field of view (Fov) of large diameters imply high values of effective dose when compared to small diameters. However, in this particular case, this is not true due to the asymmetrical beam technology. Conclude that for the cases where the scanner uses asymmetric beam to obtain images with large diameters that cover the entire face there are advantages from the point of view of reducing the exposure of patients with respect to the use of symmetrical beam and / or to Fov images with a smaller diameter. (Author)

An experimental study on the influence of scatter and beam hardening in x-ray CT for dimensional metrology

International Nuclear Information System (INIS)

Lifton, J J; McBride, J W; Malcolm, A A

2016-01-01

Scattered radiation and beam hardening introduce artefacts that degrade the quality of data in x-ray computed tomography (CT). It is unclear how these artefacts influence dimensional measurements evaluated from CT data. Understanding and quantifying the influence of these artefacts on dimensional measurements is required to evaluate the uncertainty of CT-based dimensional measurements. In this work the influence of scatter and beam hardening on dimensional measurements is investigated using the beam stop array scatter correction method and spectrum pre-filtration for the measurement of an object with internal and external cylindrical dimensional features. Scatter and beam hardening are found to influence dimensional measurements when evaluated using the ISO50 surface determination method. On the other hand, a gradient-based surface determination method is found to be robust to the influence of artefacts and leads to more accurate dimensional measurements than those evaluated using the ISO50 method. In addition to these observations the GUM method for evaluating standard measurement uncertainties is applied and the standard measurement uncertainty due to scatter and beam hardening is estimated. (paper)

Cone beam computed tomography and its image guidance technology during percutaneous nucleoplasty procedures at L5/S1 lumbar level

Energy Technology Data Exchange (ETDEWEB)

Ierardi, Anna Maria; Piacentino, Filippo; Giorlando, Francesca [University of Insubria, Unit of Interventional Radiology, Department of Radiology, Varese (Italy); Magenta Biasina, Alberto; Carrafiello, Gianpaolo [University of Milan, San Paolo Hospital, Department of Diagnostic and Interventional Radiology, Milan (Italy); Bacuzzi, Alessandro [University of Insubria, Anaesthesia and Palliative Care, Varese (Italy); Novario, Raffaele [University of Insubria, Medical Physics Department, Varese (Italy)

2016-12-15

To demonstrate the feasibility of percutaneous nucleoplasty procedures at L5/S1 level using cone beam CT (CBCT) and its associated image guidance technology for the treatment of lumbar disc herniation (LDH). We retrospectively reviewed 25 cases (20 men, 5 women) of LDH at L5/S1 levels. CBCT as guidance imaging was chosen after a first unsuccessful fluoroscopy attempt that was related to complex anatomy (n = 15), rapid pathological changes due to degenerative diseases (n = 7) or both (n = 3). Technical success, defined as correct needle positioning in the target LDH, and safety were evaluated; overall procedure time and radiation dose were registered. A visual analog scale (VAS) was used to evaluate pain and discomfort pre-intervention after 1 week and 1, 3, and 6 months after the procedure. Technical success was 100 %; using CBCT as guidance imaging the needle was correctly positioned at the first attempt in 20 out of 25 patients. Neither major nor minor complications were registered during or after the procedure. The average procedure time was 11 min and 56 s (range, 9-15 min), whereas mean procedural radiation dose was 46.25 Gy.cm{sup 2} (range 38.10-52.84 Gy.cm{sup 2}), and mean fluoroscopy time was 5 min 34 s (range 3 min 40 s to 6 min 55 s). The VAS pain score decreased significantly from 7.6 preoperatively to 3.9 at 1 week, 2.8 at 1 month, 2.1 at 3 months, and 1.6 at 6 months postoperatively. CBCT-guided percutaneous nucleoplasty is a highly effective technique for LDH with acceptable procedure time and radiation dose. (orig.)

The expressions of P53 protein and proliferating cell nuclear antigen in specimens by CT-guidance percutaneous lung biopsy

International Nuclear Information System (INIS)

Zhuang Yiping; Shen Zongli; Zhang Jin; Kang Zheng; Zhu Yueqing; Feng Yong; Shen Wenrong; Wang Yaping

2004-01-01

Objective: To evaluate relations between lung cancer and the expressions of P53 protein together with proliferating cell nuclear antigen (PCNA) in specimens of lung lesions by needle biopsy. Methods: CT-guidance percutaneous biopsy of lung lesions were performed in 66 patients with the determination of expressions of p53 protein and PCNA by flow cytometer (FCM). Results: 1. The sensitivity of CT-guidance percutaneous biopsy was 94.3% in 53 cases of lung cancer with the diagnostic accuracy of 90.9% totally. The complication rate of pneumothorax was 4.6%. 2. The expression of P53 protein was (29.9 ± 2.7)% in lung cancer (53 cases), while (17.9 ± 2.8)% in benign lesions (13 cases) (t=2.0, P 2 =6.10, P 2 =9.71, P 0.05). Conclusions: FCM plays and valuable role in determining the expression of P53 protein and PCNA in the specimen of lung cancer by CT-guided percutaneous biopsy. The expression of p53 and PCNA may be useful in the diagnosis of lung cancer by providing the relation between imaging of lung cancer and the molecular mechanism, and furthermore revealing the characteristics of molecular biology of lung cancer at protein level. (authors)

A backprojection-filtration algorithm for nonstandard spiral cone-beam CT with an n-PI-window

International Nuclear Information System (INIS)

Yu Hengyong; Ye Yangbo; Zhao Shiying; Wang Ge

2005-01-01

For applications in bolus-chasing computed tomography (CT) angiography and electron-beam micro-CT, the backprojection-filtration (BPF) formula developed by Zou and Pan was recently generalized by Ye et al to reconstruct images from cone-beam data collected along a rather flexible scanning locus, including a nonstandard spiral. A major implication of the generalized BPF formula is that it can be applied for n-PI-window-based reconstruction in the nonstandard spiral scanning case. In this paper, we design an n-PI-window-based BPF algorithm, and report the numerical simulation results with the 3D Shepp-Logan phantom and Defrise disk phantom. The proposed BPF algorithm consists of three steps: cone-beam data differentiation, weighted backprojection and inverse Hilbert filtration. Our simulated results demonstrate the feasibility and merits of the proposed algorithm

Towards 4D intervention guidance using compressed sensing

Energy Technology Data Exchange (ETDEWEB)

Kuntz, Jan; Bartling, Soenke [Deutsches Krebsforschungszentrum DKFZ, Heidelberg (Germany); Brehm, Marcus; Kachelriess, Marc [Erlangen-Nuernberg Univ., Erlangen (Germany). Inst. of Medical Physics (IMP)

2011-07-01

Interventional radiology is nowadays usually guided with projection radiography using mono- or biplane systems. Due to the projective nature of this guidance imaging certain intraprocedural situations remain unclear. Although helpful, the use of 3D CT is limited due to radiation dose. Using advanced reconstruction techniques incorporating prior knowledge, one could overcome these limitations without exceeding dose limitations. Intervention guidance is especially appealing to those algorithms, because certain constrains apply to useful images in intervention guidance that vary relevantly from other CT applications. These are: key relevance of high contrast structures, sparse temporal updates and little relevance of absolute CT values. In this paper the principal usability of reconstruction algorithms for intervention guidance is tested. Compressed sensing algorithms PICCS and ASD-POCS are compared to the McKinnon-Bates and Feldkamp-Davis-Kress algorithm. Animal experiments as well as simulations are performed. An outlook towards 4D intervention guidance is provided. (orig.)

Evaluation of positioning errors of the patient using cone beam CT megavoltage; Evaluacion de errores de posicionamiento del paciente mediante Cone Beam CT de megavoltaje

Energy Technology Data Exchange (ETDEWEB)

Garcia Ruiz-Zorrilla, J.; Fernandez Leton, J. P.; Zucca Aparicio, D.; Perez Moreno, J. M.; Minambres Moro, A.

2013-07-01

Image-guided radiation therapy allows you to assess and fix the positioning of the patient in the treatment unit, thus reducing the uncertainties due to the positioning of the patient. This work assesses errors systematic and errors of randomness from the corrections made to a series of patients of different diseases through a protocol off line of cone beam CT (CBCT) megavoltage. (Author)

Systemic Air Embolism After CT-guided Lung Biopsy

Science.gov (United States)

2017-11-27

Patients Who Underwent Percutaneous Lung Biopsy Under CT Guidance; Patients Who Presented Systemic Air Embolism After Percutaneous Lung Biopsy Under CT Guidance Depicted at the Time of the Procedure on a Whole Thoracic CT

Comparison of hand and semiautomatic tracing methods for creating maxillofacial artificial organs using sequences of computed tomography (CT) and cone beam computed tomography (CBCT) images.

Science.gov (United States)

Szabo, Bence T; Aksoy, Seçil; Repassy, Gabor; Csomo, Krisztian; Dobo-Nagy, Csaba; Orhan, Kaan

2017-06-09

The aim of this study was to compare the paranasal sinus volumes obtained by manual and semiautomatic imaging software programs using both CT and CBCT imaging. 121 computed tomography (CT) and 119 cone beam computed tomography (CBCT) examinations were selected from the databases of the authors' institutes. The Digital Imaging and Communications in Medicine (DICOM) images were imported into 3-dimensonal imaging software, in which hand mode and semiautomatic tracing methods were used to measure the volumes of both maxillary sinuses and the sphenoid sinus. The determined volumetric means were compared to previously published averages. Isometric CBCT-based volume determination results were closer to the real volume conditions, whereas the non-isometric CT-based volume measurements defined coherently lower volumes. By comparing the 2 volume measurement modes, the values gained from hand mode were closer to the literature data. Furthermore, CBCT-based image measurement results corresponded to the known averages. Our results suggest that CBCT images provide reliable volumetric information that can be depended on for artificial organ construction, and which may aid the guidance of the operator prior to or during the intervention.

Repositioning accuracy of two different mask systems-3D revisited: Comparison using true 3D/3D matching with cone-beam CT

International Nuclear Information System (INIS)

Boda-Heggemann, Judit; Walter, Cornelia; Rahn, Angelika; Wertz, Hansjoerg; Loeb, Iris; Lohr, Frank; Wenz, Frederik

2006-01-01

Purpose: The repositioning accuracy of mask-based fixation systems has been assessed with two-dimensional/two-dimensional or two-dimensional/three-dimensional (3D) matching. We analyzed the accuracy of commercially available head mask systems, using true 3D/3D matching, with X-ray volume imaging and cone-beam CT. Methods and Materials: Twenty-one patients receiving radiotherapy (intracranial/head-and-neck tumors) were evaluated (14 patients with rigid and 7 with thermoplastic masks). X-ray volume imaging was analyzed online and offline separately for the skull and neck regions. Translation/rotation errors of the target isocenter were analyzed. Four patients were treated to neck sites. For these patients, repositioning was aided by additional body tattoos. A separate analysis of the setup error on the basis of the registration of the cervical vertebra was performed. The residual error after correction and intrafractional motility were calculated. Results: The mean length of the displacement vector for rigid masks was 0.312 ± 0.152 cm (intracranial) and 0.586 ± 0.294 cm (neck). For the thermoplastic masks, the value was 0.472 ± 0.174 cm (intracranial) and 0.726 ± 0.445 cm (neck). Rigid masks with body tattoos had a displacement vector length in the neck region of 0.35 ± 0.197 cm. The intracranial residual error and intrafractional motility after X-ray volume imaging correction for rigid masks was 0.188 ± 0.074 cm, and was 0.134 ± 0.14 cm for thermoplastic masks. Conclusions: The results of our study have demonstrated that rigid masks have a high intracranial repositioning accuracy per se. Given the small residual error and intrafractional movement, thermoplastic masks may also be used for high-precision treatments when combined with cone-beam CT. The neck region repositioning accuracy was worse than the intracranial accuracy in both cases. However, body tattoos and image guidance improved the accuracy. Finally, the combination of both mask systems with 3D

SU-F-I-06: Evaluation of Imaging Dose for Modulation Layer Based Dual Energy Cone-Beam CT

Energy Technology Data Exchange (ETDEWEB)

Ju, Eunbin [Department of Medical Science, Ewha Womans University, Seoul (Korea, Republic of); Ahn, SoHyun; Cho, Samju; Keum, Ki Chang [Department of Radiation Oncology, School of Medicine, Yonsei Univeristy, Seoul (Korea, Republic of); Lee, Rena [Department of Radiation Oncology, School of Medicine, Ewha Womans University, Seoul (Korea, Republic of)

2016-06-15

Purpose: Dual energy cone beam CT system is finding a variety of promising applications in diagnostic CT, both in imaging of endogenous materials and exogenous materials across a range of body sites. Dual energy cone beam CT system to suggest in this study acquire image by rotating 360 degree with half of the X-ray window covered using copper modulation layer. In the region that covered by modulation layer absorb the low energy X-ray by modulation layer. Relative high energy X-ray passes through the layer and contributes to image reconstruction. Dose evaluation should be carried out in order to utilize such an imaging acquirement technology for clinical use. Methods: For evaluating imaging dose of modulation layer based dual energy cone beam CT system, Prototype cone beam CT that configured X-ray tube (D054SB, Toshiba, Japan) and detector (PaxScan 2520V, Varian Medical Systems, Palo Alto, CA) is used. A range of 0.5–2.0 mm thickness of modulation layer is implemented in Monte Carlo simulation (MCNPX, ver. 2.6.0, Los Alamos National Laboratory, USA) with half of X-ray window covered. In-house phantom using in this study that has 3 cylindrical phantoms configured water, Teflon air with PMMA covered for verifying the comparability the various material in human body and is implemented in Monte Carlo simulation. The actual dose with 2.0 mm copper covered half of X-ray window is measured using Gafchromic EBT3 film with 5.0 mm bolus for compared with simulative dose. Results: Dose in phantom reduced 33% by copper modulation layer of 2.0 mm. Scattering dose occurred in modulation layer by Compton scattering effect is 0.04% of overall dose. Conclusion: Modulation layer of that based dual energy cone beam CT has not influence on unnecessary scatter dose. This study was supported by the Radiation Safety Research Programs (1305033) through the Nuclear Safety and Security Commission.

Truncation artifact suppression in cone-beam radionuclide transmission CT using maximum likelihood techniques: evaluation with human subjects

International Nuclear Information System (INIS)

Manglos, S.H.

1992-01-01

Transverse image truncation can be a serious problem for human imaging using cone-beam transmission CT (CB-CT) implemented on a conventional rotating gamma camera. This paper presents a reconstruction method to reduce or eliminate the artifacts resulting from the truncation. The method uses a previously published transmission maximum likelihood EM algorithm, adapted to the cone-beam geometry. The reconstruction method is evaluated qualitatively using three human subjects of various dimensions and various degrees of truncation. (author)

Image-guided small animal radiation research platform: calibration of treatment beam alignment

International Nuclear Information System (INIS)

Matinfar, Mohammad; Iordachita, Iulian; Kazanzides, Peter; Ford, Eric; Wong, John

2009-01-01

Small animal research allows detailed study of biological processes, disease progression and response to therapy with the potential to provide a natural bridge to the clinical environment. The small animal radiation research platform (SARRP) is a portable system for precision irradiation with beam sizes down to approximately 0.5 mm and optimally planned radiation with on-board cone-beam CT (CBCT) guidance. This paper focuses on the geometric calibration of the system for high-precision irradiation. A novel technique for the calibration of the treatment beam is presented, which employs an x-ray camera whose precise positioning need not be known. Using the camera system we acquired a digitally reconstructed 3D 'star shot' for gantry calibration and then developed a technique to align each beam to a common isocenter with the robotic animal positioning stages. The calibration incorporates localization by cone-beam CT guidance. Uncorrected offsets of the beams with respect to the calibration origin ranged from 0.4 mm to 5.2 mm. With corrections, these alignment errors can be reduced to the sub-millimeter range. The calibration technique was used to deliver a stereotactic-like arc treatment to a phantom constructed with EBT Gafchromic films. All beams were shown to intersect at a common isocenter with a measured beam (FWHM) of approximately 1.07 mm using the 0.5 mm collimated beam. The desired positioning accuracy of the SARRP is 0.25 mm and the results indicate an accuracy of 0.2 mm. To fully realize the radiation localization capabilities of the SARRP, precise geometric calibration is required, as with any such system. The x-ray camera-based technique presented here provides a straightforward and semi-automatic method for system calibration.

Accuracy of Ultrasound-Based Image Guidance for Daily Positioning of the Upper Abdomen: An Online Comparison With Cone Beam CT

International Nuclear Information System (INIS)

Boda-Heggemann, Judit; Mennemeyer, Philipp; Wertz, Hansjoerg; Riesenacker, Nadja; Kuepper, Beate; Lohr, Frank; Wenz, Frederik

2009-01-01

Purpose: Image-guided intensity-modulated radiotherapy can improve protection of organs at risk when large abdominal target volumes are irradiated. We estimated the daily positioning accuracy of ultrasound-based image guidance for abdominal target volumes by a direct comparison of daily imaging obtained with cone beam computed tomography (CBCT). Methods and Materials: Daily positioning (n = 83 positionings) of 15 patients was completed by using ultrasound guidance after an initial CBCT was obtained. Residual error after ultrasound was estimated by comparison with a second CBCT. Ultrasound image quality was visually rated using a scale of 1 to 4. Results: Of 15 patients, 7 patients had good sonographic imaging quality, 5 patients had satisfactory sonographic quality, and 3 patients were excluded because of unsatisfactory sonographic quality. When image quality was good, residual errors after ultrasound were -0.1 ± 3.11 mm in the x direction (left-right; group systematic error M = -0.09 mm; standard deviation [SD] of systematic error, Σ = 1.37 mm; SD of the random error, σ = 2.99 mm), 0.93 ± 4.31 mm in the y direction (superior-inferior, M = 1.12 mm; Σ = 2.96 mm; σ = 3.39 mm), and 0.71 ± 3.15 mm in the z direction (anteroposterior; M = 1.01 mm; Σ = 2.46 mm; σ = 2.24 mm). For patients with satisfactory image quality, residual error after ultrasound was -0.6 ± 5.26 mm in the x (M = 0.07 mm; Σ = 5.67 mm; σ = 4.86 mm), 1.76 ± 4.92 mm in the y (M = 3.54 mm; Σ = 4.1 mm; σ = 5.29 mm), and 1.19 ± 4.75 mm in the z (M = 0.82 mm; Σ = 2.86 mm; σ = 3.05 mm) directions. Conclusions: In patients from whom good sonographic image quality could be obtained, ultrasound improved daily positioning accuracy. In the case of satisfactory image quality, ultrasound guidance improved accuracy compared to that of skin marks only minimally. If sonographic image quality was unsatisfactory, daily CBCT scanning improved treatment accuracy distinctly over that of ultrasound. Use of

SU-F-J-205: Effect of Cone Beam Factor On Cone Beam CT Number Accuracy

Energy Technology Data Exchange (ETDEWEB)

Yao, W; Hua, C; Farr, J; Brady, S; Merchant, T [St. Jude Children’s Research Hospital, Memphis, TN (United States)

2016-06-15

Purpose: To examine the suitability of a Catphan™ 700 phantom for image quality QA of a cone beam computed tomography (CBCT) system deployed for proton therapy. Methods: Catphan phantoms, particularly Catphan™ 504, are commonly used in image quality QA for CBCT. As a newer product, Catphan™ 700 offers more tissue equivalent inserts which may be useful for generating the electron density – CT number curve for CBCT based treatment planning. The sensitometry-and-geometry module used in Catphan™ 700 is located at the end of the phantom and after the resolution line pair module. In Catphan™ 504 the line pair module is located at the end of the phantom and after the sensitometry-and-geometry module. To investigate the effect of difference in location on CT number accuracy due to the cone beam factor, we scanned the Catphan™ 700 with the central plane of CBCT at the center of the phantom, line pair and sensitometry-andgeometry modules of the phantom, respectively. The protocol head and thorax scan modes were used. For each position, scans were repeated 4 times. Results: For the head scan mode, the standard deviation (SD) of the CT numbers of each insert under 4 repeated scans was up to 20 HU, 11 HU, and 11 HU, respectively, for the central plane of CBCT located at the center of the phantom, line pair, and sensitometry-and-geometry modules of the phantom. The mean of the SD was 9.9 HU, 5.7 HU, and 5.9 HU, respectively. For the thorax mode, the mean of the SD was 4.5 HU, 4.4 HU, and 4.4 HU, respectively. The assessment of image quality based on resolution and spatial linearity was not affected by imaging location changes. Conclusion: When the Catphan™ 700 was aligned to the center of imaging region, the CT number accuracy test may not meet expectations. We recommend reconfiguration of the modules.

A hybrid reconstruction algorithm for fast and accurate 4D cone-beam CT imaging.

Science.gov (United States)

Yan, Hao; Zhen, Xin; Folkerts, Michael; Li, Yongbao; Pan, Tinsu; Cervino, Laura; Jiang, Steve B; Jia, Xun

2014-07-01

4D cone beam CT (4D-CBCT) has been utilized in radiation therapy to provide 4D image guidance in lung and upper abdomen area. However, clinical application of 4D-CBCT is currently limited due to the long scan time and low image quality. The purpose of this paper is to develop a new 4D-CBCT reconstruction method that restores volumetric images based on the 1-min scan data acquired with a standard 3D-CBCT protocol. The model optimizes a deformation vector field that deforms a patient-specific planning CT (p-CT), so that the calculated 4D-CBCT projections match measurements. A forward-backward splitting (FBS) method is invented to solve the optimization problem. It splits the original problem into two well-studied subproblems, i.e., image reconstruction and deformable image registration. By iteratively solving the two subproblems, FBS gradually yields correct deformation information, while maintaining high image quality. The whole workflow is implemented on a graphic-processing-unit to improve efficiency. Comprehensive evaluations have been conducted on a moving phantom and three real patient cases regarding the accuracy and quality of the reconstructed images, as well as the algorithm robustness and efficiency. The proposed algorithm reconstructs 4D-CBCT images from highly under-sampled projection data acquired with 1-min scans. Regarding the anatomical structure location accuracy, 0.204 mm average differences and 0.484 mm maximum difference are found for the phantom case, and the maximum differences of 0.3-0.5 mm for patients 1-3 are observed. As for the image quality, intensity errors below 5 and 20 HU compared to the planning CT are achieved for the phantom and the patient cases, respectively. Signal-noise-ratio values are improved by 12.74 and 5.12 times compared to results from FDK algorithm using the 1-min data and 4-min data, respectively. The computation time of the algorithm on a NVIDIA GTX590 card is 1-1.5 min per phase. High-quality 4D-CBCT imaging based

A hybrid reconstruction algorithm for fast and accurate 4D cone-beam CT imaging

Energy Technology Data Exchange (ETDEWEB)

Yan, Hao; Folkerts, Michael; Jiang, Steve B., E-mail: xun.jia@utsouthwestern.edu, E-mail: steve.jiang@UTSouthwestern.edu; Jia, Xun, E-mail: xun.jia@utsouthwestern.edu, E-mail: steve.jiang@UTSouthwestern.edu [Department of Radiation Oncology, The University of Texas, Southwestern Medical Center, Dallas, Texas 75390 (United States); Zhen, Xin [Department of Biomedical Engineering, Southern Medical University, Guangzhou, Guangdong 510515 (China); Li, Yongbao [Department of Radiation Oncology, The University of Texas, Southwestern Medical Center, Dallas, Texas 75390 and Department of Engineering Physics, Tsinghua University, Beijing 100084 (China); Pan, Tinsu [Department of Imaging Physics, The University of Texas, MD Anderson Cancer Center, Houston, Texas 77030 (United States); Cervino, Laura [Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, California 92093 (United States)

2014-07-15

Purpose: 4D cone beam CT (4D-CBCT) has been utilized in radiation therapy to provide 4D image guidance in lung and upper abdomen area. However, clinical application of 4D-CBCT is currently limited due to the long scan time and low image quality. The purpose of this paper is to develop a new 4D-CBCT reconstruction method that restores volumetric images based on the 1-min scan data acquired with a standard 3D-CBCT protocol. Methods: The model optimizes a deformation vector field that deforms a patient-specific planning CT (p-CT), so that the calculated 4D-CBCT projections match measurements. A forward-backward splitting (FBS) method is invented to solve the optimization problem. It splits the original problem into two well-studied subproblems, i.e., image reconstruction and deformable image registration. By iteratively solving the two subproblems, FBS gradually yields correct deformation information, while maintaining high image quality. The whole workflow is implemented on a graphic-processing-unit to improve efficiency. Comprehensive evaluations have been conducted on a moving phantom and three real patient cases regarding the accuracy and quality of the reconstructed images, as well as the algorithm robustness and efficiency. Results: The proposed algorithm reconstructs 4D-CBCT images from highly under-sampled projection data acquired with 1-min scans. Regarding the anatomical structure location accuracy, 0.204 mm average differences and 0.484 mm maximum difference are found for the phantom case, and the maximum differences of 0.3–0.5 mm for patients 1–3 are observed. As for the image quality, intensity errors below 5 and 20 HU compared to the planning CT are achieved for the phantom and the patient cases, respectively. Signal-noise-ratio values are improved by 12.74 and 5.12 times compared to results from FDK algorithm using the 1-min data and 4-min data, respectively. The computation time of the algorithm on a NVIDIA GTX590 card is 1–1.5 min per phase

Estimation of effective dose from limited cone beam X-ray CT examination

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Iwai, Kazuo; Arai, Yoshinori; Hashimoto, Koji [Nihon Univ., Tokyo (Japan). School of Dentistry; Nishizawa, Kanae

2000-12-01

The limited cone beam X-ray CT (Ortho-CT) was developed on the basis of multi-functional panoramic apparatus, SCANORA (Soredex Co. Helsinki Finland). The imaging intensifier (I.I.) was built in this apparatus as a X-ray detection device instead of X-ray film. The signal provided from I.I. was converted from analog into digital by an analog-digital converter and image reconstitution was done as a three-directional image of the dimensions 3.8 cm of width, 3.0 cm height and 3.8 cm depth with the personal computer. The 3DX Multi image micro CT'' (3DX) was developed along similar lines by MORITA Co., Ltd. (Kyoto, JAPAN). In this study, the stochastic effect on organ and tissue caused by examinations using Ortho-CT and 3DX was measured. The effective dose was estimated according to the recommendation of ICRP60 and was compared with those of panoramic radiography and computed tomography. The irradiation conditions were as follows: 85 kV, 10 mA with the filtration of 3 mmAl and added 1 mmCu for Ortho-CT, and 80 kV, 2 mA and the filtration of 3.1 mmAL for 3DX. The measurement of organ and tissue dose was performed using an anthropomorphic Rando woman phantom (Alderson Research Laboratories Co., Stanfora, CN), as well as by using two different type of thermoluminescent dosimeter (TLD); Panasonic UD-170A (BeO) and UD-110S (CaSO{sub 4}: Tm). The UD-170A was for dose measurement of the inner useful X-ray beams, while the UD-110S was for outer beams. The measured organ and tissue were those recommended with ICRP60 (gonad, breast, bone marrow, lung, thyroid gland, esophagus, stomach, colon, liver, bladder, skin, brain, thymus, adrenal, kidney, spleen, pancrease, upper large intestine, uterus, eyes and major salivary gland). The imaging by Orhto-CT was made in the left maxillary 1st molar, left mandibular 1st molar and temporomandibular joint. 3DX measurement was made in the maxillary incisor region and middle ear regions other than the regions mentioned above. The skin

Deep inspiration breath-hold radiotherapy for lung cancer: impact on image quality and registration uncertainty in cone beam CT image guidance

DEFF Research Database (Denmark)

Josipovic, Mirjana; Persson, Gitte F; Bangsgaard, Jens Peter

2016-01-01

OBJECTIVE: We investigated the impact of deep inspiration breath-hold (DIBH) and tumour baseline shifts on image quality and registration uncertainty in image-guided DIBH radiotherapy (RT) for locally advanced lung cancer. METHODS: Patients treated with daily cone beam CT (CBCT)-guided free...... for the craniocaudal direction in FB, where it was >3 mm. On the 31st fraction, the intraobserver uncertainty increased compared with the second fraction. This increase was more pronounced in FB. Image quality scores improved in DIBH compared with FB for all parameters in all patients. Simulated tumour baseline shifts...... ≤2 mm did not affect the CBCT image quality considerably. CONCLUSION: DIBH CBCT improved image quality and reduced registration uncertainty in the craniocaudal direction in image-guided RT of locally advanced lung cancer. Baseline shifts ≤2 mm in DIBH during CBCT acquisition did not affect image...

Improved image quality of cone beam CT scans for radiotherapy image guidance using fiber-interspaced antiscatter grid

International Nuclear Information System (INIS)

Stankovic, Uros; Herk, Marcel van; Ploeger, Lennert S.; Sonke, Jan-Jakob

2014-01-01

Purpose: Medical linear accelerator mounted cone beam CT (CBCT) scanner provides useful soft tissue contrast for purposes of image guidance in radiotherapy. The presence of extensive scattered radiation has a negative effect on soft tissue visibility and uniformity of CBCT scans. Antiscatter grids (ASG) are used in the field of diagnostic radiography to mitigate the scatter. They usually do increase the contrast of the scan, but simultaneously increase the noise. Therefore, and considering other scatter mitigation mechanisms present in a CBCT scanner, the applicability of ASGs with aluminum interspacing for a wide range of imaging conditions has been inconclusive in previous studies. In recent years, grids using fiber interspacers have appeared, providing grids with higher scatter rejection while maintaining reasonable transmission of primary radiation. The purpose of this study was to evaluate the impact of one such grid on CBCT image quality. Methods: The grid used (Philips Medical Systems) had ratio of 21:1, frequency 36 lp/cm, and nominal selectivity of 11.9. It was mounted on the kV flat panel detector of an Elekta Synergy linear accelerator and tested in a phantom and a clinical study. Due to the flex of the linac and presence of gridline artifacts an angle dependent gain correction algorithm was devised to mitigate resulting artifacts. Scan reconstruction was performed using XVI4.5 augmented with inhouse developed image lag correction and Hounsfield unit calibration. To determine the necessary parameters for Hounsfield unit calibration and software scatter correction parameters, the Catphan 600 (The Phantom Laboratory) phantom was used. Image quality parameters were evaluated using CIRS CBCT Image Quality and Electron Density Phantom (CIRS) in two different geometries: one modeling head and neck and other pelvic region. Phantoms were acquired with and without the grid and reconstructed with and without software correction which was adapted for the different

A comparative study for spatial resolution and subjective image characteristics of a multi-slice CT and a cone-beam CT for dental use

International Nuclear Information System (INIS)

Watanabe, Hiroshi; Honda, Eiichi; Tetsumura, Akemi; Kurabayashi, Tohru

2011-01-01

Purpose: Multi-slice CT (MSCT) and cone-beam CT (CBCT) are widely used in dental practice. This study compared the spatial resolution of these CT systems to elucidate which CT modalities should be selected for various clinical cases. Materials and methods: As MSCT and CBCT apparatuses, Somatom Sensation 64 and 3D Accuitomo instruments, respectively, were used. As an objective evaluation of spatial resolution of these CT systems, modulation transfer function (MTF) analysis was performed employing an over-sampling method. The results of MTF analysis were confirmed with a line-pair test using CATPHAN. As a subjective evaluation, a microstructure visualization ability study was performed using a Jcl:SD rat and a head CT phantom. Results: MTF analysis showed that for the in-plane direction, the z-axis ultrahigh resolution mode (zUHR) of the Sensation 64 and 3D Accuitomo instruments had higher spatial resolutions than the conventional mode (64x) of the Sensation 64, but for the longitudinal direction, the 3D Accuitomo had clearly higher spatial resolution than either mode of the Sensation 64. A line-pair test study and microstructure visualization ability studies confirmed the results for MTF analysis. However, images of the rat and the CT phantom revealed that the 3D Accuitomo demonstrated the failure to visualize the soft tissues along with aliasing and beam-hardening artifacts, which were not observed in the Sensation 64. Conclusions: This study successfully applied spatial resolution analysis using MSCT and CBCT systems in a comparative manner. These findings could help in deciding which CT modality should be selected for various clinical cases.

Spine Stereotactic Body Radiotherapy Utilizing Cone-Beam CT Image-Guidance With a Robotic Couch: Intrafraction Motion Analysis Accounting for all Six Degrees of Freedom

Energy Technology Data Exchange (ETDEWEB)

Hyde, Derek [Department of Radiation Oncology, Sunnybrook Health Sciences Centre, University of Toronto, Ontario (Canada); British Columbia Cancer Agency, The Sindi Hawkins Cancer Centre for the Southern Interior, Kelowna (Canada); Lochray, Fiona; Korol, Renee; Davidson, Melanie; Wong, C. Shun [Department of Radiation Oncology, Sunnybrook Health Sciences Centre, University of Toronto, Ontario (Canada); Ma, Lijun [Department of Radiation Oncology, University of California San Francisco, San Francisco, CA (United States); Sahgal, Arjun, E-mail: Arjun.sahgal@rmp.uhn.on.ca [Department of Radiation Oncology, Sunnybrook Health Sciences Centre, University of Toronto, Ontario (Canada); Department of Radiation Oncology, Princess Margaret Hospital, University of Toronto, Toronto (Canada)

2012-03-01

Purpose: To evaluate the residual setup error and intrafraction motion following kilovoltage cone-beam CT (CBCT) image guidance, for immobilized spine stereotactic body radiotherapy (SBRT) patients, with positioning corrected for in all six degrees of freedom. Methods and Materials: Analysis is based on 42 consecutive patients (48 thoracic and/or lumbar metastases) treated with a total of 106 fractions and 307 image registrations. Following initial setup, a CBCT was acquired for patient alignment and a pretreatment CBCT taken to verify shifts and determine the residual setup error, followed by a midtreatment and posttreatment CBCT image. For 13 single-fraction SBRT patients, two midtreatment CBCT images were obtained. Initially, a 1.5-mm and 1 Degree-Sign tolerance was used to reposition the patient following couch shifts which was subsequently reduced to 1 mm and 1 Degree-Sign degree after the first 10 patients. Results: Small positioning errors after the initial CBCT setup were observed, with 90% occurring within 1 mm and 97% within 1 Degree-Sign . In analyzing the impact of the time interval for verification imaging (10 {+-} 3 min) and subsequent image acquisitions (17 {+-} 4 min), the residual setup error was not significantly different (p > 0.05). A significant difference (p = 0.04) in the average three-dimensional intrafraction positional deviations favoring a more strict tolerance in translation (1 mm vs. 1.5 mm) was observed. The absolute intrafraction motion averaged over all patients and all directions along x, y, and z axis ({+-} SD) were 0.7 {+-} 0.5 mm and 0.5 {+-} 0.4 mm for the 1.5 mm and 1 mm tolerance, respectively. Based on a 1-mm and 1 Degree-Sign correction threshold, the target was localized to within 1.2 mm and 0.9 Degree-Sign with 95% confidence. Conclusion: Near-rigid body immobilization, intrafraction CBCT imaging approximately every 15-20 min, and strict repositioning thresholds in six degrees of freedom yields minimal intrafraction motion

Intraoperative cone-beam computed tomography and multi-slice computed tomography in temporal bone imaging for surgical treatment.

Science.gov (United States)

Erovic, Boban M; Chan, Harley H L; Daly, Michael J; Pothier, David D; Yu, Eugene; Coulson, Chris; Lai, Philip; Irish, Jonathan C

2014-01-01

Conventional computed tomography (CT) imaging is the standard imaging technique for temporal bone diseases, whereas cone-beam CT (CBCT) imaging is a very fast imaging tool with a significant less radiation dose compared with conventional CT. We hypothesize that a system for intraoperative cone-beam CT provides comparable image quality to diagnostic CT for identifying temporal bone anatomical landmarks in cadaveric specimens. Cross-sectional study. University tertiary care facility. Twenty cadaveric temporal bones were affixed into a head phantom and scanned with both a prototype cone-beam CT C-arm and multislice helical CT. Imaging performance was evaluated by 3 otologic surgeons and 1 head and neck radiologist. Participants were presented images in a randomized order and completed landmark identification questionnaires covering 21 structures. CBCT and multislice CT have comparable performance in identifying temporal structures. Three otologic surgeons indicated that CBCT provided statistically equivalent performance for 19 of 21 landmarks, with CBCT superior to CT for the chorda tympani and inferior for the crura of the stapes. Subgroup analysis showed that CBCT performed superiorly for temporal bone structures compared with CT. The radiologist rated CBCT and CT as statistically equivalent for 18 of 21 landmarks, with CT superior to CBCT for the crura of stapes, chorda tympani, and sigmoid sinus. CBCT provides comparable image quality to conventional CT for temporal bone anatomical sites in cadaveric specimens. Clinical applications of low-dose CBCT imaging in surgical planning, intraoperative guidance, and postoperative assessment are promising but require further investigation.

Cone-Beam Computed Tomographic Image Guidance for Lung Cancer Radiation Therapy

International Nuclear Information System (INIS)

Bissonnette, Jean-Pierre; Purdie, Thomas G.; Higgins, Jane A.; Li, Winnie; Bezjak, Andrea

2009-01-01

Purpose: To determine the geometric accuracy of lung cancer radiotherapy using daily volumetric, cone-beam CT (CBCT) image guidance and online couch position adjustment. Methods and Materials: Initial setup accuracy using localization CBCT was analyzed in three lung cancer patient cohorts. The first (n = 19) involved patients with early-stage non-small-cell lung cancer (NSCLC) treated using stereotactic body radiotherapy (SBRT). The second (n = 48) and third groups (n = 20) involved patients with locally advanced NSCLC adjusted with manual and remote-controlled couch adjustment, respectively. For each group, the couch position was adjusted when positional discrepancies exceeded ±3 mm in any direction, with the remote-controlled couch correcting all three directions simultaneously. Adjustment accuracy was verified with a second CBCT. Population-based setup margins were derived from systematic (Σ) and random (σ) positional errors for each group. Results: Localization imaging demonstrates that 3D positioning errors exceeding 5 mm occur in 54.5% of all delivered fractions. CBCT reduces these errors; post-correction Σ and σ ranged from 1.2 to 1.9 mm for Group 1, with 82% of all fractions within ±3 mm. For Group 2, Σ and σ ranged between 0.8 and 1.8 mm, with 76% of all treatment fractions within ±3 mm. For Group 3, the remote-controlled couch raised this to 84%, and Σ and σ were reduced to 0.4 to 1.7 mm. For each group, the postcorrection setup margins were 4 to 6 mm, 3 to 4 mm, and 2 to 3 mm, respectively. Conclusions: Using IGRT, high geometric accuracy is achievable for NSCLC patients, potentially leading to reduced PTV margins, improved outcomes and empowering adaptive radiation therapy for lung cancer

Fusion of CT Angiography or MR Angiography with Unenhanced CBCT and Fluoroscopy Guidance in Endovascular Treatments of Aorto-Iliac Steno-Occlusion: Technical Note on a Preliminary Experience

Energy Technology Data Exchange (ETDEWEB)

Ierardi, Anna Maria; Duka, Ejona [University of Insubria, Interventional Radiology, Department of Radiology (Italy); Radaelli, Alessandro [Philips Healthcare (Netherlands); Rivolta, Nicola; Piffaretti, Gabriele [University of Insubria, Vascular Surgery Department (Italy); Carrafiello, Gianpaolo, E-mail: gcarraf@gmail.com [University of Insubria, Interventional Radiology, Department of Radiology (Italy)

2016-01-15

AimTo evaluate the feasibility of image fusion (IF) of pre-procedural arterial-phase CT angiography or MR angiography with intra-procedural fluoroscopy for road-mapping in endovascular treatment of aorto-iliac steno-occlusive disease.Materials and MethodsBetween September and November, 2014, we prospectively evaluated 5 patients with chronic aorto-iliac steno-occlusive disease, who underwent endovascular treatment in the angiography suite. Fusion image road-mapping was performed using angiographic phase CT images or MR images acquired before and intra-procedural unenhanced cone-beam CT. Radiation dose of the procedure, volume of intra-procedural iodinated contrast medium, fluoroscopy time, and overall procedural time were recorded. Reasons for potential fusion imaging inaccuracies were also evaluated.ResultsImage co-registration and fusion guidance were feasible in all procedures. Mean radiation dose of the procedure was 60.21 Gycm2 (range 55.02–63.75 Gycm2). The mean total procedure time was 32.2 min (range 27–38 min). The mean fluoroscopy time was 12 min and 3 s. The mean procedural iodinated contrast material dose was 24 mL (range 20–40 mL).ConclusionsIF gives Interventional Radiologists the opportunity to use new technologies in order to improve outcomes with a significant reduction of contrast media administration.

Fusion of CT Angiography or MR Angiography with Unenhanced CBCT and Fluoroscopy Guidance in Endovascular Treatments of Aorto-Iliac Steno-Occlusion: Technical Note on a Preliminary Experience

International Nuclear Information System (INIS)

Ierardi, Anna Maria; Duka, Ejona; Radaelli, Alessandro; Rivolta, Nicola; Piffaretti, Gabriele; Carrafiello, Gianpaolo

2016-01-01

AimTo evaluate the feasibility of image fusion (IF) of pre-procedural arterial-phase CT angiography or MR angiography with intra-procedural fluoroscopy for road-mapping in endovascular treatment of aorto-iliac steno-occlusive disease.Materials and MethodsBetween September and November, 2014, we prospectively evaluated 5 patients with chronic aorto-iliac steno-occlusive disease, who underwent endovascular treatment in the angiography suite. Fusion image road-mapping was performed using angiographic phase CT images or MR images acquired before and intra-procedural unenhanced cone-beam CT. Radiation dose of the procedure, volume of intra-procedural iodinated contrast medium, fluoroscopy time, and overall procedural time were recorded. Reasons for potential fusion imaging inaccuracies were also evaluated.ResultsImage co-registration and fusion guidance were feasible in all procedures. Mean radiation dose of the procedure was 60.21 Gycm2 (range 55.02–63.75 Gycm2). The mean total procedure time was 32.2 min (range 27–38 min). The mean fluoroscopy time was 12 min and 3 s. The mean procedural iodinated contrast material dose was 24 mL (range 20–40 mL).ConclusionsIF gives Interventional Radiologists the opportunity to use new technologies in order to improve outcomes with a significant reduction of contrast media administration

Feasibility Study of Needle Placement in Percutaneous Vertebroplasty: Cone-Beam Computed Tomography Guidance Versus Conventional Fluoroscopy

Energy Technology Data Exchange (ETDEWEB)

Braak, Sicco J., E-mail: sjbraak@gmail.com [St. Antonius Hospital, Department of Radiology (Netherlands); Zuurmond, Kirsten, E-mail: kirsten.zuurmond@philips.com; Aerts, Hans C. J., E-mail: hans.cj.aerts@philips.com [Philips Medical, Department of Clinical Development (Netherlands); Leersum, Marc van, E-mail: m.van.leersum@antoniusziekenhuis.nl; Overtoom, Timotheus T. Th., E-mail: overtm@knoware.nl; Heesewijk, Johannes P. M. van, E-mail: j.heesewijk@antoniusziekenhuis.nl; Strijen, Marco J. L. van, E-mail: m.van.strijen@antoniusziekenhuis.nl [St. Antonius Hospital, Department of Radiology (Netherlands)

2013-08-01

ObjectiveTo investigate the accuracy, procedure time, fluoroscopy time, and dose area product (DAP) of needle placement during percutaneous vertebroplasty (PVP) using cone-beam computed tomography (CBCT) guidance versus fluoroscopy.Materials and MethodsOn 4 spine phantoms with 11 vertebrae (Th7-L5), 4 interventional radiologists (2 experienced with CBCT guidance and two inexperienced) punctured all vertebrae in a bipedicular fashion. Each side was randomization to either CBCT guidance or fluoroscopy. CBCT guidance is a sophisticated needle guidance technique using CBCT, navigation software, and real-time fluoroscopy. The placement of the needle had to be to a specific target point. After the procedure, CBCT was performed to determine the accuracy, procedure time, fluoroscopy time, and DAP. Analysis of the difference between methods and experience level was performed.ResultsMean accuracy using CBCT guidance (2.61 mm) was significantly better compared with fluoroscopy (5.86 mm) (p < 0.0001). Procedure time was in favor of fluoroscopy (7.39 vs. 10.13 min; p = 0.001). Fluoroscopy time during CBCT guidance was lower, but this difference is not significant (71.3 vs. 95.8 s; p = 0.056). DAP values for CBCT guidance and fluoroscopy were 514 and 174 mGy cm{sup 2}, respectively (p < 0.0001). There was a significant difference in favor of experienced CBCT guidance users regarding accuracy for both methods, procedure time of CBCT guidance, and added DAP values for fluoroscopy.ConclusionCBCT guidance allows users to perform PVP more accurately at the cost of higher patient dose and longer procedure time. Because procedural complications (e.g., cement leakage) are related to the accuracy of the needle placement, improvements in accuracy are clinically relevant. Training in CBCT guidance is essential to achieve greater accuracy and decrease procedure time/dose values.

Positioning errors assessed with kV cone-beam CT for image-guided prostate radiotherapy

International Nuclear Information System (INIS)

Li Jiongyan; Guo Xiaomao; Yao Weiqiang; Wang Yanyang; Ma Jinli; Chen Jiayi; Zhang Zhen; Feng Yan

2010-01-01

Objective: To assess set-up errors measured with kilovoltage cone-beam CT (KV-CBCT), and the impact of online corrections on margins required to account for set-up variability during IMRT for patients with prostate cancer. Methods: Seven patients with prostate cancer undergoing IMRT were enrolled onto the study. The KV-CBCT scans were acquired at least twice weekly. After initial set-up using the skin marks, a CBCT scan was acquired and registered with the planning CT to determine the setup errors using an auto grey-scale registration software. Corrections would be made by moving the table if the setup errors were considered clinically significant (i. e. , > 2 mm). A second CBCT scan was acquired immediately after the corrections to evaluate the residual error. PTV margins were derived to account for the measured set-up errors and residual errors determined for this group of patients. Results: 197 KV-CBCT images in total were acquired. The random and systematic positioning errors and calculated PTV margins without correction in mm were : a) Lateral 3.1, 2.1, 9.3; b) Longitudinal 1.5, 1.8, 5.1;c) Vertical 4.2, 3.7, 13.0. The random and systematic positioning errors and calculated PTV margin with correction in mm were : a) Lateral 1.1, 0.9, 3.4; b) Longitudinal 0.7, 1.1, 2.5; c) Vertical 1.1, 1.3, 3.7. Conclusions: With the guidance of online KV-CBCT, set-up errors could be reduced significantly for patients with prostate cancer receiving IMRT. The margin required after online CBCT correction for the patients enrolled in the study would be appoximatively 3-4 mm. (authors)

Ablation of lumbar sympathetic ganglia by absolute ethanol injection and paravertebral catheter placement under CT guidance: evaluation of the efficacy

International Nuclear Information System (INIS)

Xu Hua; Xiong Yuanchang; Shao Chengwei; Zuo Changjing; Sheng Jing; Tian Jianming

2009-01-01

Objective: To evaluate the ablation of lumbar sympathetic ganglia by using single injection of absolute ethanol and retaining a paravertebral catheter under CT guidance for the treatment of lower extremity ischemia. Methods: Single absolute ethanol injection of L2 sympathetic ganglia was done in 25 cases (group B), single absolute ethanol injection of L2 sympathetic ganglia together with placement of a paravertebral catheter at L3 was carried out in 23 cases (group BT). All the procedures were performed under CT guidance. Three days after the procedure, the pain severity of the lower limbs was evaluated based on VAS method. If the patient in group BT still had a VAS score ≥4 on the third day, 3 ml of 1% lidocaine was infected via the retained catheter in the prone position. If VAS score became ≤3 at 5 min after the injection, additional 5 ml of ethanol was given through the catheter. The pain severity was evaluated again one week later. VAS score, analgesic dose and temperature of lower limbs were recorded. Results: One week after the procedure the excellent rate and effective rate for group B were 32% and 80% respectively, while for group BT were 60.9% and 95.7% respectively, with a significant difference between two groups (P<0.01). Conclusion: For the ablation of lumbar sympathetic ganglia the combination of single absolute ethanol injection with paravertebral catheter placement under CT guidance is superior to the single absolute ethanol injection. This technique is more individual with better results and is more likely to be accepted by the patients. (authors)

Protocol of image guided off-line using cone beam CT megavoltage; Protocolo de imagen guiada off-line mediante Cone Beam CT de megavoltaje

Energy Technology Data Exchange (ETDEWEB)

Garcia Ruiz-Zorrilla, J.; Fernandez Leton, J. P.; Perez Moreno, J. M.; Zucca Aparicio, D.; Minambres Moro, A.

2013-07-01

The goal of image guided protocols offline is to reduce systematic errors in positioning of the patient in the treatment unit, being more important than the random errors, since the systematic have one contribution in the margin of the CTV to the PTV. This paper proposes a protocol for image guided offline with the different actions to take with their threshold values evaluated previously by anatomic location in a sample of 474 patients and 4821Cone beam Megavoltaje CT (CBCT). (Author)

Three-rooted premolar analyzed by high-resolution and cone beam CT.

Science.gov (United States)

Marca, Caroline; Dummer, Paul M H; Bryant, Susan; Vier-Pelisser, Fabiana Vieira; Só, Marcus Vinicius Reis; Fontanella, Vania; Dutra, Vinicius D'avila; de Figueiredo, José Antonio Poli

2013-07-01

The aim of this study was to analyze the variations in canal and root cross-sectional area in three-rooted maxillary premolars between high-resolution computed tomography (μCT) and cone beam computed tomography (CBCT). Sixteen extracted maxillary premolars with three distinct roots and fully formed apices were scanned using μCT and CBCT. Photoshop CS software was used to measure root and canal cross-sectional areas at the most cervical and the most apical points of each root third in images obtained using the two tomographic computed (CT) techniques, and at 30 root sections equidistant from both root ends using μCT images. Canal and root areas were compared between each method using the Student t test for paired samples and 95 % confidence intervals. Images using μCT were sharper than those obtained using CBCT. There were statistically significant differences in mean area measurements of roots and canals between the μCT and CBCT techniques (P < 0.05). Root and canal areas had similar variations in cross-sectional μCT images and became proportionally smaller in a cervical to apical direction as the cementodentinal junction was approached, from where the area then increased apically. Although variation was similar in the roots and canals under study, CBCT produced poorer image details than μCT. Although CBCT is a strong diagnosis tool, it still needs improvement to provide accuracy in details of the root canal system, especially in cases with anatomical variations, such as the three-rooted maxillary premolars.

Pin-photodiode array for the measurement of fan-beam energy and air kerma distributions of X-ray CT scanners.

Science.gov (United States)

Haba, Tomonobu; Koyama, Shuji; Aoyama, Takahiko; Kinomura, Yutaka; Ida, Yoshihiro; Kobayashi, Masanao; Kameyama, Hiroshi; Tsutsumi, Yoshinori

2016-07-01

Patient dose estimation in X-ray computed tomography (CT) is generally performed by Monte Carlo simulation of photon interactions within anthropomorphic or cylindrical phantoms. An accurate Monte Carlo simulation requires an understanding of the effects of the bow-tie filter equipped in a CT scanner, i.e. the change of X-ray energy and air kerma along the fan-beam arc of the CT scanner. To measure the effective energy and air kerma distributions, we devised a pin-photodiode array utilizing eight channels of X-ray sensors arranged at regular intervals along the fan-beam arc of the CT scanner. Each X-ray sensor consisted of two plate type of pin silicon photodiodes in tandem - front and rear photodiodes - and of a lead collimator, which only allowed X-rays to impinge vertically to the silicon surface of the photodiodes. The effective energy of the X-rays was calculated from the ratio of the output voltages of the photodiodes and the dose was calculated from the output voltage of the front photodiode using the energy and dose calibration curves respectively. The pin-photodiode array allowed the calculation of X-ray effective energies and relative doses, at eight points simultaneously along the fan-beam arc of a CT scanner during a single rotation of the scanner. The fan-beam energy and air kerma distributions of CT scanners can be effectively measured using this pin-photodiode array. Copyright © 2016 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

The neurolytic celiac plexus block using CT guidance through anterior abdominal approach to control the cancer pain

International Nuclear Information System (INIS)

Pan Jie; Yang Ning; Liu Wei; Jin Zhengyu; Zhao Yupei; Cai Lixing

2001-01-01

Objective: To evaluate the therapeutic effect and safety of neurolytic celiac plexus block (Ncb) using CT guidance through anterior abdominal approach. Methods: The clinical data of 24 patients who were given NCPB because of the suffering of upper abdominal and back pain caused by pancreatic carcinoma and other cancer in advanced stage were retrospectively analyzed. The therapeutic effect was evaluated with complete pain relief and partial pain relief. Results: The effective rate and complete pain relief rate in short period ( 3 months) were 71.4% and 14.3% respectively. No severe complications occurred. Conclusion: NCPB guided by CT through anterior abdominal approach is an effective, safe and simple method to control the upper abdominal and back pain caused by cancer

Image quality of cone beam CT on respiratory motion

International Nuclear Information System (INIS)

Zhang Ke; Li Minghui; Dai Jianrong; Wang Shi

2011-01-01

In this study,the influence of respiratory motion on Cone Beam CT (CBCT) image quality was investigated by a motion simulating platform, an image quality phantom, and a kV X-ray CBCT. A total of 21 motion states in the superior-inferior direction and the anterior-posterior direction, separately or together, was simulated by considering different respiration amplitudes, periods and hysteresis. The influence of motion on CBCT image quality was evaluated with the quality indexes of low contrast visibility, geometric accuracy, spatial resolution and uniformity of CT values. The results showed that the quality indexes were affected by the motion more prominently in AP direction than in SI direction, and the image quality was affected by the respiration amplitude more prominently than the respiration period and the hysteresis. The CBCT image quality and its characteristics influenced by the respiration motion, and may be exploited in finding solutions. (authors)

Assessment of residual error for online cone-beam CT-guided treatment of prostate cancer patients

International Nuclear Information System (INIS)

Letourneau, Daniel; Martinez, Alvaro A.; Lockman, David; Yan Di; Vargas, Carlos; Ivaldi, Giovanni; Wong, John

2005-01-01

Purpose: Kilovoltage cone-beam CT (CBCT) implemented on board a medical accelerator is available for image-guidance applications in our clinic. The objective of this work was to assess the magnitude and stability of the residual setup error associated with CBCT online-guided prostate cancer patient setup. Residual error pertains to the uncertainty in image registration, the limited mechanical accuracy, and the intrafraction motion during imaging and treatment. Methods and Materials: The residual error for CBCT online-guided correction was first determined in a phantom study. After online correction, the phantom residual error was determined by comparing megavoltage portal images acquired every 90 deg. to the corresponding digitally reconstructed radiographs. In the clinical study, 8 prostate cancer patients were implanted with three radiopaque markers made of high-winding coils. After positioning the patient using the skin marks, a CBCT scan was acquired and the setup error determined by fusing the coils on the CBCT and planning CT scans. The patient setup was then corrected by moving the couch accordingly. A second CBCT scan was acquired immediately after the correction to evaluate the residual target setup error. Intrafraction motion was evaluated by tracking the coils and the bony landmarks on kilovoltage radiographs acquired every 30 s between the two CBCT scans. Corrections based on soft-tissue registration were evaluated offline by aligning the prostate contours defined on both planning CT and CBCT images. Results: For ideal rigid phantoms, CBCT image-guided treatment can usually achieve setup accuracy of 1 mm or better. For the patients, after CBCT correction, the target setup error was reduced in almost all cases and was generally within ±1.5 mm. The image guidance process took 23-35 min, dictated by the computer speed and network configuration. The contribution of the intrafraction motion to the residual setup error was small, with a standard deviation of

GPU-Based 3D Cone-Beam CT Image Reconstruction for Large Data Volume

Directory of Open Access Journals (Sweden)

Xing Zhao

2009-01-01

Full Text Available Currently, 3D cone-beam CT image reconstruction speed is still a severe limitation for clinical application. The computational power of modern graphics processing units (GPUs has been harnessed to provide impressive acceleration of 3D volume image reconstruction. For extra large data volume exceeding the physical graphic memory of GPU, a straightforward compromise is to divide data volume into blocks. Different from the conventional Octree partition method, a new partition scheme is proposed in this paper. This method divides both projection data and reconstructed image volume into subsets according to geometric symmetries in circular cone-beam projection layout, and a fast reconstruction for large data volume can be implemented by packing the subsets of projection data into the RGBA channels of GPU, performing the reconstruction chunk by chunk and combining the individual results in the end. The method is evaluated by reconstructing 3D images from computer-simulation data and real micro-CT data. Our results indicate that the GPU implementation can maintain original precision and speed up the reconstruction process by 110–120 times for circular cone-beam scan, as compared to traditional CPU implementation.

Cone beam CT evaluation of patient set-up accuracy as a QA tool

DEFF Research Database (Denmark)

Nielsen, Morten; Bertelsen, Anders; Westberg, Jonas

2009-01-01

Purpose. To quantify by means of cone beam CT the random and systematic uncertainty involved in radiotherapy, and to determine if this information can be used for e.g. technical quality assurance, evaluation of patient immobilization and determination of margins for the treatment planning. Patients...... and lateral directions). In the CC direction, the margin has to be 5 mm for the Thorax patients. The total uncertainty on the patient position grows during the treatment course, especially in the CC direction for patients receiving thoracical irradiation. This may stem from problems in the immobilization...... and methods. Eighty four cancer patients have been cone beam CT scanned at treatment sessions 1, 2, 3, 10 and 20. Translational and rotational errors are analyzed. Results and conclusions. For the first three treatment sessions the mean translational error in the AP direction is 1 mm; this indicates a small...

Percutaneous Extraction of Cement Leakage After Vertebroplasty Under CT and Fluoroscopy Guidance: A New Technique

International Nuclear Information System (INIS)

Amoretti, Nicolas; Huwart, Laurent

2012-01-01

Purpose: We report a new minimally invasive technique of extraction of cement leakage following percutaneous vertebroplasty in adults. Methods: Seven adult patients (five women, two men; mean age: 81 years) treated for vertebral compression fractures by percutaneous vertebroplasty had cement leakage into perivertebral soft tissues along the needle route. Immediately after vertebroplasty, the procedure of extraction was performed under computed tomography (CT) and fluoroscopy guidance: a Chiba needle was first inserted using the same route as the vertebroplasty until contact was obtained with the cement fragment. This needle was then used as a guide for an 11-gauge Trocar t’am (Thiebaud, France). After needle withdrawal, a 13-gauge endoscopy clamp was inserted through the cannula to extract the cement fragments. The whole procedure was performed under local anesthesia. Results: In each patient, all cement fragments were withdrawn within 10 min, without complication. Conclusions: This report suggests that this CT- and fluoroscopy-guided percutaneous technique of extraction could reduce the rate of cement leakage-related complications.

Initial experience with megavoltage (MV) CT guidance for daily prostate alignments

International Nuclear Information System (INIS)

Langen, Katja M.; Zhang Yashan; Andrews, Rhonda D.; Hurley, Monica E.; Meeks, Sanford L.; Poole, Darrell O.; Willoughby, Twyla R.; Kupelian, Patrick A.

2005-01-01

Purpose: The on-board megavoltage (MV) computed tomography (CT) capabilities of a TomoTherapy Hi*ART unit were used to obtain daily MVCT images of prostate cancer patients. For patient alignment the daily MVCT image needs to be registered with the planning CT image to calculate couch shifts. Three manual techniques of registering the MVCT images with the planning kilovoltage (kV) CT images were evaluated. The techniques are based on visual alignment of (1) fiducial prostate markers (2) CT anatomy, and (3) kVCT contours. Methods and Materials: One hundred and twelve alignments from 3 patients were available for analysis. The radiation therapists visually registered the MVCT images with the planning kVCT images based on fiducial markers for actual patient alignment. Retrospectively, the therapists registered each image set using anatomy and contour-based techniques. In addition to the therapists, a physician retrospectively registered each image set based on each of the three techniques. For each MVCT to kVCT image pair a reference alignment was computed from the center-of-mass (COM) of the three fiducial markers. All registration results were compared with these reference alignments. The physician's image registrations were compared with the radiation therapists' registrations to assess the user variability of the different techniques. Results: The marker-based registration results agree best with the reference alignments, while the contour-based registrations show the least degree of agreement. Using anatomy and contour-based registrations, the radiation therapist's alignments differed by ≥ 3 mm from the reference alignments in 24%, 33%, and 3% and 55%, 48%, and 21% of all registrations in the anterior-posterior, superior-inferior, and lateral directions, respectively. The respective values for the marker-based alignments were 3%, 6%, and 3%. The physician's registrations showed the same general trend. The marker-based registrations showed the least amount of

A new method for x-ray scatter correction: first assessment on a cone-beam CT experimental setup

International Nuclear Information System (INIS)

Rinkel, J; Gerfault, L; Esteve, F; Dinten, J-M

2007-01-01

Cone-beam computed tomography (CBCT) enables three-dimensional imaging with isotropic resolution and a shorter acquisition time compared to a helical CT scanner. Because a larger object volume is exposed for each projection, scatter levels are much higher than in collimated fan-beam systems, resulting in cupping artifacts, streaks and quantification inaccuracies. In this paper, a general method to correct for scatter in CBCT, without supplementary on-line acquisition, is presented. This method is based on scatter calibration through off-line acquisition combined with on-line analytical transformation based on physical equations, to adapt calibration to the object observed. The method was tested on a PMMA phantom and on an anthropomorphic thorax phantom. The results were validated by comparison to simulation for the PMMA phantom and by comparison to scans obtained on a commercial multi-slice CT scanner for the thorax phantom. Finally, the improvements achieved with the new method were compared to those obtained using a standard beam-stop method. The new method provided results that closely agreed with the simulation and with the conventional CT scanner, eliminating cupping artifacts and significantly improving quantification. Compared to the beam-stop method, lower x-ray doses and shorter acquisition times were needed, both divided by a factor of 9 for the same scatter estimation accuracy

A study of respiration-correlated cone-beam CT scans to correct target positioning errors in radiotherapy of thoracic cancer

Energy Technology Data Exchange (ETDEWEB)

Santoro, J. P.; McNamara, J.; Yorke, E.; Pham, H.; Rimner, A.; Rosenzweig, K. E.; Mageras, G. S. [Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, New York 10065 (United States); Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York 10065 (United States); Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, New York 10065 (United States)

2012-10-15

Purpose: There is increasingly widespread usage of cone-beam CT (CBCT) for guiding radiation treatment in advanced-stage lung tumors, but difficulties associated with daily CBCT in conventionally fractionated treatments include imaging dose to the patient, increased workload and longer treatment times. Respiration-correlated cone-beam CT (RC-CBCT) can improve localization accuracy in mobile lung tumors, but further increases the time and workload for conventionally fractionated treatments. This study investigates whether RC-CBCT-guided correction of systematic tumor deviations in standard fractionated lung tumor radiation treatments is more effective than 2D image-based correction of skeletal deviations alone. A second study goal compares respiration-correlated vs respiration-averaged images for determining tumor deviations. Methods: Eleven stage II-IV nonsmall cell lung cancer patients are enrolled in an IRB-approved prospective off-line protocol using RC-CBCT guidance to correct for systematic errors in GTV position. Patients receive a respiration-correlated planning CT (RCCT) at simulation, daily kilovoltage RC-CBCT scans during the first week of treatment and weekly scans thereafter. Four types of correction methods are compared: (1) systematic error in gross tumor volume (GTV) position, (2) systematic error in skeletal anatomy, (3) daily skeletal corrections, and (4) weekly skeletal corrections. The comparison is in terms of weighted average of the residual GTV deviations measured from the RC-CBCT scans and representing the estimated residual deviation over the treatment course. In the second study goal, GTV deviations computed from matching RCCT and RC-CBCT are compared to deviations computed from matching respiration-averaged images consisting of a CBCT reconstructed using all projections and an average-intensity-projection CT computed from the RCCT. Results: Of the eleven patients in the GTV-based systematic correction protocol, two required no correction

A study of respiration-correlated cone-beam CT scans to correct target positioning errors in radiotherapy of thoracic cancer

International Nuclear Information System (INIS)

Santoro, J. P.; McNamara, J.; Yorke, E.; Pham, H.; Rimner, A.; Rosenzweig, K. E.; Mageras, G. S.

2012-01-01

Purpose: There is increasingly widespread usage of cone-beam CT (CBCT) for guiding radiation treatment in advanced-stage lung tumors, but difficulties associated with daily CBCT in conventionally fractionated treatments include imaging dose to the patient, increased workload and longer treatment times. Respiration-correlated cone-beam CT (RC-CBCT) can improve localization accuracy in mobile lung tumors, but further increases the time and workload for conventionally fractionated treatments. This study investigates whether RC-CBCT-guided correction of systematic tumor deviations in standard fractionated lung tumor radiation treatments is more effective than 2D image-based correction of skeletal deviations alone. A second study goal compares respiration-correlated vs respiration-averaged images for determining tumor deviations. Methods: Eleven stage II–IV nonsmall cell lung cancer patients are enrolled in an IRB-approved prospective off-line protocol using RC-CBCT guidance to correct for systematic errors in GTV position. Patients receive a respiration-correlated planning CT (RCCT) at simulation, daily kilovoltage RC-CBCT scans during the first week of treatment and weekly scans thereafter. Four types of correction methods are compared: (1) systematic error in gross tumor volume (GTV) position, (2) systematic error in skeletal anatomy, (3) daily skeletal corrections, and (4) weekly skeletal corrections. The comparison is in terms of weighted average of the residual GTV deviations measured from the RC-CBCT scans and representing the estimated residual deviation over the treatment course. In the second study goal, GTV deviations computed from matching RCCT and RC-CBCT are compared to deviations computed from matching respiration-averaged images consisting of a CBCT reconstructed using all projections and an average-intensity-projection CT computed from the RCCT. Results: Of the eleven patients in the GTV-based systematic correction protocol, two required no correction

Study of effective dose of various protocols in equipment cone beam CT

International Nuclear Information System (INIS)

Soares, M. R.; Maia, A. F.; Batista, W. O.; Caldas, L. V. E.; Lara, P. A.

2014-08-01

Currently the cone beam computed tomography is widely used in various procedures of dental radiology. Although the doses values associated with the procedures of cone beam CT are low compared to typical values associated with dental radiology procedure in multi slices CT. However can be high compared to typical values of other techniques commonly used in dental radiology. The present scenario is a very wide range of designs of equipment and, consequently, lack of uniformity in all parameters associated with x-ray generation and geometry. In this context, this study aimed to evaluate and calculate the absorbed dose in organs and tissues relevant and estimate effective dose for different protocols with different geometries of exposure in five cone beam CT equipment. For this, a female Alderson anthropomorphic phantom, manufactured by Radiology Support Devices was used. The phantom was irradiated with 26 dosimeters LiF: Mg, Ti (TLD-100), inserted in organs and tissues along the layers forming the head and neck of the phantom. The equipment used, in this present assessment, was: i-CAT Classical, Kodak 9000 3D, Gendex GXCB 500, Sirona Orthophos X G 3D and Planmeca Pro Max 3D. The effective doses were be determined by the ICRP 103 weighting factors. The values were between 7.0 and 111.5 micro Sv, confirming the broad dose range expected due to the diversity of equipment and protocols used in each equipment. The values of effective dose per Fov size were: between 7 and 51.2 micro Sv for located Fov; between 17.6 and 52.0 micro Sv for medium Fov; and between 11.5 and 43.1 micro Sv to large Fov (maxillofacial). In obtaining the effective dose the measurements highlighted a relevance contribution of dose absorbed by the remaining organs (36%), Salivary glands (30%), thyroid (12%) and bone marrow (12%). (Author)

Study of effective dose of various protocols in equipment cone beam CT

Energy Technology Data Exchange (ETDEWEB)

Soares, M. R.; Maia, A. F. [Universidade Federale de Sergipe, Departamento de Fisica, Cidade Universitaria Prof. Jose Aloisio de Campos, Marechal Rondon s/n, Jardim Rosa Elze, 49-100000 Sao Cristovao, Sergipe (Brazil); Batista, W. O. [Instituto Federal da Bahia, Rua Emidio dos Santos s/n, Barbalho, Salvador, 40301015 Bahia (Brazil); Caldas, L. V. E.; Lara, P. A., E-mail: mrs2206@gmail.com [Instituto de Pesquisas Energeticas e Nucleares / CNEN, Av. Lineu Prestes 2242, Cidade Universitaria, 05508-000 Sao Paulo (Brazil)

2014-08-15

Currently the cone beam computed tomography is widely used in various procedures of dental radiology. Although the doses values associated with the procedures of cone beam CT are low compared to typical values associated with dental radiology procedure in multi slices CT. However can be high compared to typical values of other techniques commonly used in dental radiology. The present scenario is a very wide range of designs of equipment and, consequently, lack of uniformity in all parameters associated with x-ray generation and geometry. In this context, this study aimed to evaluate and calculate the absorbed dose in organs and tissues relevant and estimate effective dose for different protocols with different geometries of exposure in five cone beam CT equipment. For this, a female Alderson anthropomorphic phantom, manufactured by Radiology Support Devices was used. The phantom was irradiated with 26 dosimeters LiF: Mg, Ti (TLD-100), inserted in organs and tissues along the layers forming the head and neck of the phantom. The equipment used, in this present assessment, was: i-CAT Classical, Kodak 9000 3D, Gendex GXCB 500, Sirona Orthophos X G 3D and Planmeca Pro Max 3D. The effective doses were be determined by the ICRP 103 weighting factors. The values were between 7.0 and 111.5 micro Sv, confirming the broad dose range expected due to the diversity of equipment and protocols used in each equipment. The values of effective dose per Fov size were: between 7 and 51.2 micro Sv for located Fov; between 17.6 and 52.0 micro Sv for medium Fov; and between 11.5 and 43.1 micro Sv to large Fov (maxillofacial). In obtaining the effective dose the measurements highlighted a relevance contribution of dose absorbed by the remaining organs (36%), Salivary glands (30%), thyroid (12%) and bone marrow (12%). (Author)

Assessment of effective dose from cone beam CT imaging in SPECT/CT examination in comparison with other modalities

International Nuclear Information System (INIS)

Tonkopi, Elena; Ross, Andrew A.

2016-01-01

The aim of this study was to assess radiation dose from the cone beam computed tomography (CBCT) component of single photon emission tomography/computed tomography (SPECT/CT) examinations and to compare it with the radiopharmaceutical related dose as well as dose from multidetector computed tomography (MDCT). Effective dose (ED) from computed tomography (CT) was estimated using dose-length product values and anatomy-specific conversion factors. The contribution from the SPECT component was evaluated using ED per unit administered activity for the radiopharmaceuticals listed in the International Commission on Radiological Protection Publications 80 and 106. With the exception of cardiac studies (0.11 mSv), the CBCT dose (3.96-6.04 mSv) was similar to that from the radiopharmaceutical accounting for 29-56 % of the total ED from the examination. In comparison with MDCT examinations, the CBCT dose was 48 and 42 % lower for abdomen/pelvis and chest/abdomen/pelvis scans, respectively, while in the chest the CBCT scan resulted in higher dose (23 %). Radiation dose from the CT component should be taken into consideration when evaluating total SPECT/CT patient dose. (authors)

Evaluation of radioactive seeds implantation under PET-CT guidance for the treatment of central lung cancer with obstructive atelectasis

International Nuclear Information System (INIS)

Zhou Yi; Jiang Zhongpu; Wang Haiting; Zhang Yanjun; Jiang Qiang; Wang Jun; Ren Lijun; Xie Bin

2010-01-01

Objective: To evaluate percutaneous puncturing 125 I seed implantation by using PET-CT guided target localization technique in treating central lung cancer complicated by obstructive pulmonary atelectasis. Methods: A total of 30 patients with suspected central lung cancer complicated by obstructive pulmonary atelectasis on preoperative chest films were enrolled in this study. As no clear distinction existed between the tumor and the atelectatic consolidation shadow on plain chest films, CT scanning was carried out in all patients. If CT scan was still not able to determine the margin of the tumor, an additional PET-CT scanning was adopted. After ascertaining the location of the lung cancer, percutaneous puncturing implantation of 125 I seeds under PET-CT guidance was performed. The clinical data and the therapeutic results were evaluated. Results: A sharp distinction between the tumor and the atelectatic consolidation shadow was demonstrated on PET-CT scans in 21 cases. The mean volume of the targeted lesion reckoned from PET-CT scans was 26 cm 3 , and the 125 I seeds were implanted. The mean volume of the targeted lesion calculated on CT scans was 37 cm 3 . Six months after the treatment, the follow-up CT exam showed that the effective rate was 93% (28/30). The one-year survival rate was 100% . The complications included pneumothorax (n = 8), small amount of hemoptysis (n = 12) and fever (n = 2). No displacement or immigration of the implanted seeds occurred. Conclusion: PET-CT scanning is far superior to conventional CT scanning in determining the target area of the tumor in patients with central lung cancer complicated by obstructive pulmonary atelectasis. (authors)

Effects of data sampling rate on image quality in fan-beam-CT system

International Nuclear Information System (INIS)

Iwata, Akira; Yamagishi, Nobutoshi; Suzumura, Nobuo; Horiba, Isao.

1984-01-01

Investigation was made into the relationship between spatial resolution or artifacts and data sampling rate in order to pursue the causes of the degradation of CT image quality by computer simulation. First the generation of projection data and reconstruction calculating process are described, and then the results are shown about the relation between angular sampling interval and spatical resolution or artifacts, and about the relation between projection data sampling interval and spatial resolution or artifacts. It was clarified that the formulation of the relationship between spatial resolution and data sampling rate performed so far for parallel X-ray beam was able to be applied to fan beam. As a conclusion, when other reconstruction parameters are the same in fan beam CT systems, spatial resolution can be determined by projection data sampling rate rather than angular sampling rate. The mechanism of artifact generation due to the insufficient number of angular samples was made clear. It was also made clear that there was a definite relationship among measuring region, angular sampling rate and projection data sampling rate, and the amount of artifacts depending upon projection data sampling rate was proportional to the amount of spatial frequency components (Aliasing components) of a test object above the Nyquist frequency of projection data. (Wakatsuki, Y.)

Ultrafast cone-beam CT scatter correction with GPU-based Monte Carlo simulation

Directory of Open Access Journals (Sweden)

Yuan Xu

2014-03-01

Full Text Available Purpose: Scatter artifacts severely degrade image quality of cone-beam CT (CBCT. We present an ultrafast scatter correction framework by using GPU-based Monte Carlo (MC simulation and prior patient CT image, aiming at automatically finish the whole process including both scatter correction and reconstruction within 30 seconds.Methods: The method consists of six steps: 1 FDK reconstruction using raw projection data; 2 Rigid Registration of planning CT to the FDK results; 3 MC scatter calculation at sparse view angles using the planning CT; 4 Interpolation of the calculated scatter signals to other angles; 5 Removal of scatter from the raw projections; 6 FDK reconstruction using the scatter-corrected projections. In addition to using GPU to accelerate MC photon simulations, we also use a small number of photons and a down-sampled CT image in simulation to further reduce computation time. A novel denoising algorithm is used to eliminate MC noise from the simulated scatter images caused by low photon numbers. The method is validated on one simulated head-and-neck case with 364 projection angles.Results: We have examined variation of the scatter signal among projection angles using Fourier analysis. It is found that scatter images at 31 angles are sufficient to restore those at all angles with < 0.1% error. For the simulated patient case with a resolution of 512 × 512 × 100, we simulated 5 × 106 photons per angle. The total computation time is 20.52 seconds on a Nvidia GTX Titan GPU, and the time at each step is 2.53, 0.64, 14.78, 0.13, 0.19, and 2.25 seconds, respectively. The scatter-induced shading/cupping artifacts are substantially reduced, and the average HU error of a region-of-interest is reduced from 75.9 to 19.0 HU.Conclusion: A practical ultrafast MC-based CBCT scatter correction scheme is developed. It accomplished the whole procedure of scatter correction and reconstruction within 30 seconds.----------------------------Cite this

Beam-hardening correction in CT based on basis image and TV model

International Nuclear Information System (INIS)

Li Qingliang; Yan Bin; Li Lei; Sun Hongsheng; Zhang Feng

2012-01-01

In X-ray computed tomography, the beam hardening leads to artifacts and reduces the image quality. It analyzes how beam hardening influences on original projection. According, it puts forward a kind of new beam-hardening correction method based on the basis images and TV model. Firstly, according to physical characteristics of the beam hardening an preliminary correction model with adjustable parameters is set up. Secondly, using different parameters, original projections are operated by the correction model. Thirdly, the projections are reconstructed to obtain a series of basis images. Finally, the linear combination of basis images is the final reconstruction image. Here, with total variation for the final reconstruction image as the cost function, the linear combination coefficients for the basis images are determined according to iterative method. To verify the effectiveness of the proposed method, the experiments are carried out on real phantom and industrial part. The results show that the algorithm significantly inhibits cup and strip artifacts in CT image. (authors)

Dual resolution cone beam breast CT: A feasibility study

International Nuclear Information System (INIS)

Chen Lingyun; Shen Youtao; Lai, Chao-Jen; Han Tao; Zhong Yuncheng; Ge Shuaiping; Liu Xinming; Wang Tianpeng; Yang, Wei T.; Whitman, Gary J.; Shaw, Chris C.

2009-01-01

Purpose: In this study, the authors investigated the feasibility of a dual resolution volume-of-interest (VOI) cone beam breast CT technique and compared two implementation approaches in terms of dose saving and scatter reduction. Methods: With this technique, a lead VOI mask with an opening is inserted between the x-ray source and the breast to deliver x-ray exposure to the VOI while blocking x rays outside the VOI. A CCD detector is used to collect the high resolution projection data of the VOI. Low resolution cone beam CT (CBCT) images of the entire breast, acquired with a flat panel (FP) detector, were used to calculate the projection data outside the VOI with the ray-tracing reprojection method. The Feldkamp-Davis-Kress filtered backprojection algorithm was used to reconstruct the dual resolution 3D images. Breast phantoms with 180 μm and smaller microcalcifications (MCs) were imaged with both FP and FP-CCD dual resolution CBCT systems, respectively. Two approaches of implementing the dual resolution technique, breast-centered approach and VOI-centered approach, were investigated and evaluated for dose saving and scatter reduction with Monte Carlo simulation using a GEANT4 package. Results: The results showed that the breast-centered approach saved more breast absorbed dose than did VOI-centered approach with similar scatter reduction. The MCs in fatty breast phantom, which were invisible with FP CBCT scan, became visible with the FP-CCD dual resolution CBCT scan. Conclusions: These results indicate potential improvement of the image quality inside the VOI with reduced breast dose both inside and outside the VOI.

Automated double-cone-beam CT fusion technique. Enhanced evaluation of glue distribution in cases of spinal dural arteriovenous fistula (SDAVF) embolisation

International Nuclear Information System (INIS)

Farago, Giuseppe; Caldiera, V.; Antozzi, C.; Bellino, A.; Innocenti, A.; Ciceri, E.

2017-01-01

Spinal dural arteriovenous fistulas (SDAVFs) are acquired diseases that represent the majority of all arteriovenous spinal shunts, leading to progressive and disabling myelopathy. Treatment is focused on accurately disconnecting the fistula point. We present our experience with the double-cone-beam CT fusion technique successfully applied to evaluate treatment results in a series of SDAVFs. Between November 2011 and December 2015 we performed double-DynaCT acquisition (pre- and post-embolisation) in 12 cases of SDAVF. A successful DynaCT fusion technique was only achieved in the group of patients with pre- and post-treatment images acquired at the same time as the treatment session, under general anaesthesia (4/12). DynaCT performed on different days proved to be inadequate for the automated fusion technique because of changes in the body position (8/12). A pre-treatment flat-panel cone-beam CT with contrast, at the time of diagnostic angiography, can be very helpful to detect the correct level of the fistula and the relationship between the fistula and the surrounding structures. In case of the endovascular approach, additional post-treatment native acquisition merged with the pre-treatment acquisition (double-cone-beam CT fusion technique) permits to immediately evaluate the distribution of the glue cast and to confirm the success of the procedure. (orig.)

Automated double-cone-beam CT fusion technique. Enhanced evaluation of glue distribution in cases of spinal dural arteriovenous fistula (SDAVF) embolisation

Energy Technology Data Exchange (ETDEWEB)

Farago, Giuseppe [Foundation Neurological Institute ' ' C. Besta' ' , Department of Interventional Neuroradiology, Milan (Italy); Fondazione IRCCS Istituto Neurologico Carlo Besta, Department of Interventional Neuroradiology, Milan (Italy); Caldiera, V. [Foundation Neurological Institute ' ' C. Besta' ' , Department of Interventional Neuroradiology, Milan (Italy); Antozzi, C.; Bellino, A. [Foundation Neurological Institute ' ' C. Besta' ' , Department of Neuroimmunology and Neuromuscular Diseases, Milan (Italy); Innocenti, A. [Foundation Neurological Institute ' ' C. Besta' ' , Department of Neuro-Oncology, Milan (Italy); Ciceri, E. [Foundation Neurological Institute ' ' C. Besta' ' , Department of Interventional Neuroradiology, Milan (Italy); Azienda Ospedaliera Universitaria Integrata Borgo Trento, Department of Neuroradiology, Verona (Italy)

2017-05-15

Spinal dural arteriovenous fistulas (SDAVFs) are acquired diseases that represent the majority of all arteriovenous spinal shunts, leading to progressive and disabling myelopathy. Treatment is focused on accurately disconnecting the fistula point. We present our experience with the double-cone-beam CT fusion technique successfully applied to evaluate treatment results in a series of SDAVFs. Between November 2011 and December 2015 we performed double-DynaCT acquisition (pre- and post-embolisation) in 12 cases of SDAVF. A successful DynaCT fusion technique was only achieved in the group of patients with pre- and post-treatment images acquired at the same time as the treatment session, under general anaesthesia (4/12). DynaCT performed on different days proved to be inadequate for the automated fusion technique because of changes in the body position (8/12). A pre-treatment flat-panel cone-beam CT with contrast, at the time of diagnostic angiography, can be very helpful to detect the correct level of the fistula and the relationship between the fistula and the surrounding structures. In case of the endovascular approach, additional post-treatment native acquisition merged with the pre-treatment acquisition (double-cone-beam CT fusion technique) permits to immediately evaluate the distribution of the glue cast and to confirm the success of the procedure. (orig.)

Computed tomography guidance for skeletal biopsy

International Nuclear Information System (INIS)

Frager, D.H.; Goldman, M.J.; Elkin, C.M.; Cynamon, J.; Leeds, N.E.; Seimon, L.P.; Habermann, E.T.; Schreiber, K.; Freeman, L.M.

1987-01-01

Computed tomographic (CT) guided biopsy and abscess drainage of multiple organ systems have been well described. Reports of spinal and skeletal applications have been less common. This study describes the use of CT guidance in the biopsy of various skeletal lesions in 46 patients. Forty-one patients had skinny needle aspirations (18 or 22 gauge) and 23 patients had trephine core biopsies. Sites of the lesions included: thoracic spine - 15 patients, lumbosacral spine - 17 patients, bony pelvis - 6 patients, rib - 2 patients, and long bones - 6 patients. Fast scanners capable of rapid image reconstruction have overcome many constraints. With CT guidance, the physician who performs the procedure receives virtually no ionizing radiation. The exact location of the needle tip is accurately visualized in relation to the lesion being biopsied and to the vital organs. (orig.)

Evaluation of positioning errors of the patient using cone beam CT megavoltage

International Nuclear Information System (INIS)

Garcia Ruiz-Zorrilla, J.; Fernandez Leton, J. P.; Zucca Aparicio, D.; Perez Moreno, J. M.; Minambres Moro, A.

2013-01-01

Image-guided radiation therapy allows you to assess and fix the positioning of the patient in the treatment unit, thus reducing the uncertainties due to the positioning of the patient. This work assesses errors systematic and errors of randomness from the corrections made to a series of patients of different diseases through a protocol off line of cone beam CT (CBCT) megavoltage. (Author)

Assessment of protocols in cone beam CT with symmetric and asymmetric beam using effective dose and P{sub ka}

Energy Technology Data Exchange (ETDEWEB)

Batista, W. O.; Linhares de O, M. V. [Instituto Federal da Bahia, Rua Emidio dos Santos s/n, Barbalho, Salvador, 40301015 Bahia (Brazil); Soares, M. R.; Maia, A. F. [Universidade Federal de Sergipe, Departamento de Fisica, Cidade Universitaria Prof. Jose Aloisio de Campos, Marechal Rondon s/n, Jardim Rosa Elze, 49-100000 Sao Cristovao, Sergipe (Brazil); Caldas, L. V. E., E-mail: wilsonottobatista@gmail.com [Instituto de Pesquisas Energeticas e Nucleares / CNEN, Av. Lineu Prestes 2242, Cidade Universitaria, 05508-000 Sao Paulo (Brazil)

2014-08-15

The cone beam CT is an emerging technology in dental radiology with significant differences the point of view of design technology between the various manufacturers on the world market. This study aims to evaluate and compare protocols with similar purposes in a cone beam CT scanner using TLDs and air kerma - area product (P{sub ka}) as kerma index. Measurements were performed on two protocols used to obtain the image the maxilla-mandible in equipment Gendex GXCB 500: Protocol [GX1] extended diameter and asymmetric beam (14 cm x 8.5 cm - maxilla / mandible) and protocol [GX2] symmetrical beam (8.5 cm x 8.5 cm - maxillary / mandible). Was used LiF dosimeters (TLD 100) inserted into a female anthropomorphic phantom manufactured by Radiology Support Devices. For all protocols evaluated the value of P{sub ka} using a meter Diamentor E2 and PTW system Radcal Rapidose. The results obtained for Effective Dose / P{sub ka} these measurements were separated by protocol image. Protocol [GX1]: 44.5 μSv/478 mGy cm{sup 2}; protocol [GX2]: 54.8 μSv/507 mGy cm{sup 2}. These values indicate that the relationship between the diameter of the image acquired in the protocol [GX1] and the diameter of the image in the protocol [GX2] is equal to 1.65, the Effective Dose for the first protocol has lower value at 18%. P{sub ka} values reveal very similar results between the two protocols, although, common sense leads to the interpretation that imaging protocols with field of view (Fov) of large diameters imply high values of effective dose when compared to small diameters. However, in this particular case, this is not true due to the asymmetrical beam technology. Conclude that for the cases where the scanner uses asymmetric beam to obtain images with large diameters that cover the entire face there are advantages from the point of view of reducing the exposure of patients with respect to the use of symmetrical beam and / or to Fov images with a smaller diameter. (Author)

Implementation of single-breath-hold cone beam CT guided hypofraction radiotherapy for lung cancer

International Nuclear Information System (INIS)

Zhong, Renming; Lu, You; Wang, Jin; Zhou, Lin; Xu, Feng; Liu, Li; Zhou, Jidan; Jiang, Xiaoqin; Chen, Nianyong; Bai, Sen

2014-01-01

To analyze the feasibility of active breath control (ABC), the lung tumor reproducibility and the rationale for single-breath-hold cone beam CT (CBCT)-guided hypofraction radiotherapy. Single-breath-hold CBCT images were acquired using ABC in a cohort of 83 lung cancer patients (95 tumors) treated with hypofraction radiotherapy. For all alignments between the reference CT and CBCT images (including the pre-correction, post-correction and post-treatment CBCT images), the tumor reproducibility was evaluated via online manual alignment of the tumors, and the vertebral bone uncertainties were evaluated via offline manual alignment of the vertebral bones. The difference between the tumor reproducibility and the vertebral bone uncertainty represents the change in the tumor position relative to the vertebral bone. The relative tumor positions along the coronal, sagittal and transverse axes were measured based on the reference CT image. The correlations between the vertebral bone uncertainty, the relative tumor position, the total treatment time and the tumor reproducibility were evaluated using the Pearson correlations. Pre-correction, the systematic/random errors of tumor reproducibility were 4.5/2.6 (medial-lateral, ML), 5.1/4.8 (cranial-caudal, CC) and 4.0/3.6 mm (anterior-posterior, AP). These errors were significantly decreased to within 3 mm, both post-correction and post-treatment. The corresponding PTV margins were 4.7 (ML), 7.4 (CC) and 5.4 (AP) mm. The changes in the tumor position relative to the vertebral bone displayed systematic/random errors of 2.2/2.0 (ML), 4.1/4.4 (CC) and 3.1/3.3 (AP) mm. The uncertainty of the vertebral bone significantly correlated to the reproducibility of the tumor position (P < 0.05), except in the CC direction post-treatment. However, no significant correlation was detected between the relative tumor position, the total treatment time and the tumor reproducibility (P > 0.05). Using ABC for single-breath-hold CBCT guidance is an

SU-F-J-211: Scatter Correction for Clinical Cone-Beam CT System Using An Optimized Stationary Beam Blocker with a Single Scan

International Nuclear Information System (INIS)

Liang, X; Zhang, Z; Xie, Y; Gong, S; Niu, T; Zhou, Q

2016-01-01

Purpose: X-ray scatter photons result in significant image quality degradation of cone-beam CT (CBCT). Measurement based algorithms using beam blocker directly acquire the scatter samples and achieve significant improvement on the quality of CBCT image. Within existing algorithms, single-scan and stationary beam blocker proposed previously is promising due to its simplicity and practicability. Although demonstrated effectively on tabletop system, the blocker fails to estimate the scatter distribution on clinical CBCT system mainly due to the gantry wobble. In addition, the uniform distributed blocker strips in our previous design results in primary data loss in the CBCT system and leads to the image artifacts due to data insufficiency. Methods: We investigate the motion behavior of the beam blocker in each projection and design an optimized non-uniform blocker strip distribution which accounts for the data insufficiency issue. An accurate scatter estimation is then achieved from the wobble modeling. Blocker wobble curve is estimated using threshold-based segmentation algorithms in each projection. In the blocker design optimization, the quality of final image is quantified using the number of the primary data loss voxels and the mesh adaptive direct search algorithm is applied to minimize the objective function. Scatter-corrected CT images are obtained using the optimized blocker. Results: The proposed method is evaluated using Catphan@504 phantom and a head patient. On the Catphan©504, our approach reduces the average CT number error from 115 Hounsfield unit (HU) to 11 HU in the selected regions of interest, and improves the image contrast by a factor of 1.45 in the high-contrast regions. On the head patient, the CT number error is reduced from 97 HU to 6 HU in the soft tissue region and image spatial non-uniformity is decreased from 27% to 5% after correction. Conclusion: The proposed optimized blocker design is practical and attractive for CBCT guided radiation

SU-F-J-211: Scatter Correction for Clinical Cone-Beam CT System Using An Optimized Stationary Beam Blocker with a Single Scan

Energy Technology Data Exchange (ETDEWEB)

Liang, X; Zhang, Z; Xie, Y [Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, GuangDong (China); Gong, S; Niu, T [Department of Radiation Oncology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang (China); Institute of Translational Medicine, Zhejiang University, Hangzhou, Zhejiang (China); Zhou, Q [Department of Radiation Oncology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang (China)

2016-06-15

Purpose: X-ray scatter photons result in significant image quality degradation of cone-beam CT (CBCT). Measurement based algorithms using beam blocker directly acquire the scatter samples and achieve significant improvement on the quality of CBCT image. Within existing algorithms, single-scan and stationary beam blocker proposed previously is promising due to its simplicity and practicability. Although demonstrated effectively on tabletop system, the blocker fails to estimate the scatter distribution on clinical CBCT system mainly due to the gantry wobble. In addition, the uniform distributed blocker strips in our previous design results in primary data loss in the CBCT system and leads to the image artifacts due to data insufficiency. Methods: We investigate the motion behavior of the beam blocker in each projection and design an optimized non-uniform blocker strip distribution which accounts for the data insufficiency issue. An accurate scatter estimation is then achieved from the wobble modeling. Blocker wobble curve is estimated using threshold-based segmentation algorithms in each projection. In the blocker design optimization, the quality of final image is quantified using the number of the primary data loss voxels and the mesh adaptive direct search algorithm is applied to minimize the objective function. Scatter-corrected CT images are obtained using the optimized blocker. Results: The proposed method is evaluated using Catphan@504 phantom and a head patient. On the Catphan©504, our approach reduces the average CT number error from 115 Hounsfield unit (HU) to 11 HU in the selected regions of interest, and improves the image contrast by a factor of 1.45 in the high-contrast regions. On the head patient, the CT number error is reduced from 97 HU to 6 HU in the soft tissue region and image spatial non-uniformity is decreased from 27% to 5% after correction. Conclusion: The proposed optimized blocker design is practical and attractive for CBCT guided radiation

Auto calibration of a cone-beam-CT

International Nuclear Information System (INIS)

Gross, Daniel; Heil, Ulrich; Schulze, Ralf; Schoemer, Elmar; Schwanecke, Ulrich

2012-01-01

Purpose: This paper introduces a novel autocalibration method for cone-beam-CTs (CBCT) or flat-panel CTs, assuming a perfect rotation. The method is based on ellipse-fitting. Autocalibration refers to accurate recovery of the geometric alignment of a CBCT device from projection images alone, without any manual measurements. Methods: The authors use test objects containing small arbitrarily positioned radio-opaque markers. No information regarding the relative positions of the markers is used. In practice, the authors use three to eight metal ball bearings (diameter of 1 mm), e.g., positioned roughly in a vertical line such that their projection image curves on the detector preferably form large ellipses over the circular orbit. From this ellipse-to-curve mapping and also from its inversion the authors derive an explicit formula. Nonlinear optimization based on this mapping enables them to determine the six relevant parameters of the system up to the device rotation angle, which is sufficient to define the geometry of a CBCT-machine assuming a perfect rotational movement. These parameters also include out-of-plane rotations. The authors evaluate their method by simulation based on data used in two similar approaches [L. Smekal, M. Kachelriess, S. E, and K. Wa, “Geometric misalignment and calibration in cone-beam tomography,” Med. Phys. 31(12), 3242–3266 (2004); K. Yang, A. L. C. Kwan, D. F. Miller, and J. M. Boone, “A geometric calibration method for cone beam CT systems,” Med. Phys. 33(6), 1695–1706 (2006)]. This allows a direct comparison of accuracy. Furthermore, the authors present real-world 3D reconstructions of a dry human spine segment and an electronic device. The reconstructions were computed from projections taken with a commercial dental CBCT device having two different focus-to-detector distances that were both calibrated with their method. The authors compare their reconstruction with a reconstruction computed by the manufacturer of the

The completeness condition and source orbits for exact image reconstruction in 3D cone-beam CT

International Nuclear Information System (INIS)

Mao Xiping; Kang Kejun

1997-01-01

The completeness condition for exact image reconstruction in 3D cone-beam CT are carefully analyzed in theory, and discussions about some source orbits which fulfill the completeness condition are followed

Cone beam CT dose reduction in prostate radiotherapy using Likert scale methods.

Science.gov (United States)

Langmack, Keith A; Newton, Louise A; Jordan, Suzanne; Smith, Ruth

2016-01-01

To use a Likert scale method to optimize image quality (IQ) for cone beam CT (CBCT) soft-tissue matching for image-guided radiotherapy of the prostate. 23 males with local/locally advanced prostate cancer had the CBCT IQ assessed using a 4-point Likert scale (4 = excellent, no artefacts; 3 = good, few artefacts; 2 = poor, just able to match; 1 = unsatisfactory, not able to match) at three levels of exposure. The lateral separations of the subjects were also measured. The Friedman test and Wilcoxon signed-rank tests were used to determine if the IQ was associated with the exposure level. We used the point-biserial correlation and a χ(2) test to investigate the relationship between the separation and IQ. The Friedman test showed that the IQ was related to exposure (p = 2 × 10(-7)) and the Wilcoxon signed-rank test demonstrated that the IQ decreased as exposure decreased (all p-values <0.005). We did not find a correlation between the IQ and the separation (correlation coefficient 0.045), but for separations <35 cm, it was possible to use the lowest exposure parameters studied. We can reduce exposure factors to 80% of those supplied with the system without hindering the matching process for all patients. For patients with lateral separations <35 cm, the exposure factors can be reduced further to 64% of the original values. Likert scales are a useful tool for measuring IQ in the optimization of CBCT IQ for soft-tissue matching in radiotherapy image guidance applications.

Feasibility of contrast-enhanced cone-beam CT for target localization and treatment monitoring

International Nuclear Information System (INIS)

Rodal, Jan; Sovik, Aste; Skogmo, Hege Kippenes; Knudtsen, Ingerid Skjei; Malinen, Eirik

2010-01-01

A dog with a spontaneous maxillary tumour was given 40 Gy of fractionated radiotherapy. At five out of 10 fractions cone-beam CT (CBCT) imaging before and after administration of an iodinated contrast agent were performed. Contrast enhancement maps were overlaid on the pre-contrast CBCT images. The tumour was clearly visualized in the images thus produced.

Calibration of megavoltage cone-beam CT for radiotherapy dose calculations: Correction of cupping artifacts and conversion of CT numbers to electron density

International Nuclear Information System (INIS)

Petit, Steven F.; Elmpt, Wouter J. C. van; Nijsten, Sebastiaan M. J. J. G.; Lambin, Philippe; Dekker, Andre L. A. J.

2008-01-01

Megavoltage cone-beam CT (MV CBCT) is used for three-dimensional imaging of the patient anatomy on the treatment table prior to or just after radiotherapy treatment. To use MV CBCT images for radiotherapy dose calculation purposes, reliable electron density (ED) distributions are needed. Patient scatter, beam hardening and softening effects result in cupping artifacts in MV CBCT images and distort the CT number to ED conversion. A method based on transmission images is presented to correct for these effects without using prior knowledge of the object's geometry. The scatter distribution originating from the patient is calculated with pencil beam scatter kernels that are fitted based on transmission measurements. The radiological thickness is extracted from the scatter subtracted transmission images and is then converted to the primary transmission used in the cone-beam reconstruction. These corrections are performed in an iterative manner, without using prior knowledge regarding the geometry and composition of the object. The method was tested using various homogeneous and inhomogeneous phantoms with varying shapes and compositions, including a phantom with different electron density inserts, phantoms with large density variations, and an anthropomorphic head phantom. For all phantoms, the cupping artifact was substantially removed from the images and a linear relation between the CT number and electron density was found. After correction the deviations in reconstructed ED from the true values were reduced from up to 0.30 ED units to 0.03 for the majority of the phantoms; the residual difference is equal to the amount of noise in the images. The ED distributions were evaluated in terms of absolute dose calculation accuracy for homogeneous cylinders of different size; errors decreased from 7% to below 1% in the center of the objects for the uncorrected and corrected images, respectively, and maximum differences were reduced from 17% to 2%, respectively. The

High-quality 3D correction of ring and radiant artifacts in flat panel detector-based cone beam volume CT imaging

Science.gov (United States)

Abu Anas, Emran Mohammad; Kim, Jae Gon; Lee, Soo Yeol; Kamrul Hasan, Md

2011-10-01

The use of an x-ray flat panel detector is increasingly becoming popular in 3D cone beam volume CT machines. Due to the deficient semiconductor array manufacturing process, the cone beam projection data are often corrupted by different types of abnormalities, which cause severe ring and radiant artifacts in a cone beam reconstruction image, and as a result, the diagnostic image quality is degraded. In this paper, a novel technique is presented for the correction of error in the 2D cone beam projections due to abnormalities often observed in 2D x-ray flat panel detectors. Template images are derived from the responses of the detector pixels using their statistical properties and then an effective non-causal derivative-based detection algorithm in 2D space is presented for the detection of defective and mis-calibrated detector elements separately. An image inpainting-based 3D correction scheme is proposed for the estimation of responses of defective detector elements, and the responses of the mis-calibrated detector elements are corrected using the normalization technique. For real-time implementation, a simplification of the proposed off-line method is also suggested. Finally, the proposed algorithms are tested using different real cone beam volume CT images and the experimental results demonstrate that the proposed methods can effectively remove ring and radiant artifacts from cone beam volume CT images compared to other reported techniques in the literature.

High-quality 3D correction of ring and radiant artifacts in flat panel detector-based cone beam volume CT imaging

International Nuclear Information System (INIS)

Anas, Emran Mohammad Abu; Hasan, Md Kamrul; Kim, Jae Gon; Lee, Soo Yeol

2011-01-01

The use of an x-ray flat panel detector is increasingly becoming popular in 3D cone beam volume CT machines. Due to the deficient semiconductor array manufacturing process, the cone beam projection data are often corrupted by different types of abnormalities, which cause severe ring and radiant artifacts in a cone beam reconstruction image, and as a result, the diagnostic image quality is degraded. In this paper, a novel technique is presented for the correction of error in the 2D cone beam projections due to abnormalities often observed in 2D x-ray flat panel detectors. Template images are derived from the responses of the detector pixels using their statistical properties and then an effective non-causal derivative-based detection algorithm in 2D space is presented for the detection of defective and mis-calibrated detector elements separately. An image inpainting-based 3D correction scheme is proposed for the estimation of responses of defective detector elements, and the responses of the mis-calibrated detector elements are corrected using the normalization technique. For real-time implementation, a simplification of the proposed off-line method is also suggested. Finally, the proposed algorithms are tested using different real cone beam volume CT images and the experimental results demonstrate that the proposed methods can effectively remove ring and radiant artifacts from cone beam volume CT images compared to other reported techniques in the literature.

Percutaneous discectomy on lumbar radiculopathy related to disk herniation: Why under CT guidance? An open study of 100 consecutive patients

International Nuclear Information System (INIS)

Amoretti, Nicolas; Hauger, Olivier; Marcy, Pierre-Yves; Amoretti, Marie-eve; Lesbats, Virginie; Yvonne, Maratos; Ianessi, Antoine; Boileau, Pascal

2012-01-01

The primary objective of this study conducted on 100 patients is to demonstrate that performing CT-guided percutaneous discectomy for herniated disks results in a significant improvement in pain symptoms at several times (D1, D2, D7, 1 month, 3 months, 6 months). This objective assesses the effectiveness and feasibility of this technique under CT guidance in patients presenting documented lower back pain related to disk herniation that has not improved with appropriate medical treatment. The impact of various factors on the effectiveness of discectomy will also be evaluated. At 1 week, we notes a decrease in average VAS respectively of 71% and 67% in patients treated for posterolateral and foraminal herniated disks; the result for posteromedian herniated disks is only 45% in average decrease. At 6 months post op, 79% of lateralized herniated disks have a satisfactory result (≥70% decrease in pain as compared to initial pain), whereas post median herniated disks had a satisfactory result in only 50% of cases. Percutaneous fine needle discectomy probe under combined CT and fluoroscopic guidance is a minimally invasive spine surgery which should be considered as an alternative to surgery. This technique presents several advantages: the small diameter of the probe used (maximum 16G or 1.5 mm) allows a cutaneous incision of only a few millimeters, and a trans-canal approach can be possible; it also decreases the risk of ligamentary lesion and does not cause an osseous lesion of the posterior arc or of the adjacent muscular structures.

Image guidance doses delivered during radiotherapy: Quantification, management, and reduction: Report of the AAPM Therapy Physics Committee Task Group 180.

Science.gov (United States)

Ding, George X; Alaei, Parham; Curran, Bruce; Flynn, Ryan; Gossman, Michael; Mackie, T Rock; Miften, Moyed; Morin, Richard; Xu, X George; Zhu, Timothy C

2018-05-01

With radiotherapy having entered the era of image guidance, or image-guided radiation therapy (IGRT), imaging procedures are routinely performed for patient positioning and target localization. The imaging dose delivered may result in excessive dose to sensitive organs and potentially increase the chance of secondary cancers and, therefore, needs to be managed. This task group was charged with: a) providing an overview on imaging dose, including megavoltage electronic portal imaging (MV EPI), kilovoltage digital radiography (kV DR), Tomotherapy MV-CT, megavoltage cone-beam CT (MV-CBCT) and kilovoltage cone-beam CT (kV-CBCT), and b) providing general guidelines for commissioning dose calculation methods and managing imaging dose to patients. We briefly review the dose to radiotherapy (RT) patients resulting from different image guidance procedures and list typical organ doses resulting from MV and kV image acquisition procedures. We provide recommendations for managing the imaging dose, including different methods for its calculation, and techniques for reducing it. The recommended threshold beyond which imaging dose should be considered in the treatment planning process is 5% of the therapeutic target dose. Although the imaging dose resulting from current kV acquisition procedures is generally below this threshold, the ALARA principle should always be applied in practice. Medical physicists should make radiation oncologists aware of the imaging doses delivered to patients under their care. Balancing ALARA with the requirement for effective target localization requires that imaging dose be managed based on the consideration of weighing risks and benefits to the patient. © 2018 American Association of Physicists in Medicine.

Reduction of Cone-Beam CT scan time without compromising the accuracy of the image registration in IGRT

DEFF Research Database (Denmark)

Westberg, Jonas; Jensen, Henrik R; Bertelsen, Anders

2010-01-01

In modern radiotherapy accelerators are equipped with 3D cone-beam CT (CBCT) which is used to verify patient position before treatment. The verification is based on an image registration between the CBCT acquired just before treatment and the CT scan made for the treatment planning. The purpose...... of this study is to minimise the scan time of the CBCT without compromising the accuracy of the image registration in IGRT....

A limited cone-beam CT for dental, head and neck regions

International Nuclear Information System (INIS)

Kirimura, Susumu

2004-01-01

Recently, limited cone-beam CTs for dental or head-and-neck regions, which utilize two-dimensional X-ray detectors, have been gaining popularity. With one single rotation, they provide high-resolution volumetric data of a small region, which is suitable for specialized medical applications in the dental and otorhinolaryngology fields. It is particularly useful in visualizing small structures such as temporal, maxilla or mandibula bones. Since the imaging area is limited to a small but sufficient region, it can reduce unnecessary X-ray exposure to the patient. As the entire system is designed to be space-efficient compared to existing CT systems in the field, it is possible fit the unit into a small clinic. This type of device can be a far more practical and useful tool than an existing CT for special applications requiring detailed imaging of the fine bone structures of teeth, the middle ear, etc. (author)

WE-DE-207A-02: Advances in Cone Beam CT Anatomical and Functional Imaging in Angio-Suite to Enable One-Stop-Shop Stroke Imaging Workflow

Energy Technology Data Exchange (ETDEWEB)

Chen, G. [University of Wisconsin (United States)

2016-06-15

1. Parallels in the evolution of x-ray angiographic systems and devices used for minimally invasive endovascular therapy Charles Strother - DSA, invented by Dr. Charles Mistretta at UW-Madison, was the technology which enabled the development of minimally invasive endovascular procedures. As DSA became widely available and the potential benefits for accessing the cerebral vasculature from an endovascular approach began to be apparent, industry began efforts to develop tools for use in these procedures. Along with development of catheters, embolic materials, pushable coils and the GDC coils there was simultaneous development and improvement of 2D DSA image quality and the introduction of 3D DSA. Together, these advances resulted in an enormous expansion in the scope and numbers of minimally invasive endovascular procedures. The introduction of flat detectors for c-arm angiographic systems in 2002 provided the possibility of the angiographic suite becoming not just a location for vascular imaging where physiological assessments might also be performed. Over the last decade algorithmic and hardware advances have been sufficient to now realize this potential in clinical practice. The selection of patients for endovascular treatments is enhanced by this dual capability. Along with these advances has been a steady reduction in the radiation exposure required so that today, vascular and soft tissue images may be obtained with equal or in many cases less radiation exposure than is the case for comparable images obtained with multi-detector CT. Learning Objectives: To understand the full capabilities of today’s angiographic suite To understand how c-arm cone beam CT soft tissue imaging can be used for assessments of devices, blood flow and perfusion. Advances in real-time x-ray neuro-endovascular image guidance Stephen Rudin - Reacting to the demands on real-time image guidance for ever finer neurovascular interventions, great improvements in imaging chains are being

WE-DE-207A-02: Advances in Cone Beam CT Anatomical and Functional Imaging in Angio-Suite to Enable One-Stop-Shop Stroke Imaging Workflow

International Nuclear Information System (INIS)

Chen, G.

2016-01-01

1. Parallels in the evolution of x-ray angiographic systems and devices used for minimally invasive endovascular therapy Charles Strother - DSA, invented by Dr. Charles Mistretta at UW-Madison, was the technology which enabled the development of minimally invasive endovascular procedures. As DSA became widely available and the potential benefits for accessing the cerebral vasculature from an endovascular approach began to be apparent, industry began efforts to develop tools for use in these procedures. Along with development of catheters, embolic materials, pushable coils and the GDC coils there was simultaneous development and improvement of 2D DSA image quality and the introduction of 3D DSA. Together, these advances resulted in an enormous expansion in the scope and numbers of minimally invasive endovascular procedures. The introduction of flat detectors for c-arm angiographic systems in 2002 provided the possibility of the angiographic suite becoming not just a location for vascular imaging where physiological assessments might also be performed. Over the last decade algorithmic and hardware advances have been sufficient to now realize this potential in clinical practice. The selection of patients for endovascular treatments is enhanced by this dual capability. Along with these advances has been a steady reduction in the radiation exposure required so that today, vascular and soft tissue images may be obtained with equal or in many cases less radiation exposure than is the case for comparable images obtained with multi-detector CT. Learning Objectives: To understand the full capabilities of today’s angiographic suite To understand how c-arm cone beam CT soft tissue imaging can be used for assessments of devices, blood flow and perfusion. Advances in real-time x-ray neuro-endovascular image guidance Stephen Rudin - Reacting to the demands on real-time image guidance for ever finer neurovascular interventions, great improvements in imaging chains are being

A preliminary study on cone beam CT image based treatment planning

International Nuclear Information System (INIS)

Padmanaban, Sriram; Jeevanandham, Prakash; Boopathy, Raghavendiran; Sukumar, Prabakar; Syam Kumar, S.A.; Kunjithapatham, Bhuvana; Nagarajan, Vivekanandan

2008-01-01

Kilovolt Cone beam computed tomography (CBCT) based on flat panel technology is primarily used for positioning verification. However it is required to evaluate the accuracy of dose calculation based on CBCT images for the purpose of re-planning in adaptive radiation therapy (ART). In this study, 3DCRT and IMRT plans were done using both the planning CT and CBCT images and the corresponding variations in dose and MUs were analyzed, hence evaluating the feasibility of using kilovolt CBCT for dose calculation and patient dose verification. (author)

Utilization of cone-beam CT for offline evaluation of target volume coverage during prostate image-guided radiotherapy based on bony anatomy alignment.

Science.gov (United States)

Paluska, Petr; Hanus, Josef; Sefrova, Jana; Rouskova, Lucie; Grepl, Jakub; Jansa, Jan; Kasaova, Linda; Hodek, Miroslav; Zouhar, Milan; Vosmik, Milan; Petera, Jiri

2012-01-01

To assess target volume coverage during prostate image-guided radiotherapy based on bony anatomy alignment and to assess possibility of safety margin reduction. Implementation of IGRT should influence safety margins. Utilization of cone-beam CT provides current 3D anatomic information directly in irradiation position. Such information enables reconstruction of the actual dose distribution. Seventeen prostate patients were treated with daily bony anatomy image-guidance. Cone-beam CT (CBCT) scans were acquired once a week immediately after bony anatomy alignment. After the prostate, seminal vesicles, rectum and bladder were contoured, the delivered dose distribution was reconstructed. Target dose coverage was evaluated by the proportion of the CTV encompassed by the 95% isodose. Original plans employed a 1 cm safety margin. Alternative plans assuming a smaller 7 mm margin between CTV and PTV were evaluated in the same way. Rectal and bladder volumes were compared with the initial ones. Rectal and bladder volumes irradiated with doses higher than 75 Gy, 70 Gy, 60 Gy, 50 Gy and 40 Gy were analyzed. In 12% of reconstructed plans the prostate coverage was not sufficient. The prostate underdosage was observed in 5 patients. Coverage of seminal vesicles was not satisfactory in 3% of plans. Most of the target underdosage corresponded to excessive rectal or bladder filling. Evaluation of alternative plans assuming a smaller 7 mm margin revealed 22% and 11% of plans where prostate and seminal vesicles coverage, respectively, was compromised. These were distributed over 8 and 7 patients, respectively. Sufficient dose coverage of target volumes was not achieved for all patients. Reducing of safety margin is not acceptable. Initial rectal and bladder volumes cannot be considered representative for subsequent treatment.

Investigation of practical approaches to evaluating cumulative dose for cone beam computed tomography (CBCT) from standard CT dosimetry measurements: a Monte Carlo study.

Science.gov (United States)

Abuhaimed, Abdullah; Martin, Colin J; Sankaralingam, Marimuthu; Gentle, David J

2015-07-21

A function called Gx(L) was introduced by the International Commission on Radiation Units and Measurements (ICRU) Report-87 to facilitate measurement of cumulative dose for CT scans within long phantoms as recommended by the American Association of Physicists in Medicine (AAPM) TG-111. The Gx(L) function is equal to the ratio of the cumulative dose at the middle of a CT scan to the volume weighted CTDI (CTDIvol), and was investigated for conventional multi-slice CT scanners operating with a moving table. As the stationary table mode, which is the basis for cone beam CT (CBCT) scans, differs from that used for conventional CT scans, the aim of this study was to investigate the extension of the Gx(L) function to CBCT scans. An On-Board Imager (OBI) system integrated with a TrueBeam linac was simulated with Monte Carlo EGSnrc/BEAMnrc, and the absorbed dose was calculated within PMMA, polyethylene (PE), and water head and body phantoms using EGSnrc/DOSXYZnrc, where the body PE body phantom emulated the ICRU/AAPM phantom. Beams of width 40-500 mm and beam qualities at tube potentials of 80-140 kV were studied. Application of a modified function of beam width (W) termed Gx(W), for which the cumulative dose for CBCT scans f (0) is normalized to the weighted CTDI (CTDIw) for a reference beam of width 40 mm, was investigated as a possible option. However, differences were found in Gx(W) with tube potential, especially for body phantoms, and these were considered to be due to differences in geometry between wide beams used for CBCT scans and those for conventional CT. Therefore, a modified function Gx(W)100 has been proposed, taking the form of values of f (0) at each position in a long phantom, normalized with respect to dose indices f 100(150)x measured with a 100 mm pencil ionization chamber within standard 150 mm PMMA phantoms, using the same scanning parameters, beam widths and positions within the phantom. f 100(150)x averages the dose resulting from

Passive breath gating equipment for cone beam CT-guided RapidArc gastric cancer treatments

International Nuclear Information System (INIS)

Hu, Weigang; Li, Guichao; Ye, Jinsong; Wang, Jiazhou; Peng, Jiayuan; Gong, Min; Yu, Xiaoli; Studentski, Matthew T.; Xiao, Ying; Zhang, Zhen

2015-01-01

Background and purpose: To report preliminary results of passive breath gating (PBG) equipment for cone-beam CT image-guided gated RapidArc gastric cancer treatments. Material and methods: Home-developed PBG equipment integrated with the real-time position management system (RPM) for passive patient breath hold was used in CT simulation, online partial breath hold (PBH) CBCT acquisition, and breath-hold gating (BHG) RapidArc delivery. The treatment was discontinuously delivered with beam on during BH and beam off for free breathing (FB). Pretreatment verification PBH CBCT was obtained with the PBG-RPM system. Additionally, the reproducibility of the gating accuracy was evaluated. Results: A total of 375 fractions of breath-hold gating RapidArc treatments were successfully delivered and 233 PBH CBCTs were available for analysis. The PBH CBCT images were acquired with 2–3 breath holds and 1–2 FB breaks. The imaging time was the same for PBH CBCT and conventional FB CBCT (60 s). Compared to FB CBCT, the motion artifacts seen in PBH CBCT images were remarkably reduced. The average BHG RapidArc delivery time was 103 s for one 270-degree arc and 269 s for two full arcs. Conclusions: The PBG-RPM based PBH CBCT verification and BHG RapidArc delivery was successfully implemented clinically. The BHG RapidArc treatment was accomplished using a conventional RapidArc machine with high delivery efficiency

The European Society of Therapeutic Radiology and Oncology-European Institute of Radiotherapy (ESTRO-EIR) report on 3D CT-based in-room image guidance systems: a practical and technical review and guide.

Science.gov (United States)

Korreman, Stine; Rasch, Coen; McNair, Helen; Verellen, Dirk; Oelfke, Uwe; Maingon, Philippe; Mijnheer, Ben; Khoo, Vincent

2010-02-01

The past decade has provided many technological advances in radiotherapy. The European Institute of Radiotherapy (EIR) was established by the European Society of Therapeutic Radiology and Oncology (ESTRO) to provide current consensus statement with evidence-based and pragmatic guidelines on topics of practical relevance for radiation oncology. This report focuses primarily on 3D CT-based in-room image guidance (3DCT-IGRT) systems. It will provide an overview and current standing of 3DCT-IGRT systems addressing the rationale, objectives, principles, applications, and process pathways, both clinical and technical for treatment delivery and quality assurance. These are reviewed for four categories of solutions; kV CT and kV CBCT (cone-beam CT) as well as MV CT and MV CBCT. It will also provide a framework and checklist to consider the capability and functionality of these systems as well as the resources needed for implementation. Two different but typical clinical cases (tonsillar and prostate cancer) using 3DCT-IGRT are illustrated with workflow processes via feedback questionnaires from several large clinical centres currently utilizing these systems. The feedback from these clinical centres demonstrates a wide variability based on local practices. This report whilst comprehensive is not exhaustive as this area of development remains a very active field for research and development. However, it should serve as a practical guide and framework for all professional groups within the field, focussed on clinicians, physicists and radiation therapy technologists interested in IGRT. Copyright 2010 Elsevier Ireland Ltd. All rights reserved.

Robot-assisted endoscope guidance versus manual endoscope guidance in functional endonasal sinus surgery (FESS).

Science.gov (United States)

Eichhorn, Klaus Wolfgang; Westphal, Ralf; Rilk, Markus; Last, Carsten; Bootz, Friedrich; Wahl, Friedrich; Jakob, Mark; Send, Thorsten

2017-10-01

Having one hand occupied with the endoscope is the major disadvantage for the surgeon when it comes to functional endoscopic sinus surgery (FESS). Only the other hand is free to use the surgical instruments. Tiredness or frequent instrument changes can thus lead to shaky endoscopic images. We collected the pose data (position and orientation) of the rigid 0° endoscope and all the instruments used in 16 FESS procedures with manual endoscope guidance as well as robot-assisted endoscope guidance. In combination with the DICOM CT data, we tracked the endoscope poses and workspaces using self-developed tracking markers. All surgeries were performed once with the robot and once with the surgeon holding the endoscope. Looking at the durations required, we observed a decrease in the operating time because one surgeon doing all the procedures and so a learning curve occurred what we expected. The visual inspection of the specimens showed no damages to any of the structures outside the paranasal sinuses. Robot-assisted endoscope guidance in sinus surgery is possible. Further CT data, however, are desirable for the surgical analysis of a tracker-based navigation within the anatomic borders. Our marker-based tracking of the endoscope as well as the instruments makes an automated endoscope guidance feasible. On the subjective side, we see that RASS brings a relief for the surgeon.

Advantages of computed tomographic guidance

International Nuclear Information System (INIS)

Casola, G.; Vansonnenberg, E.

1987-01-01

Both ultrasound and CT are successfully used to guide interventional procedures throughout the body. There are advantages and disadvantages to each modality and choosing one over the other will vary from case to case. Major factors influencing choice are discussed in this paper. As a general rule CT guidance is usually required for lesions in the thorax, the adrenals, the pancreas, lymph nodes, and for percutaneous abscess drainage. The authors feel that a complimentary use of ultrasound and CT is essential to optimize success and cost-effectiveness; therefore, the interventional radiologist should be familiar with both imaging modalities

CT angiography using electron-beam computed tomography (EBCT). A phantom study

International Nuclear Information System (INIS)

Uchino, Akira; Kato, Akira; Kudo, Sho

1997-01-01

The purpose of this study was to evaluate the accuracy of CT angiography in small vessels using electron-beam computed tomography (EBCT). Vessel phantoms with inner diameters of 8 mm, 6 mm, and 4 mm were prepared with segments of 75%, 50%, and 25% stenosis in each vessel. The vessels were filled with contrast medium (Iopamidol 300 at 1/24 dilution, approximately 380 HU). The EBCT apparatus used was an Imatron C-150. The step volume scan mode was used with slice thicknesses of 1.5 mm and 3.0 mm, scan time of 0.3 sec, and 210 mm field of view. Images with a slice thickness of 1.5 mm were definitely better than those with a slice thickness of 3.0 mm. The quality of maximum intensity projection (MIP) images was quite similar to that of three-dimensional (3D) images. Using the 8 mm vessel phantom, all stenotic segments were accurately visualized on CT angiography. The 50% stenotic segments were accurately estimated in all vessels. However, the 75% stenotic segments were slightly overestimated in smaller vessels, and the 25% stenotic segments were slightly underestimated in smaller vessels. We consider CT angiography using EBCT to be a useful, less invasive diagnostic modality for stenoocclusive lesions. (author)

Conventional multi-slice computed tomography (CT) and cone-beam CT (CBCT) for computer-aided implant placement. Part II: reliability of mucosa-supported stereolithographic guides.

Science.gov (United States)

Arisan, Volkan; Karabuda, Zihni Cüneyt; Pişkin, Bülent; Özdemir, Tayfun

2013-12-01

Deviations of implants that were placed by conventional computed tomography (CT)- or cone beam CT (CBCT)-derived mucosa-supported stereolithographic (SLA) surgical guides were analyzed in this study. Eleven patients were randomly scanned by a multi-slice CT (CT group) or a CBCT scanner (CBCT group). A total of 108 implants were planned on the software and placed using SLA guides. A new CT or CBCT scan was obtained and merged with the planning data to identify the deviations between the planned and placed implants. Results were analyzed by Mann-Whitney U test and multiple regressions (p < .05). Mean angular and linear deviations in the CT group were 3.30° (SD 0.36), and 0.75 (SD 0.32) and 0.80 mm (SD 0.35) at the implant shoulder and tip, respectively. In the CBCT group, mean angular and linear deviations were 3.47° (SD 0.37), and 0.81 (SD 0.32) and 0.87 mm (SD 0.32) at the implant shoulder and tip, respectively. No statistically significant differences were detected between the CT and CBCT groups (p = .169 and p = .551, p = .113 for angular and linear deviations, respectively). Implant placement via CT- or CBCT-derived mucosa-supported SLA guides yielded similar deviation values. Results should be confirmed on alternative CBCT scanners. © 2012 Wiley Periodicals, Inc.

Quantitative assessment of the physical potential of proton beam range verification with PET/CT

Science.gov (United States)

Knopf, A.; Parodi, K.; Paganetti, H.; Cascio, E.; Bonab, A.; Bortfeld, T.

2008-08-01

A recent clinical pilot study demonstrated the feasibility of offline PET/CT range verification for proton therapy treatments. In vivo PET measurements are challenged by blood perfusion, variations of tissue compositions, patient motion and image co-registration uncertainties. Besides these biological and treatment specific factors, the accuracy of the method is constrained by the underlying physical processes. This phantom study distinguishes physical factors from other factors, assessing the reproducibility, consistency and sensitivity of the PET/CT range verification method. A spread-out Bragg-peak (SOBP) proton field was delivered to a phantom consisting of poly-methyl methacrylate (PMMA), lung and bone equivalent material slabs. PET data were acquired in listmode at a commercial PET/CT scanner available within 10 min walking distance from the proton therapy unit. The measured PET activity distributions were compared to simulations of the PET signal based on Geant4 and FLUKA Monte Carlo (MC) codes. To test the reproducibility of the measured PET signal, data from two independent measurements at the same geometrical position in the phantom were compared. Furthermore, activation depth profiles within identical material arrangements but at different positions within the irradiation field were compared to test the consistency of the measured PET signal. Finally, activation depth profiles through air/lung, air/bone and lung/bone interfaces parallel as well as at 6° to the beam direction were studied to investigate the sensitivity of the PET/CT range verification method. The reproducibility and the consistency of the measured PET signal were found to be of the same order of magnitude. They determine the physical accuracy of the PET measurement to be about 1 mm. However, range discrepancies up to 2.6 mm between two measurements and range variations up to 2.6 mm within one measurement were found at the beam edge and at the edge of the field of view (FOV) of the PET

Quantitative assessment of the physical potential of proton beam range verification with PET/CT

Energy Technology Data Exchange (ETDEWEB)

Knopf, A; Paganetti, H; Cascio, E; Bortfeld, T [Department of Radiation Oncology, MGH and Harvard Medical School, Boston, MA 02114 (United States); Parodi, K [Heidelberg Ion Therapy Center, Heidelberg (Germany); Bonab, A [Department of Radiology, MGH and Harvard Medical School, Boston, MA 02114 (United States)

2008-08-07

A recent clinical pilot study demonstrated the feasibility of offline PET/CT range verification for proton therapy treatments. In vivo PET measurements are challenged by blood perfusion, variations of tissue compositions, patient motion and image co-registration uncertainties. Besides these biological and treatment specific factors, the accuracy of the method is constrained by the underlying physical processes. This phantom study distinguishes physical factors from other factors, assessing the reproducibility, consistency and sensitivity of the PET/CT range verification method. A spread-out Bragg-peak (SOBP) proton field was delivered to a phantom consisting of poly-methyl methacrylate (PMMA), lung and bone equivalent material slabs. PET data were acquired in listmode at a commercial PET/CT scanner available within 10 min walking distance from the proton therapy unit. The measured PET activity distributions were compared to simulations of the PET signal based on Geant4 and FLUKA Monte Carlo (MC) codes. To test the reproducibility of the measured PET signal, data from two independent measurements at the same geometrical position in the phantom were compared. Furthermore, activation depth profiles within identical material arrangements but at different positions within the irradiation field were compared to test the consistency of the measured PET signal. Finally, activation depth profiles through air/lung, air/bone and lung/bone interfaces parallel as well as at 6{sup 0} to the beam direction were studied to investigate the sensitivity of the PET/CT range verification method. The reproducibility and the consistency of the measured PET signal were found to be of the same order of magnitude. They determine the physical accuracy of the PET measurement to be about 1 mm. However, range discrepancies up to 2.6 mm between two measurements and range variations up to 2.6 mm within one measurement were found at the beam edge and at the edge of the field of view (FOV) of the

Quantitative assessment of the physical potential of proton beam range verification with PET/CT.

Science.gov (United States)

Knopf, A; Parodi, K; Paganetti, H; Cascio, E; Bonab, A; Bortfeld, T

2008-08-07

A recent clinical pilot study demonstrated the feasibility of offline PET/CT range verification for proton therapy treatments. In vivo PET measurements are challenged by blood perfusion, variations of tissue compositions, patient motion and image co-registration uncertainties. Besides these biological and treatment specific factors, the accuracy of the method is constrained by the underlying physical processes. This phantom study distinguishes physical factors from other factors, assessing the reproducibility, consistency and sensitivity of the PET/CT range verification method. A spread-out Bragg-peak (SOBP) proton field was delivered to a phantom consisting of poly-methyl methacrylate (PMMA), lung and bone equivalent material slabs. PET data were acquired in listmode at a commercial PET/CT scanner available within 10 min walking distance from the proton therapy unit. The measured PET activity distributions were compared to simulations of the PET signal based on Geant4 and FLUKA Monte Carlo (MC) codes. To test the reproducibility of the measured PET signal, data from two independent measurements at the same geometrical position in the phantom were compared. Furthermore, activation depth profiles within identical material arrangements but at different positions within the irradiation field were compared to test the consistency of the measured PET signal. Finally, activation depth profiles through air/lung, air/bone and lung/bone interfaces parallel as well as at 6 degrees to the beam direction were studied to investigate the sensitivity of the PET/CT range verification method. The reproducibility and the consistency of the measured PET signal were found to be of the same order of magnitude. They determine the physical accuracy of the PET measurement to be about 1 mm. However, range discrepancies up to 2.6 mm between two measurements and range variations up to 2.6 mm within one measurement were found at the beam edge and at the edge of the field of view (FOV) of the

Evaluation of deformable image registration for contour propagation between CT and cone-beam CT images in adaptive head and neck radiotherapy.

Science.gov (United States)

Li, X; Zhang, Y Y; Shi, Y H; Zhou, L H; Zhen, X

2016-04-29

Deformable image registration (DIR) is a critical technic in adaptive radiotherapy (ART) to propagate contours between planning computerized tomography (CT) images and treatment CT/Cone-beam CT (CBCT) image to account for organ deformation for treatment re-planning. To validate the ability and accuracy of DIR algorithms in organ at risk (OAR) contours mapping, seven intensity-based DIR strategies are tested on the planning CT and weekly CBCT images from six Head & Neck cancer patients who underwent a 6 ∼ 7 weeks intensity-modulated radiation therapy (IMRT). Three similarity metrics, i.e. the Dice similarity coefficient (DSC), the percentage error (PE) and the Hausdorff distance (HD), are employed to measure the agreement between the propagated contours and the physician delineated ground truths. It is found that the performance of all the evaluated DIR algorithms declines as the treatment proceeds. No statistically significant performance difference is observed between different DIR algorithms (p> 0.05), except for the double force demons (DFD) which yields the worst result in terms of DSC and PE. For the metric HD, all the DIR algorithms behaved unsatisfactorily with no statistically significant performance difference (p= 0.273). These findings suggested that special care should be taken when utilizing the intensity-based DIR algorithms involved in this study to deform OAR contours between CT and CBCT, especially for those organs with low contrast.

A dual centre study of setup accuracy for thoracic patients based on Cone-Beam CT data

DEFF Research Database (Denmark)

Nielsen, Tine B; Hansen, Vibeke N; Westberg, Jonas

2011-01-01

BACKGROUND AND PURPOSE: To compare setup uncertainties at two different institutions by using identical imaging and analysis techniques for thoracic patients with different fixation equipments. METHODS AND MATERIALS: Patient registration results from Cone-Beam CT (CBCT) scans of 174 patients were...... increase of the systematic setup uncertainties in between imaging fractions. A margin reduction of ⩾0.2cm can be achieved for patients with peak-to-peak respiration amplitudes of ⩾1.2cm when changing from 4D-CT to Active Breathing Coordinator™ (ABC). CONCLUSIONS: The setup uncertainties at the two...

Dose optimisation for intraoperative cone-beam flat-detector CT in paediatric spinal surgery

International Nuclear Information System (INIS)

Petersen, Asger Greval; Eiskjaer, Soeren; Kaspersen, Jon

2012-01-01

During surgery for spinal deformities, accurate placement of pedicle screws may be guided by intraoperative cone-beam flat-detector CT. The purpose of this study was to identify appropriate paediatric imaging protocols aiming to reduce the radiation dose in line with the ALARA principle. Using O-arm registered (Medtronic, Inc.), three paediatric phantoms were employed to measure CTDI w doses with default and lowered exposure settings. Images from 126 scans were evaluated by two spinal surgeons and scores were compared (Kappa statistics). Effective doses were calculated. The recommended new low-dose 3-D spine protocols were then used in 15 children. The lowest acceptable exposure as judged by image quality for intraoperative use was 70 kVp/40 mAs, 70 kVp/80 mAs and 80 kVp/40 mAs for the 1-, 5- and 12-year-old-equivalent phantoms respectively (kappa = 0,70). Optimised dose settings reduced CTDI w doses 89-93%. The effective dose was 0.5 mSv (91-94,5% reduction). The optimised protocols were used clinically without problems. Radiation doses for intraoperative 3-D CT using a cone-beam flat-detector scanner could be reduced at least 89% compared to manufacturer settings and still be used to safely navigate pedicle screws. (orig.)

Cone-Beam CT Localization of Internal Target Volumes for Stereotactic Body Radiotherapy of Lung Lesions

International Nuclear Information System (INIS)

Wang Zhiheng; Wu, Q. Jackie; Marks, Lawrence B.; Larrier, Nicole; Yin Fangfang

2007-01-01

Purpose: In this study, we investigate a technique of matching internal target volumes (ITVs) in four-dimensional (4D) simulation computed tomography (CT) to the composite target volume in free-breathing on-board cone-beam (CB) CT. The technique is illustrated by using both phantom and patient cases. Methods and Materials: A dynamic phantom with a target ball simulating respiratory motion with various amplitude and cycle times was used to verify localization accuracy. The dynamic phantom was scanned using simulation CT with a phase-based retrospective sorting technique. The ITV was then determined based on 10 sets of sorted images. The size and epicenter of the ITV identified from 4D simulation CT images and the composite target volume identified from on-board CBCT images were compared to assess localization accuracy. Similarly, for two clinical cases of patients with lung cancer, ITVs defined from 4D simulation CT images and CBCT images were compared. Results: For the phantom, localization accuracy between the ITV in 4D simulation CT and the composite target volume in CBCT was within 1 mm, and ITV was within 8.7%. For patient cases, ITVs on simulation CT and CBCT were within 8.0%. Conclusion: This study shows that CBCT is a useful tool to localize ITV for targets affected by respiratory motion. Verification of the ITV from 4D simulation CT using on-board free-breathing CBCT is feasible for the target localization of lung tumors

A cone beam CT-guided online plan modification technique to correct interfractional anatomic changes for prostate cancer IMRT treatment

International Nuclear Information System (INIS)

Fu Weihua; Yang Yong; Yue, Ning J; Heron, Dwight E; Huq, M Saiful

2009-01-01

The purpose of this work is to develop an online plan modification technique to compensate for the interfractional anatomic changes for prostate cancer intensity-modulated radiation therapy (IMRT) treatment based on daily cone beam CT (CBCT) images. In this proposed technique, pre-treatment CBCT images are acquired after the patient is set up on the treatment couch using an in-room laser with the guidance of the setup skin marks. Instead of moving the couch to rigidly align the target or re-planning using the CBCT images, we modify the original IMRT plan to account for the interfractional target motion and deformation based on the daily CBCT image feedback. The multileaf collimator (MLC) leaf positions for each subfield are automatically adjusted in the proposed algorithm based on the position and shape changes of target projection in the beam's eye view (BEV). Three typical prostate cases were adopted to evaluate the proposed technique, and the results were compared with those obtained with bony-structure-based rigid translation correction, prostate-based correction and CBCT-based re-planning strategies. The study revealed that the proposed modification technique is superior to the bony-structure-based and prostate-based correction techniques, especially when interfractional target deformation exists. Its dosimetric performance is closer to that of the re-planned strategy, but with much higher efficiency, indicating that the introduced online CBCT-guided plan modification technique may be an efficient and practical method to compensate for the interfractional target position and shape changes for prostate IMRT.

Fast 4D cone-beam CT from 60 s acquisitions

Directory of Open Access Journals (Sweden)

David C. Hansen

2018-01-01

Full Text Available Background & purpose: Four dimensional Cone beam CT (CBCT has many potential benefits for radiotherapy but suffers from poor image quality, long acquisition times, and/or long reconstruction times. In this work we present a fast iterative reconstruction algorithm for 4D reconstruction of fast acquisition cone beam CT, as well as a new method for temporal regularization and compare to state of the art methods for 4D CBCT. Materials & methods: Regularization parameters for the iterative algorithms were found automatically via computer optimization on 60 s acquisitions using the XCAT phantom. Nineteen lung cancer patients were scanned with 60 s arcs using the onboard image on a Varian trilogy linear accelerator. Images were reconstructed using an accelerated ordered subset algorithm. A frequency based temporal regularization algorithm was developed and compared to the McKinnon-Bates algorithm, 4D total variation and prior images compressed sensing (PICCS. Results: All reconstructions were completed in 60 s or less. The proposed method provided a structural similarity of 0.915, compared with 0.786 for the classic McKinnon-bates method. For the patient study, it provided fewer image artefacts than PICCS, and better spatial resolution than 4D TV. Conclusion: Four dimensional iterative CBCT reconstruction was done in less than 60 s, demonstrating the clinical feasibility. The frequency based method outperformed 4D total variation and PICCS on the simulated data, and for patients allowed for tumor location based on 60 s acquisitions, even for slowly breathing patients. It should thus be suitable for routine clinical use.

Robust methods for automatic image-to-world registration in cone-beam CT interventional guidance

International Nuclear Information System (INIS)

Dang, H.; Otake, Y.; Schafer, S.; Stayman, J. W.; Kleinszig, G.; Siewerdsen, J. H.

2012-01-01

Purpose: Real-time surgical navigation relies on accurate image-to-world registration to align the coordinate systems of the image and patient. Conventional manual registration can present a workflow bottleneck and is prone to manual error and intraoperator variability. This work reports alternative means of automatic image-to-world registration, each method involving an automatic registration marker (ARM) used in conjunction with C-arm cone-beam CT (CBCT). The first involves a Known-Model registration method in which the ARM is a predefined tool, and the second is a Free-Form method in which the ARM is freely configurable. Methods: Studies were performed using a prototype C-arm for CBCT and a surgical tracking system. A simple ARM was designed with markers comprising a tungsten sphere within infrared reflectors to permit detection of markers in both x-ray projections and by an infrared tracker. The Known-Model method exercised a predefined specification of the ARM in combination with 3D-2D registration to estimate the transformation that yields the optimal match between forward projection of the ARM and the measured projection images. The Free-Form method localizes markers individually in projection data by a robust Hough transform approach extended from previous work, backprojected to 3D image coordinates based on C-arm geometric calibration. Image-domain point sets were transformed to world coordinates by rigid-body point-based registration. The robustness and registration accuracy of each method was tested in comparison to manual registration across a range of body sites (head, thorax, and abdomen) of interest in CBCT-guided surgery, including cases with interventional tools in the radiographic scene. Results: The automatic methods exhibited similar target registration error (TRE) and were comparable or superior to manual registration for placement of the ARM within ∼200 mm of C-arm isocenter. Marker localization in projection data was robust across all

Electron-beam CT diagnosis of congenital cardiovascular diverticula

International Nuclear Information System (INIS)

Yang Youyou; Zheng Lili; Li Xiangmin; Zhou Xuhui; Peng Qian; Meng Quanfei; Dai Ruping

2008-01-01

Objective: To investigate the clinical application of electron-beam CT (EBCT) in the diagnosis of congenital cardiovascular diverticula. Methods: Retrospective analysis of 9 patients with congenital cardiovascular diverticula confirmed by operation and pathology was done. Of them, enhanced continuous volume scan was performed on 8 patients and enhanced single slice scan was performed on one patient with an Imatron C-150 scanner. Results: The group of 9 patients included one patient with diverticulum of the left ventricle, 3 patients with diverticulum of the atria and 5 patients with diverticulum of the aorta. EBCT scan and three dimensional reconstruction could demonstrate not only the origin, size, shape, location and adjacent structure of diverticula, but also other important complicated abnormalities such as ventriculoarterial connection disorder, cardiac septal defect, aortic coarctation and even dissection. Conclusion: EBCT is an ideal noninvasive technique in the diagnosis of congenital cardiovascular diverticula. (authors)

WE-AB-BRA-04: Evaluation of the Tumor Registration Error in Biopsy Procedures Performed Under Real Time PET/CT Guidance

International Nuclear Information System (INIS)

Fanchon, L; Apte, A; Dzyubak, O; Mageras, G; Yorke, E; Solomon, S; Kirov, A; Visvikis, D; Hatt, M

2015-01-01

Purpose: PET/CT guidance is used for biopsies of metabolically active lesions, which are not well seen on CT alone or to target the metabolically active tissue in tumor ablations. It has also been shown that PET/CT guided biopsies provide an opportunity to verify the location of the lesion border at the place of needle insertion. However the error in needle placement with respect to the metabolically active region may be affected by motion between the PET/CT scan performed at the start of the procedure and the CT scan performed with the needle in place and this error has not been previously quantified. Methods: Specimens from 31 PET/CT guided biopsies were investigated and correlated to the intraoperative PET scan under an IRB approved HIPAA compliant protocol. For 4 of the cases in which larger motion was suspected a second PET scan was obtained with the needle in place. The CT and the PET images obtained before and after the needle insertion were used to calculate the displacement of the voxels along the needle path. CTpost was registered to CTpre using a free form deformable registration and then fused with PETpre. The shifts between the PET image contours (42% of SUVmax) for PETpre and PETpost were obtained at the needle position. Results: For these extreme cases the displacement of the CT voxels along the needle path ranged from 2.9 to 8 mm with a mean of 5 mm. The shift of the PET image segmentation contours (42% of SUVmax) at the needle position ranged from 2.3 to 7 mm between the two scans. Conclusion: Evaluation of the mis-registration between the CT with the needle in place and the pre-biopsy PET can be obtained using deformable registration of the respective CT scans and can be used to indicate the need of a second PET in real-time. This work is supported in part by a grant from Biospace Lab, S.A

Daily fraction dose recalculation based on rigid registration using Cone Beam CT

Directory of Open Access Journals (Sweden)

Courtney Bosse

2014-03-01

Full Text Available Purpose: To calculate the daily fraction dose for CBCT recalculations based on rigid registration and compare it to the planned CT doses.Methods: For this study, 30 patients that were previously treated (10 SBRT lung, 10 prostate and 10 abdomen were considered. The daily CBCT images were imported into the Pinnacle treatment planning system from Mosaic. Pinnacle was used to re-contour the regions of interest (ROI for the specific CBCT by copying the contours from the original CT plan, planned by the prescribing physician, onto each daily CBCT and then manually reshaping contours to match the ROIs. A new plan is then created with the re-contoured CBCT as primary image in order to calculate the daily dose delivered to each ROI. The DVH values are then exported into Excel and overlaid onto the original CT DVH to produce a graph.Results: For the SBRT lung patients, we found that there were small daily volume changes in the lungs, trachea and esophagus. For almost all regions of interest we found that the dose received each day was less than the predicted dose of the planned CT while the PTV dose was relatively the same each day. The results for the prostate patients were similar, showing slight differences in the DVH values for different days in the rectum and bladder but similar PTV.Conclusion: By comparing daily fraction dose between the re-contoured CBCT images and the original planned CT show that PTV coverage for both prostate and SBRT, it has been shown that for PTV coverage, a planned CT is adequate. However, there are differences between the dose for the organs surrounding the PTV. The dose difference is less than the planned in most instances.-----------------------Cite this article as: Bosse C, Tuohy R, Mavroidis P, Shi Z, Crownover R, Gutierrez A, Papanikolaou N, Stathakis S. Daily fraction dose recalculation based on rigid registration using Cone Beam CT. Int J Cancer Ther Oncol 2014; 2(2:020217. DOI: 10.14319/ijcto.0202.17

MRI-guided and CT-guided cervical nerve root infiltration therapy. A cost comparison

Energy Technology Data Exchange (ETDEWEB)

Maurer, M.H.; Froeling, V.; Roettgen, R.; Bucourt, M. de; Hamm, B.; Streitparth, F. [Charite University Medicine Berlin (Germany). Dept. of Diagnostic and Interventional Radiology; Bretschneider, T. [Magdeburg Univ. (Germany). Dept. of Radiology and Nuclear Medicine; Hartwig, T.; Disch, A.C. [Charite University Medicine Berlin (Germany). Center for Musculoskeletal Surgery

2014-06-15

Purpose: To evaluate and compare the costs of MRI-guided and CT-guided cervical nerve root infiltration for the minimally invasive treatment of radicular neck pain. Materials and Methods: Between September 2009 and April 2012, 22 patients (9 men, 13 women; mean age: 48.2 years) underwent MRI-guided (1.0 Tesla, Panorama HFO, Philips) single-site periradicular cervical nerve root infiltration with 40 mg triamcinolone acetonide. A further 64 patients (34 men, 30 women; mean age: 50.3 years) were treated under CT fluoroscopic guidance (Somatom Definition 64, Siemens). The mean overall costs were calculated as the sum of the prorated costs of equipment use (purchase, depreciation, maintenance, and energy costs), personnel costs and expenditure for disposables that were identified for MRI- and CT-guided procedures. Additionally, the cost of ultrasound guidance was calculated. Results: The mean intervention time was 24.9 min. (range: 12-36 min.) for MRI-guided infiltration and 19.7 min. (range: 5-54 min.) for CT-guided infiltration. The average total costs per patient were EUR 240 for MRI-guided interventions and EUR 124 for CT-guided interventions. These were (MRI/CT guidance) EUR 150/60 for equipment use, EUR 46/40 for personnel, and EUR 44/25 for disposables. The mean overall cost of ultrasound guidance was EUR 76. Conclusion: Cervical nerve root infiltration using MRI guidance is still about twice as expensive as infiltration using CT guidance. However, since it does not involve radiation exposure for patients and personnel, MRI-guided nerve root infiltration may become a promising alternative to the CT-guided procedure, especially since a further price decrease is expected for MRI devices and MR-compatible disposables. In contrast, ultrasound remains the less expensive method for nerve root infiltration guidance. (orig.)

MRI-guided and CT-guided cervical nerve root infiltration therapy. A cost comparison

International Nuclear Information System (INIS)

Maurer, M.H.; Froeling, V.; Roettgen, R.; Bucourt, M. de; Hamm, B.; Streitparth, F.; Bretschneider, T.; Hartwig, T.; Disch, A.C.

2014-01-01

Purpose: To evaluate and compare the costs of MRI-guided and CT-guided cervical nerve root infiltration for the minimally invasive treatment of radicular neck pain. Materials and Methods: Between September 2009 and April 2012, 22 patients (9 men, 13 women; mean age: 48.2 years) underwent MRI-guided (1.0 Tesla, Panorama HFO, Philips) single-site periradicular cervical nerve root infiltration with 40 mg triamcinolone acetonide. A further 64 patients (34 men, 30 women; mean age: 50.3 years) were treated under CT fluoroscopic guidance (Somatom Definition 64, Siemens). The mean overall costs were calculated as the sum of the prorated costs of equipment use (purchase, depreciation, maintenance, and energy costs), personnel costs and expenditure for disposables that were identified for MRI- and CT-guided procedures. Additionally, the cost of ultrasound guidance was calculated. Results: The mean intervention time was 24.9 min. (range: 12-36 min.) for MRI-guided infiltration and 19.7 min. (range: 5-54 min.) for CT-guided infiltration. The average total costs per patient were EUR 240 for MRI-guided interventions and EUR 124 for CT-guided interventions. These were (MRI/CT guidance) EUR 150/60 for equipment use, EUR 46/40 for personnel, and EUR 44/25 for disposables. The mean overall cost of ultrasound guidance was EUR 76. Conclusion: Cervical nerve root infiltration using MRI guidance is still about twice as expensive as infiltration using CT guidance. However, since it does not involve radiation exposure for patients and personnel, MRI-guided nerve root infiltration may become a promising alternative to the CT-guided procedure, especially since a further price decrease is expected for MRI devices and MR-compatible disposables. In contrast, ultrasound remains the less expensive method for nerve root infiltration guidance. (orig.)

SU-F-P-32: A Phantom Study of Accuracy of Four-Dimensional Cone-Beam CT (4D-CBCT) Vs. Three-Dimensional Cone Beam CT (3D-CBCT) in Image Guided Radiotherapy

Energy Technology Data Exchange (ETDEWEB)

He, R; Morris, B; Duggar, N; Markovich, A; Standford, J; Lu, J; Yang, C [University of Mississippi Med. Center, Jackson, MS (United States)

2016-06-15

Purpose: SymmetryTM 4D IGRT system of Elekta has been installed at our institution, which offers the 4D CBCT registration option. This study is to evaluate the accuracy of 4D CBCT system by using the CIRS 4D motion phantom and to perform a feasibility study on the implementation of 4D-CBCT as image guidance for SBRT treatment. Methods: The 3D and 4D CT image data sets are acquired using the CIRS motion phantom on a Philips large bore CT simulator. The motion was set as 0.5 cm superior and inferior directions with 6 seconds recycle time. The 4D CT data were sorted as 10 phases. One identifiable part of the 4D CT QA insert from CIRS phantom was used as the target. The ITV MIP was drawn based on maximum intensity projection (MIP) and transferred as a planning structure into 4D CBCT system. Then the 3D CBCT and 4D CBCT images were taken and registered with the free breath (3D), MIP (4D) and average intensity projection (AIP)(4D) reference data sets. The couch shifts (X, Y, Z) are recorded and compared. Results: Table 1 listed the twelve couch shifts based on the registration of MIP, AIP and free breath CT data sets with 3D CBCT and 4D CBCT for both whole body and local registration. X, Y and Z represent couch shifts in the direction of the right-left, superior-inferior and anterior-posterior. The biggest differences of 0.73 cm and 0.57 cm are noted in the free breath CT data with 4D CBCT and 3D CBCT data registration. Fig. 1 and Fig. 2 are the shift analysis in diagram. Fig. 3 shows the registration. Conclusion: Significant differences exist in the shifts corresponding with the direction of target motion. Further investigations are ongoing.

Adaptive radiotherapy based on contrast enhanced cone beam CT imaging

International Nuclear Information System (INIS)

Soevik, Aaste; Skogmo, Hege K.; Roedal, Jan; Lervaag, Christoffer; Eilertsen, Karsten; Malinen, Eirik

2010-01-01

Cone beam CT (CBCT) imaging has become an integral part of radiation therapy, with images typically used for offline or online patient setup corrections based on bony anatomy co-registration. Ideally, the co-registration should be based on tumor localization. However, soft tissue contrast in CBCT images may be limited. In the present work, contrast enhanced CBCT (CECBCT) images were used for tumor visualization and treatment adaptation. Material and methods. A spontaneous canine maxillary tumor was subjected to repeated cone beam CT imaging during fractionated radiotherapy (10 fractions in total). At five of the treatment fractions, CECBCT images, employing an iodinated contrast agent, were acquired, as well as pre-contrast CBCT images. The tumor was clearly visible in post-contrast minus pre-contrast subtraction images, and these contrast images were used to delineate gross tumor volumes. IMRT dose plans were subsequently generated. Four different strategies were explored: 1) fully adapted planning based on each CECBCT image series, 2) planning based on images acquired at the first treatment fraction and patient repositioning following bony anatomy co-registration, 3) as for 2), but with patient repositioning based on co-registering contrast images, and 4) a strategy with no patient repositioning or treatment adaptation. The equivalent uniform dose (EUD) and tumor control probability (TCP) calculations to estimate treatment outcome for each strategy. Results. Similar translation vectors were found when bony anatomy and contrast enhancement co-registration were compared. Strategy 1 gave EUDs closest to the prescription dose and the highest TCP. Strategies 2 and 3 gave EUDs and TCPs close to that of strategy 1, with strategy 3 being slightly better than strategy 2. Even greater benefits from strategies 1 and 3 are expected with increasing tumor movement or deformation during treatment. The non-adaptive strategy 4 was clearly inferior to all three adaptive strategies

Automatic calibration method of voxel size for cone-beam 3D-CT scanning system

International Nuclear Information System (INIS)

Yang Min; Wang Xiaolong; Wei Dongbo; Liu Yipeng; Meng Fanyong; Li Xingdong; Liu Wenli

2014-01-01

For a cone-beam three-dimensional computed tomography (3D-CT) scanning system, voxel size is an important indicator to guarantee the accuracy of data analysis and feature measurement based on 3D-CT images. Meanwhile, the voxel size changes with the movement of the rotary stage along X-ray direction. In order to realize the automatic calibration of the voxel size, a new and easily-implemented method is proposed. According to this method, several projections of a spherical phantom are captured at different imaging positions and the corresponding voxel size values are calculated by non-linear least-square fitting. Through these interpolation values, a linear equation is obtained that reflects the relationship between the voxel size and the rotary stage translation distance from its nominal zero position. Finally, the linear equation is imported into the calibration module of the 3D-CT scanning system. When the rotary stage is moving along X-ray direction, the accurate value of the voxel size is dynamically exported. The experimental results prove that this method meets the requirements of the actual CT scanning system, and has virtues of easy implementation and high accuracy. (authors)

Cone-beam CT image contrast and attenuation-map linearity improvement (CALI) for brain stereotactic radiosurgery procedures

Science.gov (United States)

Hashemi, Sayed Masoud; Lee, Young; Eriksson, Markus; Nordström, Hâkan; Mainprize, James; Grouza, Vladimir; Huynh, Christopher; Sahgal, Arjun; Song, William Y.; Ruschin, Mark

2017-03-01

A Contrast and Attenuation-map (CT-number) Linearity Improvement (CALI) framework is proposed for cone-beam CT (CBCT) images used for brain stereotactic radiosurgery (SRS). The proposed framework is used together with our high spatial resolution iterative reconstruction algorithm and is tailored for the Leksell Gamma Knife ICON (Elekta, Stockholm, Sweden). The incorporated CBCT system in ICON facilitates frameless SRS planning and treatment delivery. The ICON employs a half-cone geometry to accommodate the existing treatment couch. This geometry increases the amount of artifacts and together with other physical imperfections causes image inhomogeneity and contrast reduction. Our proposed framework includes a preprocessing step, involving a shading and beam-hardening artifact correction, and a post-processing step to correct the dome/capping artifact caused by the spatial variations in x-ray energy generated by bowtie-filter. Our shading correction algorithm relies solely on the acquired projection images (i.e. no prior information required) and utilizes filtered-back-projection (FBP) reconstructed images to generate a segmented bone and soft-tissue map. Ideal projections are estimated from the segmented images and a smoothed version of the difference between the ideal and measured projections is used in correction. The proposed beam-hardening and dome artifact corrections are segmentation free. The CALI was tested on CatPhan, as well as patient images acquired on the ICON system. The resulting clinical brain images show substantial improvements in soft contrast visibility, revealing structures such as ventricles and lesions which were otherwise un-detectable in FBP-reconstructed images. The linearity of the reconstructed attenuation-map was also improved, resulting in more accurate CT#.

Monitoring and guidance of HIFU beams with dual-mode ultrasound arrays.

Science.gov (United States)

Ballard, John R; Casper, Andrew J; Ebbini, Emad S

2009-01-01

We present experimental results illustrating the unique advantages of dual-mode array (DMUA) systems in monitoring and guidance of high intensity focused ultrasound (HIFU) lesion formation. DMUAs offer a unique paradigm in image-guided surgery; one in which images obtained using the same therapeutic transducer provide feedback for: 1) refocusing the array in the presence of strongly scattering objects, e.g. the ribs, 2) temperature change at the intended location of the HIFU focus, and 3) changes in the echogenicity of the tissue in response to therapeutic HIFU. These forms of feedback have been demonstrated in vitro in preparation for the design and implementation of a real-time system for imaging and therapy with DMUAs. The results clearly demonstrate that DMUA image feedback is spatially accurate and provide sufficient spatial and contrast resolution for identification of high contrast objects like the ribs and significant blood vessels in the path of the HIFU beam.

A method for patient set-up guidance in radiotherapy using augmented reality

International Nuclear Information System (INIS)

Talbot, J.; Meyer, J.; Watts, R.; Grasset, R.

2009-01-01

Full text: A system for patient set-up in external beam radiotherapy was developed using Augmented Reality (AR). Live images of the linac treatment couch and patient were obtained with video cameras and displayed on a nearby monitor. A 3D model of the patient's external contour was obtained from planning CT data, and AR tracking software was used to superimpose the model onto the video images in the correct position for treatment. Throughout set-up and treatment, the user can view the monitor and visually confirm that the patient is positioned correctly. To ensure that the virtual contour was displayed in the correct position, a process was devised to register the coordinates of the linac with the camera images. A cube with AR tracking markers attached to its faces was constructed for alignment with the isocentre using room lasers or cone-beam CT. The performance of the system was investigated in a clinical environment by using it to position an anthropomorphic phantom without the aid of additional set-up methods. The positioning errors were determined by means of CBCT and image registration. The translational set-up errors were found to be less than 2.4 mm and the rotational errors less than 0.3 0 . This proof-of-principle study has demonstrated the feasibility of using AR for patient position and pose guidance.

Sacral-neuromodulation CT-guided

International Nuclear Information System (INIS)

Amoroso, Lamberto; Ricci, Stefano; Pelliccioni, Giuseppe; Scarpino, Osvaldo; Ghiselli, Roberto; Saba, Vittorio

2005-01-01

Purpose: Sacral neuromodulation is a new treatment for refractory voiding disorders such as urge incontinence, urinary retention, frequency-urgency syndromes and faecal incontinence. The current approach to sacral nerve stimulation consists of a two-stage procedure. The first is a PNE test (Percutaneous Nerve Evaluation) by a provisional electrically stimulated spinal needle, placed percutaneously in the S3 foramina for four of ten days. If successful, the second stage, permanent implantation, is carried out. The PNE test is performed under fluoroscopic control using the palpable bony sacral foramina as referral points. This technique can show some limitations, such as operator Rx exposure, poor visualization of sacral foramina because of bowel gas artefacts or sacral malformation. In order to reduce these inconveniences and to improve efficiency of the test we tried an alternative technique. The purpose of our study was to test the use of CT as an alternative technique in order to evaluate its advantages and possible routine use. Materials and methods: We tested 30 patients with the PNE test under CT guidance (16 males and 14 females) suffering from serious pelvic disorders and not responding to the normal therapeutic regime. Twenty-seven patient showed relative anatomical integrity of the pelvis and the sacrum, the remaining 3 patients presented morphological anormalities of the sacral foramina. With the patient in the prone position the sacral foramina were identified with CT volumetric scanning using a spiral CT scanner equipped with a second console for the three-dimensional reconstructions. Having identified the location of the S3 foramina, a sterile field was prepared and the spiral needle introduced checking correct positioning with a CT control scan. An electrode was inserted after having checked correct muscular contractile response and the precise position with a further CT scan. Results: Thirty patients were subjected to PNE under CT guidance for a

SU-F-T-215: An Investigation Of Multi-Scanner CT Hounsfield Unit Calibration for Pencil Beam Scanning Proton Therapy Using 3D Gamma Analysis

International Nuclear Information System (INIS)

Zhang, J; Li, X; Liu, G; Liu, Q; Liang, J; Ding, X

2016-01-01

Purpose: We compare and investigate the dosimetric impacts on pencil beam scanning (PBS) proton treatment plans generated with CT calibration curves from four different CT scanners and one averaged ‘global’ CT calibration curve. Methods: The four CT scanners are located at three different hospital locations within the same health system. CT density calibration curves were collected from these scanners using the same CT calibration phantom and acquisition parameters. Mass density to HU value tables were then commissioned in a commercial treatment planning system. Five disease sites were chosen for dosimetric comparisons at brain, lung, head and neck, adrenal, and prostate. Three types of PBS plans were generated at each treatment site using SFUD, IMPT, and robustness optimized IMPT techniques. 3D dose differences were investigated using 3D Gamma analysis. Results: The CT calibration curves for all four scanners display very similar shapes. Large HU differences were observed at both the high HU and low HU regions of the curves. Large dose differences were generally observed at the distal edges of the beams and they are beam angle dependent. Out of the five treatment sites, lung plans exhibits the most overall range uncertainties and prostate plans have the greatest dose discrepancy. There are no significant differences between the SFUD, IMPT, and the RO-IMPT methods. 3D gamma analysis with 3%, 3 mm criteria showed all plans with greater than 95% passing rate. Two of the scanners with close HU values have negligible dose difference except for lung. Conclusion: Our study shows that there are more than 5% dosimetric differences between different CT calibration curves. PBS treatment plans generated with SFUD, IMPT, and the robustness optimized IMPT has similar sensitivity to the CT density uncertainty. More patient data and tighter gamma criteria based on structure location and size will be used for further investigation.

Evaluation of a method for correction of scatter radiation in thorax cone beam CT

International Nuclear Information System (INIS)

Rinkel, J.; Dinten, J.M.; Esteve, F.

2004-01-01

Purpose: Cone beam CT (CBCT) enables three-dimensional imaging with isotropic resolution. X-ray scatter estimation is a big challenge for quantitative CBCT imaging of thorax: scatter level is significantly higher on cone beam systems compared to collimated fan beam systems. The effects of this scattered radiation are cupping artefacts, streaks, and quantification inaccuracies. The beam stops conventional scatter estimation approach can be used for CBCT but leads to a significant increase in terms of dose and acquisition time. At CEA-LETI has been developed an original scatter management process without supplementary acquisition. Methods and Materials: This Analytical Plus Indexing-based method (API) of scatter correction in CBCT is based on scatter calibration through offline acquisitions with beam stops on lucite plates, combined to an analytical transformation issued from physical equations. This approach has been applied with success in bone densitometry and mammography. To evaluate this method in CBCT, acquisitions from a thorax phantom with and without beam stops have been performed. To compare different scatter correction approaches, Feldkamp algorithm has been applied on rough data corrected from scatter by API and by beam stops approaches. Results: The API method provides results in good agreement with the beam stops array approach, suppressing cupping artefact. Otherwise influence of the scatter correction method on the noise in the reconstructed images has been evaluated. Conclusion: The results indicate that the API method is effective for quantitative CBCT imaging of thorax. Compared to a beam stops array method it needs a lower x-ray dose and shortens acquisition time. (authors)

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

International Nuclear Information System (INIS)

Collier, J; Aldoohan, S; Gill, K

2014-01-01

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

Comparison of effective dose for imaging of mandible between multi-detector CT and cone-beam CT

International Nuclear Information System (INIS)

Jeong, Dae Kyo; Lee, Sang Chul; Huh, Kyung Hoe; Yi, Won Jin; Lee, Sam Sun; Choi, Soon Chul

2012-01-01

The aim of this study was to compare the effective dose for imaging of mandible between multi-detector computed tomography (MDCT) and cone-beam computed tomography (CBCT). An MDCT with low dose technique was also compared with them. Thermoluminescent dosimeter (TLD) chips were placed at 25 organ sites of an anthropomorphic phantom. The mandible of the phantom was exposed using 2 different types of MDCT units (Somatom Sensation 10 for standard-dose MDCT, Somatom Emotion 6 for low-dose MDCT) and 3 different CBCT units (AZ3000CT, Implagraphy, and Kavo 3D eXaM). The radiation absorbed dose was measured and the effective dose was calculated according to the ICRP 2007 report. The effective dose was the highest for Somatom Sensation 10 (425.84 μSv), followed by AZ3000CT (332.4 μSv), Somatom Emotion 6 (199.38 μSv), and 3D eXaM (111.6 μSv); it was the lowest for Implagraphy (83.09 μSv). The CBCT showed significant variation in dose level with different device. The effective doses of MDCTs were not significantly different from those of CBCTs for imaging of mandible. The effective dose of MDCT could be markedly decreased by using the low-dose technique.

Comparison of effective dose for imaging of mandible between multi-detector CT and cone-beam CT

Energy Technology Data Exchange (ETDEWEB)

Jeong, Dae Kyo; Lee, Sang Chul; Huh, Kyung Hoe; Yi, Won Jin; Lee, Sam Sun; Choi, Soon Chul [School of Dentistry, Seoul National University, Seoul (Korea, Republic of)

2012-06-15

The aim of this study was to compare the effective dose for imaging of mandible between multi-detector computed tomography (MDCT) and cone-beam computed tomography (CBCT). An MDCT with low dose technique was also compared with them. Thermoluminescent dosimeter (TLD) chips were placed at 25 organ sites of an anthropomorphic phantom. The mandible of the phantom was exposed using 2 different types of MDCT units (Somatom Sensation 10 for standard-dose MDCT, Somatom Emotion 6 for low-dose MDCT) and 3 different CBCT units (AZ3000CT, Implagraphy, and Kavo 3D eXaM). The radiation absorbed dose was measured and the effective dose was calculated according to the ICRP 2007 report. The effective dose was the highest for Somatom Sensation 10 (425.84 {mu}Sv), followed by AZ3000CT (332.4 {mu}Sv), Somatom Emotion 6 (199.38 {mu}Sv), and 3D eXaM (111.6 {mu}Sv); it was the lowest for Implagraphy (83.09 {mu}Sv). The CBCT showed significant variation in dose level with different device. The effective doses of MDCTs were not significantly different from those of CBCTs for imaging of mandible. The effective dose of MDCT could be markedly decreased by using the low-dose technique.

Three-dimensional Image Fusion Guidance for Transjugular Intrahepatic Portosystemic Shunt Placement.

Science.gov (United States)

Tacher, Vania; Petit, Arthur; Derbel, Haytham; Novelli, Luigi; Vitellius, Manuel; Ridouani, Fourat; Luciani, Alain; Rahmouni, Alain; Duvoux, Christophe; Salloum, Chady; Chiaradia, Mélanie; Kobeiter, Hicham

2017-11-01

To assess the safety, feasibility and effectiveness of image fusion guidance with pre-procedural portal phase computed tomography with intraprocedural fluoroscopy for transjugular intrahepatic portosystemic shunt (TIPS) placement. All consecutive cirrhotic patients presenting at our interventional unit for TIPS creation from January 2015 to January 2016 were prospectively enrolled. Procedures were performed under general anesthesia in an interventional suite equipped with flat panel detector, cone-beam computed tomography (CBCT) and image fusion technique. All TIPSs were placed under image fusion guidance. After hepatic vein catheterization, an unenhanced CBCT acquisition was performed and co-registered with the pre-procedural portal phase CT images. A virtual path between hepatic vein and portal branch was made using the virtual needle path trajectory software. Subsequently, the 3D virtual path was overlaid on 2D fluoroscopy for guidance during portal branch cannulation. Safety, feasibility, effectiveness and per-procedural data were evaluated. Sixteen patients (12 males; median age 56 years) were included. Procedures were technically feasible in 15 of the 16 patients (94%). One procedure was aborted due to hepatic vein catheterization failure related to severe liver distortion. No periprocedural complications occurred within 48 h of the procedure. The median dose-area product was 91 Gy cm 2 , fluoroscopy time 15 min, procedure time 40 min and contrast media consumption 65 mL. Clinical benefit of the TIPS placement was observed in nine patients (56%). This study suggests that 3D image fusion guidance for TIPS is feasible, safe and effective. By identifying virtual needle path, CBCT enables real-time multiplanar guidance and may facilitate TIPS placement.

TH-CD-202-02: A Preliminary Study Evaluating Beam-Hardening Artifact Reduction On CT Direct Electron-Density Images

Energy Technology Data Exchange (ETDEWEB)

Li, H; Dolly, S; Zhao, T; Anastasio, M; Mutic, S [Washington University School of Medicine, Saint Louis, MO (United States); Ritter, A; Colombo, V; Raupach, R; Huenemohr, N [Siemens Healthcare GmbH, Deutschland (Germany); Mistry, N [Siemens Medical Solutions USA, Malvern, PA (United States); Yu, L [Mayo Clinic, Rochester, MN (United States)

2016-06-15

Purpose: A prototype reconstruction algorithm that can provide direct electron density (ED) images from single energy CT scans is being currently developed by Siemens Healthcare GmbH. This feature can eliminate the need for kV specific calibration curve for radiation treatemnt planning. An added benefit is that beam-hardening artifacts are also reduced on direct-ED images due to the underlying material decomposition. This study is to quantitatively analyze the reduction of beam-hardening artifacts on direct-ED images and suggest additional clinical usages. Methods: HU and direct-ED images were reconstructed on a head phantom scanned on a Siemens Definition AS CT scanner at five tube potentials of 70kV, 80kV, 100kV, 120kV and 140kV respectively. From these images, mean, standard deviation (SD), and local NPS were calculated for regions of interest (ROI) of same locations and sizes. A complete analysis of beam-hardening artifact reduction and image quality improvement was conducted. Results: Along with the increase of tube potentials, ROI means and SDs decrease on both HU and direct-ED images. The mean value differences between HU and direct-ED images are up to 8% with absolute value of 2.9. Compared to that on HU images, the SDs are lower on direct-ED images, and the differences are up to 26%. Interestingly, the local NPS calculated from direct-ED images shows consistent values in the low spatial frequency domain for images acquired from all tube potential settings, while varied dramatically on HU images. This also confirms the beam -hardening artifact reduction on ED images. Conclusions: The low SDs on direct-ED images and relative consistent NPS values in the low spatial frequency domain indicate a reduction of beam-hardening artifacts. The direct-ED image has the potential to assist in more accurate organ contouring, and is a better fit for the desired purpose of CT simulations for radiotherapy.

SU-F-J-214: Dose Reduction by Spatially Optimized Image Quality Via Fluence Modulated Proton CT (FMpCT)

International Nuclear Information System (INIS)

De Angelis, L; Landry, G; Dedes, G; Parodi, K; Hansen, D; Rit, S; Belka, C

2016-01-01

Purpose: Proton CT (pCT) is a promising imaging modality for reducing range uncertainty in image-guided proton therapy. Range uncertainties partially originate from X-ray CT number conversion to stopping power ratio (SPR) and are limiting the exploitation of the full potential of proton therapy. In this study we explore the concept of spatially dependent fluence modulated proton CT (FMpCT), for achieving optimal image quality in a clinical region of interest (ROI), while reducing significantly the imaging dose to the patient. Methods: The study was based on simulated ideal pCT using pencil beam (PB) scanning. A set of 250 MeV protons PBs was used to create 360 projections of a cylindrical water phantom and a head and neck cancer patient. The tomographic images were reconstructed using a filtered backprojection (FBP) as well as an iterative algorithm (ITR). Different fluence modulation levels were investigated and their impact on the image was quantified in terms of SPR accuracy as well as noise within and outside selected ROIs, as a function of imaging dose. The unmodulated image served as reference. Results: Both FBP reconstruction and ITR without total variation (TV) yielded image quality in the ROIs similar to the reference images, for modulation down to 0.1 of the full proton fluence. The average dose was reduced by 75% for the water phantom and by 40% for the patient. FMpCT does not improve the noise for ITR with TV and modulation 0.1. Conclusion: This is the first work proposing and investigating FMpCT for producing optimal image quality for treatment planning and image guidance, while simultaneously reducing imaging dose. Future work will address spatial resolution effects and the impact of FMpCT on the quality of proton treatment plans for a prototype pCT scanner capable of list mode data acquisition. Acknowledgement: DFG-MAP DFG - Munich-Centre for Advanced Photonics (MAP)

SU-F-J-214: Dose Reduction by Spatially Optimized Image Quality Via Fluence Modulated Proton CT (FMpCT)

Energy Technology Data Exchange (ETDEWEB)

De Angelis, L; Landry, G; Dedes, G; Parodi, K [Ludwig-Maximilians-Universitaet Muenchen (LMU Munich), Garching b. Muenchen (Germany); Hansen, D [Aarhus University Hospital, Aarhus, Jutland (Denmark); Rit, S [University Lyon, Lyon, Auvergne-Rhone-Alpes (France); Belka, C [LMU Munich, Munich (Germany)

2016-06-15

Purpose: Proton CT (pCT) is a promising imaging modality for reducing range uncertainty in image-guided proton therapy. Range uncertainties partially originate from X-ray CT number conversion to stopping power ratio (SPR) and are limiting the exploitation of the full potential of proton therapy. In this study we explore the concept of spatially dependent fluence modulated proton CT (FMpCT), for achieving optimal image quality in a clinical region of interest (ROI), while reducing significantly the imaging dose to the patient. Methods: The study was based on simulated ideal pCT using pencil beam (PB) scanning. A set of 250 MeV protons PBs was used to create 360 projections of a cylindrical water phantom and a head and neck cancer patient. The tomographic images were reconstructed using a filtered backprojection (FBP) as well as an iterative algorithm (ITR). Different fluence modulation levels were investigated and their impact on the image was quantified in terms of SPR accuracy as well as noise within and outside selected ROIs, as a function of imaging dose. The unmodulated image served as reference. Results: Both FBP reconstruction and ITR without total variation (TV) yielded image quality in the ROIs similar to the reference images, for modulation down to 0.1 of the full proton fluence. The average dose was reduced by 75% for the water phantom and by 40% for the patient. FMpCT does not improve the noise for ITR with TV and modulation 0.1. Conclusion: This is the first work proposing and investigating FMpCT for producing optimal image quality for treatment planning and image guidance, while simultaneously reducing imaging dose. Future work will address spatial resolution effects and the impact of FMpCT on the quality of proton treatment plans for a prototype pCT scanner capable of list mode data acquisition. Acknowledgement: DFG-MAP DFG - Munich-Centre for Advanced Photonics (MAP)

Reconstruction of a cone-beam CT image via forward iterative projection matching

International Nuclear Information System (INIS)

Brock, R. Scott; Docef, Alen; Murphy, Martin J.

2010-01-01

Purpose: To demonstrate the feasibility of reconstructing a cone-beam CT (CBCT) image by deformably altering a prior fan-beam CT (FBCT) image such that it matches the anatomy portrayed in the CBCT projection data set. Methods: A prior FBCT image of the patient is assumed to be available as a source image. A CBCT projection data set is obtained and used as a target image set. A parametrized deformation model is applied to the source FBCT image, digitally reconstructed radiographs (DRRs) that emulate the CBCT projection image geometry are calculated and compared to the target CBCT projection data, and the deformation model parameters are adjusted iteratively until the DRRs optimally match the CBCT projection data set. The resulting deformed FBCT image is hypothesized to be an accurate representation of the patient's anatomy imaged by the CBCT system. The process is demonstrated via numerical simulation. A known deformation is applied to a prior FBCT image and used to create a synthetic set of CBCT target projections. The iterative projection matching process is then applied to reconstruct the deformation represented in the synthetic target projections; the reconstructed deformation is then compared to the known deformation. The sensitivity of the process to the number of projections and the DRR/CBCT projection mismatch is explored by systematically adding noise to and perturbing the contrast of the target projections relative to the iterated source DRRs and by reducing the number of projections. Results: When there is no noise or contrast mismatch in the CBCT projection images, a set of 64 projections allows the known deformed CT image to be reconstructed to within a nRMS error of 1% and the known deformation to within a nRMS error of 7%. A CT image nRMS error of less than 4% is maintained at noise levels up to 3% of the mean projection intensity, at which the deformation error is 13%. At 1% noise level, the number of projections can be reduced to 8 while maintaining

Lumbar sympathectomy under CT guidance: therapeutic option in critical limb ischaemia; la simpaticolisi TC guidata: alternativa terapeutica delle ischemie critiche

Energy Technology Data Exchange (ETDEWEB)

Pieri, Stefano; Agresti, Paolo [Az. Osp. S. Camillo-Forlanini, Roma (Italy). U.O. di radiologia vascolare ed interventistica; Ialongo, Pasquale; Fedeli, Stefano [Radiologia diagnostica Busi, Roma (Italy); Di Cesare, Fabio; Ricci, Guiseppe [Az. Osp. S. Camillo-Forlanini, Roma (Italy). Chirurgia vascolare

2005-04-01

Purpose: Lumbar sympathectomy is a complementary therapeutic option for patients with severe peripheral vascular occlusive disease presenting rest pain or gangrene and not eligible for surgical revascularisation. Traditional surgical sympathectomy was widely used in the past. However, due to its invasive character, it has increasingly been replaced by percutaneous techniques and, in some recent cases, by laparoscopic procedures. Percutaneous lumbar sympathectomy is a safe, cost-effective and widely available treatment option. We report our experience on 19 patients subjected to percutaneous sympathectomy under CT guidance. Materials and methods: Between 1998 and 2000, 19 patients underwent percutaneous sympathectomy under CT guidance. All patients had severe vascular disease of the lower extremities (Fontaine stage IV), with rest pain and gangrene. They were not eligible for surgical revascularization. Phenol was injected at the level of L2 and L4 using two 22 G needles (15 cm long). Signs of interrupted sympathetic activity usually occur 2'-15' after the procedure with warmth and flushing and dryness of the lower extremities. Results: Percutaneous sympathectomy under CT guidance is a simple, safe and well-tolerated procedure with a low rate of complications. Of the 19 patients, 9 (47.3%) showed clinical improvement, whereas 5 experienced a worsening of ischaemia in the month immediately following the procedure. Discussion: Results suggest that percutaneous lumbar sympathectomy causes a sympathetic blockade in patients with advanced vascular disease of the limb. CT guidance ensures a high level of precision in drug dosing, thus lowering the risk of complications. Although the results are demoralizing. the impossibility of achieving surgical revascularisation in advanced peripheral arteriosclerosis enhances the role of Ct-guided percutaneous sympathectomy in relieving rest pain and healing ulcers in order to postpone the amputation. [Italian] Scopo: La

Estimation of absorbed doses from paediatric cone-beam CT scans: MOSFET measurements and Monte Carlo simulations.

Science.gov (United States)

Kim, Sangroh; Yoshizumi, Terry T; Toncheva, Greta; Frush, Donald P; Yin, Fang-Fang

2010-03-01

The purpose of this study was to establish a dose estimation tool with Monte Carlo (MC) simulations. A 5-y-old paediatric anthropomorphic phantom was computed tomography (CT) scanned to create a voxelised phantom and used as an input for the abdominal cone-beam CT in a BEAMnrc/EGSnrc MC system. An X-ray tube model of the Varian On-Board Imager((R)) was built in the MC system. To validate the model, the absorbed doses at each organ location for standard-dose and low-dose modes were measured in the physical phantom with MOSFET detectors; effective doses were also calculated. In the results, the MC simulations were comparable to the MOSFET measurements. This voxelised phantom approach could produce a more accurate dose estimation than the stylised phantom method. This model can be easily applied to multi-detector CT dosimetry.

Tooth labeling in cone-beam CT using deep convolutional neural network for forensic identification

Science.gov (United States)

Miki, Yuma; Muramatsu, Chisako; Hayashi, Tatsuro; Zhou, Xiangrong; Hara, Takeshi; Katsumata, Akitoshi; Fujita, Hiroshi

2017-03-01

In large disasters, dental record plays an important role in forensic identification. However, filing dental charts for corpses is not an easy task for general dentists. Moreover, it is laborious and time-consuming work in cases of large scale disasters. We have been investigating a tooth labeling method on dental cone-beam CT images for the purpose of automatic filing of dental charts. In our method, individual tooth in CT images are detected and classified into seven tooth types using deep convolutional neural network. We employed the fully convolutional network using AlexNet architecture for detecting each tooth and applied our previous method using regular AlexNet for classifying the detected teeth into 7 tooth types. From 52 CT volumes obtained by two imaging systems, five images each were randomly selected as test data, and the remaining 42 cases were used as training data. The result showed the tooth detection accuracy of 77.4% with the average false detection of 5.8 per image. The result indicates the potential utility of the proposed method for automatic recording of dental information.

PET/CT-guided Interventions: Personnel Radiation Dose

Energy Technology Data Exchange (ETDEWEB)

Ryan, E. Ronan, E-mail: ronan@ronanryan.com; Thornton, Raymond; Sofocleous, Constantinos T.; Erinjeri, Joseph P. [Memorial Sloan-Kettering Cancer Center, Department of Radiology (United States); Hsu, Meier [Memorial Sloan-Kettering Cancer Center, Department of Epidemiology and Biostatistics (United States); Quinn, Brian; Dauer, Lawrence T. [Memorial Sloan-Kettering Cancer Center, Department of Medical Physics (United States); Solomon, Stephen B. [Memorial Sloan-Kettering Cancer Center, Department of Radiology (United States)

2013-08-01

PurposeTo quantify radiation exposure to the primary operator and staff during PET/CT-guided interventional procedures.MethodsIn this prospective study, 12 patients underwent PET/CT-guided interventions over a 6 month period. Radiation exposure was measured for the primary operator, the radiology technologist, and the nurse anesthetist by means of optically stimulated luminescence dosimeters. Radiation exposure was correlated with the procedure time and the use of in-room image guidance (CT fluoroscopy or ultrasound).ResultsThe median effective dose was 0.02 (range 0-0.13) mSv for the primary operator, 0.01 (range 0-0.05) mSv for the nurse anesthetist, and 0.02 (range 0-0.05) mSv for the radiology technologist. The median extremity dose equivalent for the operator was 0.05 (range 0-0.62) mSv. Radiation exposure correlated with procedure duration and with the use of in-room image guidance. The median operator effective dose for the procedure was 0.015 mSv when conventional biopsy mode CT was used, compared to 0.06 mSv for in-room image guidance, although this did not achieve statistical significance as a result of the small sample size (p = 0.06).ConclusionThe operator dose from PET/CT-guided procedures is not significantly different than typical doses from fluoroscopically guided procedures. The major determinant of radiation exposure to the operator from PET/CT-guided interventional procedures is time spent in close proximity to the patient.

TH-EF-207A-04: A Dynamic Contrast Enhanced Cone Beam CT Technique for Evaluation of Renal Functions

Energy Technology Data Exchange (ETDEWEB)

Wang, Z; Shi, J; Yang, Y [University of Miami School of Medicine, Miami, FL (United States)

2016-06-15

Purpose: To develop a simple but robust method for the early detection and evaluation of renal functions using dynamic contrast enhanced cone beam CT technique. Methods: Experiments were performed on an integrated imaging and radiation research platform developed by our lab. Animals (n=3) were anesthetized with 20uL Ketamine/Xylazine cocktail, and then received 200uL injection of iodinated contrast agent Iopamidol via tail vein. Cone beam CT was acquired following contrast injection once per minute and up to 25 minutes. The cone beam CT was reconstructed with a dimension of 300×300×800 voxels of 130×130×130um voxel resolution. The middle kidney slices in the transvers and coronal planes were selected for image analysis. A double exponential function was used to fit the contrast enhanced signal intensity versus the time after contrast injection. Both pixel-based and region of interest (ROI)-based curve fitting were performed. Four parameters obtained from the curve fitting, namely the amplitude and flow constant for both contrast wash in and wash out phases, were investigated for further analysis. Results: Robust curve fitting was demonstrated for both pixel based (with R{sup 2}>0.8 for >85% pixels within the kidney contour) and ROI based (R{sup 2}>0.9 for all regions) analysis. Three different functional regions: renal pelvis, medulla and cortex, were clearly differentiated in the functional parameter map in the pixel based analysis. ROI based analysis showed the half-life T1/2 for contrast wash in and wash out phases were 0.98±0.15 and 17.04±7.16, 0.63±0.07 and 17.88±4.51, and 1.48±0.40 and 10.79±3.88 minutes for the renal pelvis, medulla and cortex, respectively. Conclusion: A robust method based on dynamic contrast enhanced cone beam CT and double exponential curve fitting has been developed to analyze the renal functions for different functional regions. Future study will be performed to investigate the sensitivity of this technique in the detection

Development of high-resolution x-ray CT system using parallel beam geometry

Energy Technology Data Exchange (ETDEWEB)

Yoneyama, Akio, E-mail: akio.yoneyama.bu@hitachi.com; Baba, Rika [Central Research Laboratory, Hitachi Ltd., Hatoyama, Saitama (Japan); Hyodo, Kazuyuki [Institute of Materials Science, High Energy Accelerator Research Organization, Tsukuba, Ibaraki (Japan); Takeda, Tohoru [School of Allied Health Sciences, Kitasato University, Sagamihara, Kanagawa (Japan); Nakano, Haruhisa; Maki, Koutaro [Department of Orthodontics, School of Dentistry Showa University, Ota-ku, Tokyo (Japan); Sumitani, Kazushi; Hirai, Yasuharu [Kyushu Synchrotron Light Research Center, Tosu, Saga (Japan)

2016-01-28

For fine three-dimensional observations of large biomedical and organic material samples, we developed a high-resolution X-ray CT system. The system consists of a sample positioner, a 5-μm scintillator, microscopy lenses, and a water-cooled sCMOS detector. Parallel beam geometry was adopted to attain a field of view of a few mm square. A fine three-dimensional image of birch branch was obtained using a 9-keV X-ray at BL16XU of SPring-8 in Japan. The spatial resolution estimated from the line profile of a sectional image was about 3 μm.

The importance of cone beam CT in the radiological detection of osteomalacia.

Science.gov (United States)

Cakur, B; Sümbüllü, M A; Dagistan, S; Durna, D

2012-01-01

Although osteomalacia is one of the most common osteometabolic diseases among the elderly, there is no case in the literature that presents the effects of osteomalacia in detail using cone beam CT (CBCT). While thin and porous bones are the most common radiographic sign of the disease, the radiological hallmarks are pseudofractures (Looser's zone). We coincidentally detected osteomalacia in a 23-year-old female and we showed the pseudofracture on CBCT images. In the present case, we aim to present the images of osteomalacia that were detected by CBCT in detail. CBCT has an important value in screening for osteomalacia.

Cone beam CT for organs motion evaluation in pediatric abdominal neuroblastoma

International Nuclear Information System (INIS)

Nazmy, Mohamed Soliman; Khafaga, Yasser; Mousa, Amr; Khalil, Ehab

2012-01-01

Background and purpose: To quantify the organ motion relative to bone in different breathing states in pediatric neuroblastoma using cone beam CT (CBCT) for better definition of the planning margins during abdominal IMRT. Methods and materials: Forty-two datasets of kV CBCT for 9 pediatric patients with abdominal neuroblastoma treated with IMRT were evaluated. Organs positions on planning CT scan were considered the reference position against which organs and target motions were evaluated. The position of the kidneys and the liver was assessed in all scans. The target movement was evaluated in four patients who were treated for gross residual disease. Results: The mean age of the patients was 4.1 ± 1.6 years. The range of target movement in the craniocaudal direction (CC) was 5 mm. In the CC direction, the range of movement was 10 mm for the right kidney, and 8 mm for the left kidney. Similarly, the liver upper edge range of motion was 11 mm while the lower edge range of motion was 13 mm. Conclusions: With the use of daily CBCT we may be able to reduce the PTV margin. If CBCT is not used daily, a wider margin is needed.

3D dictionary learning based iterative cone beam CT reconstruction

Directory of Open Access Journals (Sweden)

Ti Bai

2014-03-01

Full Text Available Purpose: This work is to develop a 3D dictionary learning based cone beam CT (CBCT reconstruction algorithm on graphic processing units (GPU to improve the quality of sparse-view CBCT reconstruction with high efficiency. Methods: A 3D dictionary containing 256 small volumes (atoms of 3 × 3 × 3 was trained from a large number of blocks extracted from a high quality volume image. On the basis, we utilized cholesky decomposition based orthogonal matching pursuit algorithm to find the sparse representation of each block. To accelerate the time-consuming sparse coding in the 3D case, we implemented the sparse coding in a parallel fashion by taking advantage of the tremendous computational power of GPU. Conjugate gradient least square algorithm was adopted to minimize the data fidelity term. Evaluations are performed based on a head-neck patient case. FDK reconstruction with full dataset of 364 projections is used as the reference. We compared the proposed 3D dictionary learning based method with tight frame (TF by performing reconstructions on a subset data of 121 projections. Results: Compared to TF based CBCT reconstruction that shows good overall performance, our experiments indicated that 3D dictionary learning based CBCT reconstruction is able to recover finer structures, remove more streaking artifacts and also induce less blocky artifacts. Conclusion: 3D dictionary learning based CBCT reconstruction algorithm is able to sense the structural information while suppress the noise, and hence to achieve high quality reconstruction under the case of sparse view. The GPU realization of the whole algorithm offers a significant efficiency enhancement, making this algorithm more feasible for potential clinical application.-------------------------------Cite this article as: Bai T, Yan H, Shi F, Jia X, Lou Y, Xu Q, Jiang S, Mou X. 3D dictionary learning based iterative cone beam CT reconstruction. Int J Cancer Ther Oncol 2014; 2(2:020240. DOI: 10

Study of Beam-Beam Effects at PEP-II

International Nuclear Information System (INIS)

Narsky, I

2004-01-01

Using a self-consistent three-dimensional simulation running on parallel supercomputers, we have modeled the beam-beam interaction at the PEP-II asymmetric e + e - collider. To provide guidance for luminosity improvement, we scanned the tunes and currents in both rings and computed their impact on the luminosity and transverse beam sizes. We also studied the effects of colliding the beams with a small crossing angle. Where possible, the code was benchmarked against experimental measurements of luminosity and beam sizes, yielding an acceptable agreement

Refinement of Treatment Setup and Target Localization Accuracy Using Three-Dimensional Cone-Beam Computed Tomography for Stereotactic Body Radiotherapy

International Nuclear Information System (INIS)

Wang Zhiheng; Nelson, John W.; Yoo, Sua; Wu, Q. Jackie; Kirkpatrick, John P.; Marks, Lawrence B.; Yin Fangfang

2009-01-01

Purposes: To quantitatively compare two-dimensional (2D) orthogonal kV with three-dimensional (3D) cone-beam CT (CBCT) for target localization; and to assess intrafraction motion with kV images in patients undergoing stereotactic body radiotherapy (SBRT). Methods and Materials: A total of 50 patients with 58 lesions received 178 fractions of SBRT. After clinical setup using in-room lasers and skin/cradle marks placed at simulation, patients were imaged and repositioned according to orthogonal kV/MV registration of bony landmarks to digitally reconstructed radiographs from the planning CT. A subsequent CBCT was registered to the planning CT using soft tissue information, and the resultant 'residual error' was measured and corrected before treatment. Posttreatment 2D kV and/or 3D CBCT images were compared with pretreatment images to determine any intrafractional position changes. Absolute averages, statistical means, standard deviations, and root mean square (RMS) values of observed setup error were calculated. Results: After initial setup to external marks with laser guidance, 2D kV images revealed vector mean setup deviations of 0.67 cm (RMS). Cone-beam CT detected residual setup deviations of 0.41 cm (RMS). Posttreatment imaging demonstrated intrafractional variations of 0.15 cm (RMS). The individual shifts in three standard orthogonal planes showed no obvious directional biases. Conclusions: After localization based on superficial markings in patients undergoing SBRT, orthogonal kV imaging detects setup variations of approximately 3 to 4 mm in each direction. Cone-beam CT detects residual setup variations of approximately 2 to 3 mm

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

International Nuclear Information System (INIS)

Lee, H; Cho, S; Cheong, K; Jung, J; Jung, S; Kim, J; Yeo, I

2016-01-01

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

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

Energy Technology Data Exchange (ETDEWEB)

Lee, H; Cho, S [KAIST, Yuseong-gu, Daejeon (Korea, Republic of); Cheong, K [Hallym University Sacred Heart Hospital, Anyang (Korea, Republic of); Jung, J [East Carolina University Greenville, NC (United States); Jung, S [Samsung Medical Cener, Gangnam-gu, Seoul (Korea, Republic of); Kim, J [Yonsei Cancer Center, Seoul (Korea, Republic of); Yeo, I [Loma Linda University Medical Center, Loma Linda, CA (United States)

2016-06-15

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

Self-calibration of a cone-beam micro-CT system

International Nuclear Information System (INIS)

Patel, V.; Chityala, R. N.; Hoffmann, K. R.; Ionita, C. N.; Bednarek, D. R.; Rudin, S.

2009-01-01

Use of cone-beam computed tomography (CBCT) is becoming more frequent. For proper reconstruction, the geometry of the CBCT systems must be known. While the system can be designed to reduce errors in the geometry, calibration measurements must still be performed and corrections applied. Investigators have proposed techniques using calibration objects for system calibration. In this study, the authors present methods to calibrate a rotary-stage CB micro-CT (CBμCT) system using only the images acquired of the object to be reconstructed, i.e., without the use of calibration objects. Projection images are acquired using a CBμCT system constructed in the authors' laboratories. Dark- and flat-field corrections are performed. Exposure variations are detected and quantified using analysis of image regions with an unobstructed view of the x-ray source. Translations that occur during the acquisition in the horizontal direction are detected, quantified, and corrected based on sinogram analysis. The axis of rotation is determined using registration of antiposed projection images. These techniques were evaluated using data obtained with calibration objects and phantoms. The physical geometric axis of rotation is determined and aligned with the rotational axis (assumed to be the center of the detector plane) used in the reconstruction process. The parameters describing this axis agree to within 0.1 mm and 0.3 deg with those determined using other techniques. Blurring due to residual calibration errors has a point-spread function in the reconstructed planes with a full-width-at-half-maximum of less than 125 μm in a tangential direction and essentially zero in the radial direction for the rotating object. The authors have used this approach on over 100 acquisitions over the past 2 years and have regularly obtained high-quality reconstructions, i.e., without artifacts and no detectable blurring of the reconstructed objects. This self-calibrating approach not only obviates

A proposed method for accurate 3D analysis of cochlear implant migration using fusion of cone beam CT

Directory of Open Access Journals (Sweden)

Guido eDees

2016-01-01

Full Text Available IntroductionThe goal of this investigation was to compare fusion of sequential cone beam CT volumes to the gold standard (fiducial registration in order to be able to analyze clinical CI migration with high accuracy in three dimensions. Materials and MethodsPaired time-lapsed cone beam CT volumes were performed on five human cadaver temporal bones and one human subject. These volumes were fused using 3D Slicer 4 and BRAINSFit software. Using a gold standard fiducial technique, the accuracy, robustness and performance time of the fusion process were assessed.Results This proposed fusion protocol achieves a sub voxel mean Euclidean distance of 0.05 millimeter in human cadaver temporal bones and 0.16 millimeter when applied to the described in vivo human synthetic data set in over 95% of all fusions. Performance times are less than two minutes.ConclusionHere a new and validated method based on existing techniques is described which could be used to accurately quantify migration of cochlear implant electrodes.

PET/CT-guided Interventions: Personnel Radiation Dose

International Nuclear Information System (INIS)

Ryan, E. Ronan; Thornton, Raymond; Sofocleous, Constantinos T.; Erinjeri, Joseph P.; Hsu, Meier; Quinn, Brian; Dauer, Lawrence T.; Solomon, Stephen B.

2013-01-01

PurposeTo quantify radiation exposure to the primary operator and staff during PET/CT-guided interventional procedures.MethodsIn this prospective study, 12 patients underwent PET/CT-guided interventions over a 6 month period. Radiation exposure was measured for the primary operator, the radiology technologist, and the nurse anesthetist by means of optically stimulated luminescence dosimeters. Radiation exposure was correlated with the procedure time and the use of in-room image guidance (CT fluoroscopy or ultrasound).ResultsThe median effective dose was 0.02 (range 0–0.13) mSv for the primary operator, 0.01 (range 0–0.05) mSv for the nurse anesthetist, and 0.02 (range 0–0.05) mSv for the radiology technologist. The median extremity dose equivalent for the operator was 0.05 (range 0–0.62) mSv. Radiation exposure correlated with procedure duration and with the use of in-room image guidance. The median operator effective dose for the procedure was 0.015 mSv when conventional biopsy mode CT was used, compared to 0.06 mSv for in-room image guidance, although this did not achieve statistical significance as a result of the small sample size (p = 0.06).ConclusionThe operator dose from PET/CT-guided procedures is not significantly different than typical doses from fluoroscopically guided procedures. The major determinant of radiation exposure to the operator from PET/CT-guided interventional procedures is time spent in close proximity to the patient

SU-E-T-161: Evaluation of Dose Calculation Based On Cone-Beam CT

International Nuclear Information System (INIS)

Abe, T; Nakazawa, T; Saitou, Y; Nakata, A; Yano, M; Tateoka, K; Fujimoto, K; Sakata, K

2014-01-01

Purpose: The purpose of this study is to convert pixel values in cone-beam CT (CBCT) using histograms of pixel values in the simulation CT (sim-CT) and the CBCT images and to evaluate the accuracy of dose calculation based on the CBCT. Methods: The sim-CT and CBCT images immediately before the treatment of 10 prostate cancer patients were acquired. Because of insufficient calibration of the pixel values in the CBCT, it is difficult to be directly used for dose calculation. The pixel values in the CBCT images were converted using an in-house program. A 7 fields treatment plans (original plan) created on the sim-CT images were applied to the CBCT images and the dose distributions were re-calculated with same monitor units (MUs). These prescription doses were compared with those of original plans. Results: In the results of the pixel values conversion in the CBCT images,the mean differences of pixel values for the prostate,subcutaneous adipose, muscle and right-femur were −10.78±34.60, 11.78±41.06, 29.49±36.99 and 0.14±31.15 respectively. In the results of the calculated doses, the mean differences of prescription doses for 7 fields were 4.13±0.95%, 0.34±0.86%, −0.05±0.55%, 1.35±0.98%, 1.77±0.56%, 0.89±0.69% and 1.69±0.71% respectively and as a whole, the difference of prescription dose was 1.54±0.4%. Conclusion: The dose calculation on the CBCT images achieve an accuracy of <2% by using this pixel values conversion program. This may enable implementation of efficient adaptive radiotherapy

Physical performance and image optimization of megavoltage cone-beam CT

Energy Technology Data Exchange (ETDEWEB)

Morin, Olivier; Aubry, Jean-Francois; Aubin, Michele; Chen, Josephine; Descovich, Martina; Hashemi, Ali-Bani; Pouliot, Jean [Department of Radiation Oncology, Helen Diller Comprehensive Cancer Center, University of California San Francisco, San Francisco, California 94143 and UCSF/UC Berkeley Joint Graduate Group in Bioengineering, San Francisco, California 94158 (United States); Department of Radiation Oncology, Helen Diller Comprehensive Cancer Center, University of California San Francisco, San Francisco, California 94143 (United States); Siemens Oncology Care Systems, Concord, California 94520 (United States); Department of Radiation Oncology, Helen Diller Comprehensive Cancer Center, University of California San Francisco, San Francisco, California 94143 and UCSF/UC Berkeley Joint Graduate Group in Bioengineering, San Francisco, California 94158 (United States)

2009-04-15

Megavoltage cone-beam CT (MVCBCT) is the most recent addition to the in-room CT systems developed for image-guided radiation therapy. The first generation MVCBCT system consists of a 6 MV treatment x-ray beam produced by a conventional linear accelerator equipped with a flat panel amorphous silicon detector. The objective of this study was to evaluate the physical performance of MVCBCT in order to optimize the system acquisition and reconstruction parameters for image quality. MVCBCT acquisitions were performed with the clinical system but images were reconstructed and analyzed with a separate research workstation. The geometrical stability and the positioning accuracy of the system were evaluated by comparing geometrical calibrations routinely performed over a period of 12 months. The beam output and detector intensity stability during MVCBCT acquisition were also evaluated by analyzing in-air acquisitions acquired at different exposure levels. Several system parameters were varied to quantify their impact on image quality including the exposure (2.7, 4.5, 9.0, 18.0, and 54.0 MU), the craniocaudal imaging length (2, 5, 15, and 27.4 cm), the voxel size (0.5, 1, and 2 mm), the slice thickness (1, 3, and 5 mm), and the phantom size. For the reconstruction algorithm, the study investigated the effect of binning, averaging and diffusion filtering of raw projections as well as three different projection filters. A head-sized water cylinder was used to measure and improve the uniformity of MVCBCT images. Inserts of different electron densities were placed in a water cylinder to measure the contrast-to-noise ratio (CNR). The spatial resolution was obtained by measuring the point-spread function of the system using an iterative edge blurring technique. Our results showed that the geometric stability and accuracy of MVCBCT were better than 1 mm over a period of 12 months. Beam intensity variations per projection of up to 35.4% were observed for a 2.7 MU MVCBCT acquisition

Radiation dose response of normal lung assessed by Cone Beam CT - a potential tool for biologically adaptive radiation therapy

DEFF Research Database (Denmark)

Bertelsen, Anders; Schytte, Tine; Bentzen, Søren M

2011-01-01

Density changes of healthy lung tissue during radiotherapy as observed by Cone Beam CT (CBCT) might be an early indicator of patient specific lung toxicity. This study investigates the time course of CBCT density changes and tests for a possible correlation with locally delivered dose....

Classification of teeth in cone-beam CT using deep convolutional neural network.

Science.gov (United States)

Miki, Yuma; Muramatsu, Chisako; Hayashi, Tatsuro; Zhou, Xiangrong; Hara, Takeshi; Katsumata, Akitoshi; Fujita, Hiroshi

2017-01-01

Dental records play an important role in forensic identification. To this end, postmortem dental findings and teeth conditions are recorded in a dental chart and compared with those of antemortem records. However, most dentists are inexperienced at recording the dental chart for corpses, and it is a physically and mentally laborious task, especially in large scale disasters. Our goal is to automate the dental filing process by using dental x-ray images. In this study, we investigated the application of a deep convolutional neural network (DCNN) for classifying tooth types on dental cone-beam computed tomography (CT) images. Regions of interest (ROIs) including single teeth were extracted from CT slices. Fifty two CT volumes were randomly divided into 42 training and 10 test cases, and the ROIs obtained from the training cases were used for training the DCNN. For examining the sampling effect, random sampling was performed 3 times, and training and testing were repeated. We used the AlexNet network architecture provided in the Caffe framework, which consists of 5 convolution layers, 3 pooling layers, and 2 full connection layers. For reducing the overtraining effect, we augmented the data by image rotation and intensity transformation. The test ROIs were classified into 7 tooth types by the trained network. The average classification accuracy using the augmented training data by image rotation and intensity transformation was 88.8%. Compared with the result without data augmentation, data augmentation resulted in an approximately 5% improvement in classification accuracy. This indicates that the further improvement can be expected by expanding the CT dataset. Unlike the conventional methods, the proposed method is advantageous in obtaining high classification accuracy without the need for precise tooth segmentation. The proposed tooth classification method can be useful in automatic filing of dental charts for forensic identification. Copyright © 2016 Elsevier Ltd

Radiation dosage of various CT-methods in lung diagnostics

International Nuclear Information System (INIS)

Heinz-Peer, G.; Weninger, F.; Nowotny, R.; Herold, C.J.

1996-01-01

Introduction of the computed tomography index CTDI and the multiple scan average dose (MSAD) has led to standardization of the dose description in CT examinations. Despite the use of these dose parameters, many different dosages are reported in the literature for different CT methods. In addition, there is still a wide range of radiation dosimetry results reported for conventional CT, helical CT, and HRCT used in chest examinations. The variations in dosage are mainly due to difference in factors affecting the dose, i.e. beam geometry, beam quality, scanner geometry ('generation'), and operating parameters. In addition, CT dosimetry instrumentation and methodology make a contribution to dosages. Recent studies calculating differences in factors affecting dosage and CT dosimetry and using similar operating parameters, show similar results in CT dosimetry for conventional and helical CT. On the other hand, dosages for HRCT were greatly reduced. This was mainly caused by narrow beam collimation and increasing section spacing. (orig.) [de

A new approximate algorithm for image reconstruction in cone-beam spiral CT at small cone-angles

International Nuclear Information System (INIS)

Schaller, S.; Flohr, T.; Steffen, P.

1996-01-01

This paper presents a new approximate algorithm for image reconstruction with cone-beam spiral CT data at relatively small cone-angles. Based on the algorithm of Wang et al., our method combines a special complementary interpolation with filtered backprojection. The presented algorithm has three main advantages over Wang's algorithm: (1) It overcomes the pitch limitation of Wang's algorithm. (2) It significantly improves z-resolution when suitable sampling schemes are applied. (3) It avoids the waste of applied radiation dose inherent to Wang's algorithm. Usage of the total applied dose is an important requirement in medical imaging. Our method has been implemented on a standard workstation. Reconstructions of computer-simulated data of different phantoms, assuming sampling conditions and image quality requirements typical to medical CT, show encouraging results

Reduction of Cone-Beam CT scan time without compromising the accuracy of the image registration in IGRT

International Nuclear Information System (INIS)

Westberg, Jonas; Jensen, Henrik R.; Bertelsen, Anders; Brink, Carsten

2010-01-01

Background. In modern radiotherapy accelerators are equipped with 3D cone-beam CT (CBCT) which is used to verify patient position before treatment. The verification is based on an image registration between the CBCT acquired just before treatment and the CT scan made for the treatment planning. The purpose of this study is to minimise the scan time of the CBCT without compromising the accuracy of the image registration in IGRT. Material and methods. Fast scans were simulated by reducing the number of acquired projection images, i.e. new reconstructions based on a subset of the original projections were made. The deviation between the registrations of these new reconstructions and the original registration was measured as function of the amount of reduction. Results and Discussion. Twenty nine head and neck (HandN) and 11 stereotactic lung patients were included in the study. The mean of the registration deviation did not differ significantly from zero independently of the number of projections included in the reconstruction. Except for the smallest subset of reconstructions (10% and 25% of the original projection for the lung and HandN patients, respectively) the standard deviation of the registration differences was constant. The standard deviations were approximately 0.1 mm and 0.2 mm for the HandN and lung group, respectively. Based on these results an in-house developed solution, able to reduce the Cone-Beam CT scan time, has been implemented clinically

Correction of patient motion in cone-beam CT using 3D-2D registration

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Ouadah, S.; Jacobson, M.; Stayman, J. W.; Ehtiati, T.; Weiss, C.; Siewerdsen, J. H.

2017-12-01

Cone-beam CT (CBCT) is increasingly common in guidance of interventional procedures, but can be subject to artifacts arising from patient motion during fairly long (~5-60 s) scan times. We present a fiducial-free method to mitigate motion artifacts using 3D-2D image registration that simultaneously corrects residual errors in the intrinsic and extrinsic parameters of geometric calibration. The 3D-2D registration process registers each projection to a prior 3D image by maximizing gradient orientation using the covariance matrix adaptation-evolution strategy optimizer. The resulting rigid transforms are applied to the system projection matrices, and a 3D image is reconstructed via model-based iterative reconstruction. Phantom experiments were conducted using a Zeego robotic C-arm to image a head phantom undergoing 5-15 cm translations and 5-15° rotations. To further test the algorithm, clinical images were acquired with a CBCT head scanner in which long scan times were susceptible to significant patient motion. CBCT images were reconstructed using a penalized likelihood objective function. For phantom studies the structural similarity (SSIM) between motion-free and motion-corrected images was  >0.995, with significant improvement (p  values of uncorrected images. Additionally, motion-corrected images exhibited a point-spread function with full-width at half maximum comparable to that of the motion-free reference image. Qualitative comparison of the motion-corrupted and motion-corrected clinical images demonstrated a significant improvement in image quality after motion correction. This indicates that the 3D-2D registration method could provide a useful approach to motion artifact correction under assumptions of local rigidity, as in the head, pelvis, and extremities. The method is highly parallelizable, and the automatic correction of residual geometric calibration errors provides added benefit that could be valuable in routine use.

Impact of Image Guidance on Outcomes After External Beam Radiotherapy for Localized Prostate Cancer

International Nuclear Information System (INIS)

Kupelian, Patrick A.; Willoughby, Twyla R.; Reddy, Chandana A.; Klein, Eric A.; Mahadevan, Arul

2008-01-01

Purpose: To verify whether rectal distention at the time of planning impacts outcomes in patients with localized prostate cancer treated with daily image guidance. Methods and Materials: Between 1998 and 2002, a total of 488 prostate cancer patients were treated with intensity-modulated radiotherapy. The radiation dose was 70 Gy delivered at 2.5 Gy per fraction in all cases. All cases were treated with a 4-mm margin posteriorly. In all cases the total rectal volume documented on the CT scan was used for treatment planning. No special bowel preparation instructions were given, either for the simulation or the daily treatments. Before each daily treatment, alignment of the prostate was performed with the B-mode acquisition and targeting (BAT) transabdominal ultrasound system. The median follow-up for all 488 patients was 60 months (range, 24-96 months). Results: For all patients the biochemical relapse-free survival (bRFS) rate at 5 years was 86%. The 5-year bRFS rate for the rectal distention 3 , 50 to 3 , and ≥100 cm 3 groups was 90%, 83%, and 85%, respectively (p = 0.18). To adjust for other potential variables affecting bRFS rates, a multivariate time-to-failure analysis using the Cox proportional hazards model was performed. Rectal distention was not an independent predictor of biochemical failure on multivariate analysis (p = 0.80). Rectal distention was not a predictor of rectal or urinary toxicity. Conclusion: The use of daily image guidance eliminates errors such as rectal distention at the initial planning stage that can affect outcomes after radiotherapy for localized prostate cancer

Conventional multi-slice computed tomography (CT) and cone-beam CT (CBCT) for computer-assisted implant placement. Part I: relationship of radiographic gray density and implant stability.

Science.gov (United States)

Arisan, Volkan; Karabuda, Zihni Cüneyt; Avsever, Hakan; Özdemir, Tayfun

2013-12-01

The relationship of conventional multi-slice computed tomography (CT)- and cone beam CT (CBCT)-based gray density values and the primary stability parameters of implants that were placed by stereolithographic surgical guides were analyzed in this study. Eighteen edentulous jaws were randomly scanned by a CT (CT group) or a CBCT scanner (CBCT group) and radiographic gray density was measured from the planned implants. A total of 108 implants were placed, and primary stability parameters were measured by insertion torque value (ITV) and resonance frequency analysis (RFA). Radiographic and subjective bone quality classification (BQC) was also classified. Results were analyzed by correlation tests and multiple regressions (p < .05). CBCT-based gray density values (765 ± 97.32 voxel value) outside the implants were significantly higher than those of CT-based values (668.4 ± 110 Hounsfield unit, p < .001). Significant relations were found among the gray density values outside the implants, ITV (adjusted r(2)  = 0.6142, p = .001 and adjusted r(2)  = 0.5166, p = .0021), and RFA (adjusted r(2)  = 0.5642, p = .0017 and adjusted r(2)  = 0.5423, p = .0031 for CT and CBCT groups, respectively). Data from radiographic and subjective BQC were also in agreement. Similar to the gray density values of CT, that of CBCT could also be predictive for the subjective BQC and primary implant stability. Results should be confirmed on different CBCT scanners. © 2012 Wiley Periodicals, Inc.

A BPF-FBP tandem algorithm for image reconstruction in reverse helical cone-beam CT

International Nuclear Information System (INIS)

Cho, Seungryong; Xia, Dan; Pellizzari, Charles A.; Pan Xiaochuan

2010-01-01

Purpose: Reverse helical cone-beam computed tomography (CBCT) is a scanning configuration for potential applications in image-guided radiation therapy in which an accurate anatomic image of the patient is needed for image-guidance procedures. The authors previously developed an algorithm for image reconstruction from nontruncated data of an object that is completely within the reverse helix. The purpose of this work is to develop an image reconstruction approach for reverse helical CBCT of a long object that extends out of the reverse helix and therefore constitutes data truncation. Methods: The proposed approach comprises of two reconstruction steps. In the first step, a chord-based backprojection-filtration (BPF) algorithm reconstructs a volumetric image of an object from the original cone-beam data. Because there exists a chordless region in the middle of the reverse helix, the image obtained in the first step contains an unreconstructed central-gap region. In the second step, the gap region is reconstructed by use of a Pack-Noo-formula-based filteredbackprojection (FBP) algorithm from the modified cone-beam data obtained by subtracting from the original cone-beam data the reprojection of the image reconstructed in the first step. Results: The authors have performed numerical studies to validate the proposed approach in image reconstruction from reverse helical cone-beam data. The results confirm that the proposed approach can reconstruct accurate images of a long object without suffering from data-truncation artifacts or cone-angle artifacts. Conclusions: They developed and validated a BPF-FBP tandem algorithm to reconstruct images of a long object from reverse helical cone-beam data. The chord-based BPF algorithm was utilized for converting the long-object problem into a short-object problem. The proposed approach is applicable to other scanning configurations such as reduced circular sinusoidal trajectories.

Automatic tracking of implanted fiducial markers in cone beam CT projection images

International Nuclear Information System (INIS)

Marchant, T. E.; Skalski, A.; Matuszewski, B. J.

2012-01-01

Purpose: This paper describes a novel method for simultaneous intrafraction tracking of multiple fiducial markers. Although the proposed method is generic and can be adopted for a number of applications including fluoroscopy based patient position monitoring and gated radiotherapy, the tracking results presented in this paper are specific to tracking fiducial markers in a sequence of cone beam CT projection images. Methods: The proposed method is accurate and robust thanks to utilizing the mean shift and random sampling principles, respectively. The performance of the proposed method was evaluated with qualitative and quantitative methods, using data from two pancreatic and one prostate cancer patients and a moving phantom. The ground truth, for quantitative evaluation, was calculated based on manual tracking preformed by three observers. Results: The average dispersion of marker position error calculated from the tracking results for pancreas data (six markers tracked over 640 frames, 3840 marker identifications) was 0.25 mm (at iscoenter), compared with an average dispersion for the manual ground truth estimated at 0.22 mm. For prostate data (three markers tracked over 366 frames, 1098 marker identifications), the average error was 0.34 mm. The estimated tracking error in the pancreas data was < 1 mm (2 pixels) in 97.6% of cases where nearby image clutter was detected and in 100.0% of cases with no nearby image clutter. Conclusions: The proposed method has accuracy comparable to that of manual tracking and, in combination with the proposed batch postprocessing, superior robustness. Marker tracking in cone beam CT (CBCT) projections is useful for a variety of purposes, such as providing data for assessment of intrafraction motion, target tracking during rotational treatment delivery, motion correction of CBCT, and phase sorting for 4D CBCT.

An optimization-based method for geometrical calibration in cone-beam CT without dedicated phantoms

International Nuclear Information System (INIS)

Panetta, D; Belcari, N; Guerra, A Del; Moehrs, S

2008-01-01

In this paper we present a new method for the determination of geometrical misalignments in cone-beam CT scanners, from the analysis of the projection data of a generic object. No a priori knowledge of the object shape and positioning is required. We show that a cost function, which depends on the misalignment parameters, can be defined using the projection data and that such a cost function has a local minimum in correspondence to the actual parameters of the system. Hence, the calibration of the scanner can be carried out by minimizing the cost function using standard optimization techniques. The method is developed for a particular class of 3D object functions, for which the redundancy of the fan beam sinogram in the transaxial midplane can be extended to cone-beam projection data, even at wide cone angles. The method has an approximated validity for objects which do not belong to that class; in that case, a suitable subset of the projection data can be selected in order to compute the cost function. We show by numerical simulations that our method is capable to determine with high accuracy the most critical misalignment parameters of the scanner, i.e., the transversal shift and the skew of the detector. Additionally, the detector slant can be determined. Other parameters such as the detector tilt, the longitudinal shift and the error in the source-detector distance cannot be determined with our method, as the proposed cost function has a very weak dependence on them. However, due to the negligible influence of these latter parameters in the reconstructed image quality, they can be kept fixed at estimated values in both calibration and reconstruction processes without compromising the final result. A trade-off between computational cost and calibration accuracy must be considered when choosing the data subset used for the computation of the cost function. Results on real data of a mouse femur as obtained with a small animal micro-CT are shown as well, proving

Task-driven image acquisition and reconstruction in cone-beam CT

International Nuclear Information System (INIS)

Gang, Grace J; Stayman, J Webster; Siewerdsen, Jeffrey H; Ehtiati, Tina

2015-01-01

This work introduces a task-driven imaging framework that incorporates a mathematical definition of the imaging task, a model of the imaging system, and a patient-specific anatomical model to prospectively design image acquisition and reconstruction techniques to optimize task performance. The framework is applied to joint optimization of tube current modulation, view-dependent reconstruction kernel, and orbital tilt in cone-beam CT. The system model considers a cone-beam CT system incorporating a flat-panel detector and 3D filtered backprojection and accurately describes the spatially varying noise and resolution over a wide range of imaging parameters in the presence of a realistic anatomical model. Task-based detectability index (d′) is incorporated as the objective function in a task-driven optimization of image acquisition and reconstruction techniques. The orbital tilt was optimized through an exhaustive search across tilt angles ranging ±30°. For each tilt angle, the view-dependent tube current and reconstruction kernel (i.e. the modulation profiles) that maximized detectability were identified via an alternating optimization. The task-driven approach was compared with conventional unmodulated and automatic exposure control (AEC) strategies for a variety of imaging tasks and anthropomorphic phantoms. The task-driven strategy outperformed the unmodulated and AEC cases for all tasks. For example, d′ for a sphere detection task in a head phantom was improved by 30% compared to the unmodulated case by using smoother kernels for noisy views and distributing mAs across less noisy views (at fixed total mAs) in a manner that was beneficial to task performance. Similarly for detection of a line-pair pattern, the task-driven approach increased d′ by 80% compared to no modulation by means of view-dependent mA and kernel selection that yields modulation transfer function and noise-power spectrum optimal to the task. Optimization of orbital tilt identified the

SU-E-J-43: Deformed Planning CT as An Electron Density Substitute for Cone-Beam CT

International Nuclear Information System (INIS)

Mishra, K; Godley, A

2014-01-01

Purpose: To confirm that deforming the planning CT to the daily Cone-Beam CTs (CBCT) can provide suitable electron density for adaptive planning. We quantify the dosimetric difference between plans calculated on deformed planning CTs (DPCT) and daily CT-on-rails images (CTOR). CTOR is used as a test of the method as CTOR already contains accurate electron density to compare against. Methods: Five prostate only IMRT patients, each with five CTOR images, were selected and re-planned on Panther (Prowess Inc.) with a uniform 5 mm PTV expansion, prescribed 78 Gy. The planning CT was deformed to match each CTOR using ABAS (Elekta Inc.). Contours were drawn on the CTOR, and copied to the DPCT. The original treatment plan was copied to both the CTOR and DPCT, keeping the center of the prostate as the isocenter. The plans were then calculated using the collapsed cone heterogeneous dose engine of Prowess and typical DVH planning parameters used to compare them. Results: Each DPCT was visually compared to its CTOR with no differences observed. The agreement of the copied CTOR contours with the DPCT anatomy further demonstrated the deformation accuracy. The plans calculated using CTOR and DPCT were compared. Over the 25 plan pairs, the average difference between them for prostate D100, D98 and D95 were 0.5%, 0.2%, and 0.2%; PTV D98, D95 and mean dose: 0.3%, 0.2% and 0.3%; bladder V70, V60 and mean dose: 1.1%, 0.7%, and 0.2%; and rectum mean dose: 0.3%. (D100 is the dose covering 100% of the target; V70 is the volume of the organ receiving 70 Gy). Conclusion: We observe negligible difference between the dose calculated on the DPCT and the CTOR, implying that deformed planning CTs are a suitable substitute for electron density. The method can now be applied to CBCTs. Research version of Panther provided by Prowess Inc. Research version of ABAS provided by Elekta Inc

SU-E-J-43: Deformed Planning CT as An Electron Density Substitute for Cone-Beam CT

Energy Technology Data Exchange (ETDEWEB)

Mishra, K [Cleveland State University, Cleveland, OH (United States); Godley, A [Cleveland Clinic, Cleveland, OH (United States)

2014-06-01

Purpose: To confirm that deforming the planning CT to the daily Cone-Beam CTs (CBCT) can provide suitable electron density for adaptive planning. We quantify the dosimetric difference between plans calculated on deformed planning CTs (DPCT) and daily CT-on-rails images (CTOR). CTOR is used as a test of the method as CTOR already contains accurate electron density to compare against. Methods: Five prostate only IMRT patients, each with five CTOR images, were selected and re-planned on Panther (Prowess Inc.) with a uniform 5 mm PTV expansion, prescribed 78 Gy. The planning CT was deformed to match each CTOR using ABAS (Elekta Inc.). Contours were drawn on the CTOR, and copied to the DPCT. The original treatment plan was copied to both the CTOR and DPCT, keeping the center of the prostate as the isocenter. The plans were then calculated using the collapsed cone heterogeneous dose engine of Prowess and typical DVH planning parameters used to compare them. Results: Each DPCT was visually compared to its CTOR with no differences observed. The agreement of the copied CTOR contours with the DPCT anatomy further demonstrated the deformation accuracy. The plans calculated using CTOR and DPCT were compared. Over the 25 plan pairs, the average difference between them for prostate D100, D98 and D95 were 0.5%, 0.2%, and 0.2%; PTV D98, D95 and mean dose: 0.3%, 0.2% and 0.3%; bladder V70, V60 and mean dose: 1.1%, 0.7%, and 0.2%; and rectum mean dose: 0.3%. (D100 is the dose covering 100% of the target; V70 is the volume of the organ receiving 70 Gy). Conclusion: We observe negligible difference between the dose calculated on the DPCT and the CTOR, implying that deformed planning CTs are a suitable substitute for electron density. The method can now be applied to CBCTs. Research version of Panther provided by Prowess Inc. Research version of ABAS provided by Elekta Inc.

Improving the accuracy of CT dimensional metrology by a novel beam hardening correction method

International Nuclear Information System (INIS)

Zhang, Xiang; Li, Lei; Zhang, Feng; Xi, Xiaoqi; Deng, Lin; Yan, Bin

2015-01-01

Its powerful nondestructive characteristics are attracting more and more research into the study of computed tomography (CT) for dimensional metrology, which offers a practical alternative to the common measurement methods. However, the inaccuracy and uncertainty severely limit the further utilization of CT for dimensional metrology due to many factors, among which the beam hardening (BH) effect plays a vital role. This paper mainly focuses on eliminating the influence of the BH effect in the accuracy of CT dimensional metrology. To correct the BH effect, a novel exponential correction model is proposed. The parameters of the model are determined by minimizing the gray entropy of the reconstructed volume. In order to maintain the consistency and contrast of the corrected volume, a punishment term is added to the cost function, enabling more accurate measurement results to be obtained by the simple global threshold method. The proposed method is efficient, and especially suited to the case where there is a large difference in gray value between material and background. Different spheres with known diameters are used to verify the accuracy of dimensional measurement. Both simulation and real experimental results demonstrate the improvement in measurement precision. Moreover, a more complex workpiece is also tested to show that the proposed method is of general feasibility. (paper)

A technique for on-board CT reconstruction using both kilovoltage and megavoltage beam projections for 3D treatment verification

International Nuclear Information System (INIS)

Yin Fangfang; Guan Huaiqun; Lu Wenkai

2005-01-01

The technologies with kilovoltage (kV) and megavoltage (MV) imaging in the treatment room are now available for image-guided radiation therapy to improve patient setup and target localization accuracy. However, development of strategies to efficiently and effectively implement these technologies for patient treatment remains challenging. This study proposed an aggregated technique for on-board CT reconstruction using combination of kV and MV beam projections to improve the data acquisition efficiency and image quality. These projections were acquired in the treatment room at the patient treatment position with a new kV imaging device installed on the accelerator gantry, orthogonal to the existing MV portal imaging device. The projection images for a head phantom and a contrast phantom were acquired using both the On-Board Imager TM kV imaging device and the MV portal imager mounted orthogonally on the gantry of a Varian Clinac TM 21EX linear accelerator. MV projections were converted into kV information prior to the aggregated CT reconstruction. The multilevel scheme algebraic-reconstruction technique was used to reconstruct CT images involving either full, truncated, or a combination of both full and truncated projections. An adaptive reconstruction method was also applied, based on the limited numbers of kV projections and truncated MV projections, to enhance the anatomical information around the treatment volume and to minimize the radiation dose. The effects of the total number of projections, the combination of kV and MV projections, and the beam truncation of MV projections on the details of reconstructed kV/MV CT images were also investigated

Fixed, object-specific intensity compensation for cone beam optical CT radiation dosimetry

Science.gov (United States)

Dekker, Kurtis H.; Hazarika, Rubin; Silveira, Matheus A.; Jordan, Kevin J.

2018-03-01

Optical cone beam computed tomography (CT) scanning of radiochromic gel dosimeters, using a CCD camera and a low stray light convergent source, provides fast, truly 3D radiation dosimetry with high accuracy. However, a key limiting factor in radiochromic gel dosimetry at large (⩾10 cm diameter) volumes is the initial attenuation of the dosimeters. It is not unusual to observe a 5–10×  difference in signal intensity through the dosimeter center versus through the surrounding medium in pre-irradiation images. Thus, all dosimetric information in a typical experiment is measured within the lower 10%–20% of the camera sensor’s range, and re-use of gels is often not possible due to a lack of transmission. To counteract this, in this note we describe a simple method to create source compensators by printing on transparent films. This technique, which is easily implemented and inexpensive, is an optical analogue to the bowtie filter in x-ray CT. We present transmission images and solution phantom reconstructions to demonstrate that (1) placing compensators beyond the focal zone of the imaging lens prevents high spatial frequency features of the printed films from generating reconstruction artifacts, and (2) object-specific compensation considerably reduces the range of intensities measured in projection images. This will improve the measurable dose range in optical CT dosimetry, and will enable imaging of larger gel volumes (∼15 cm diameter). Additionally, it should enable re-use of dosimeters by printing a new compensator for a second experiment.

Comprehensive evaluation of ten deformable image registration algorithms for contour propagation between CT and cone-beam CT images in adaptive head & neck radiotherapy.

Science.gov (United States)

Li, Xin; Zhang, Yuyu; Shi, Yinghua; Wu, Shuyu; Xiao, Yang; Gu, Xuejun; Zhen, Xin; Zhou, Linghong

2017-01-01

Deformable image registration (DIR) is a critical technic in adaptive radiotherapy (ART) for propagating contours between planning computerized tomography (CT) images and treatment CT/cone-beam CT (CBCT) images to account for organ deformation for treatment re-planning. To validate the ability and accuracy of DIR algorithms in organ at risk (OAR) contour mapping, ten intensity-based DIR strategies, which were classified into four categories-optical flow-based, demons-based, level-set-based and spline-based-were tested on planning CT and fractional CBCT images acquired from twenty-one head & neck (H&N) cancer patients who underwent 6~7-week intensity-modulated radiation therapy (IMRT). Three similarity metrics, i.e., the Dice similarity coefficient (DSC), the percentage error (PE) and the Hausdorff distance (HD), were employed to measure the agreement between the propagated contours and the physician-delineated ground truths of four OARs, including the vertebra (VTB), the vertebral foramen (VF), the parotid gland (PG) and the submandibular gland (SMG). It was found that the evaluated DIRs in this work did not necessarily outperform rigid registration. DIR performed better for bony structures than soft-tissue organs, and the DIR performance tended to vary for different ROIs with different degrees of deformation as the treatment proceeded. Generally, the optical flow-based DIR performed best, while the demons-based DIR usually ranked last except for a modified demons-based DISC used for CT-CBCT DIR. These experimental results suggest that the choice of a specific DIR algorithm depends on the image modality, anatomic site, magnitude of deformation and application. Therefore, careful examinations and modifications are required before accepting the auto-propagated contours, especially for automatic re-planning ART systems.

Cone-Beam CT with Flat-Panel-Detector Digital Angiography System: Early Experience in Abdominal Interventional Procedures

International Nuclear Information System (INIS)

Hirota, Shozo; Nakao, Norio; Yamamoto, Satoshi; Kobayashi, Kaoru; Maeda, Hiroaki; Ishikura, Reiichi; Miura, Koui; Sakamoto, Kiyoshi; Ueda, Ken; Baba, Rika

2006-01-01

We developed a cone-beam computed tomography (CBCT) system equipped with a large flat-panel detector. Data obtained by 200 o rotation imaging are reconstructed by means of CBCT to generate three-dimensional images. We report the use of CBCT angiography using CBCT in 10 patients with 8 liver malignancies and 2 hypersplenisms during abdominal interventional procedures. CBCT was very useful for interventional radiologists to confirm a perfusion area of the artery catheter wedged on CT by injection of contrast media through the catheter tip, although the image quality was slightly degraded, scoring as 2.60 on average by streak artifacts. CBCT is space-saving because it does not require a CT system with a gantry, and it is also time-saving because it does not require the transfer of patients

Algorithms of CT value correction for reconstructing a radiotherapy simulation image through axial CT images

International Nuclear Information System (INIS)

Ogino, Takashi; Egawa, Sunao

1991-01-01

New algorithms of CT value correction for reconstructing a radiotherapy simulation image through axial CT images were developed. One, designated plane weighting method, is to correct CT value in proportion to the position of the beam element passing through the voxel. The other, designated solid weighting method, is to correct CT value in proportion to the length of the beam element passing through the voxel and the volume of voxel. Phantom experiments showed fair spatial resolution in the transverse direction. In the longitudinal direction, however, spatial resolution of under slice thickness could not be obtained. Contrast resolution was equivalent for both methods. In patient studies, the reconstructed radiotherapy simulation image was almost similar in visual perception of the density resolution to a simulation film taken by X-ray simulator. (author)

SU-D-206-03: Segmentation Assisted Fast Iterative Reconstruction Method for Cone-Beam CT

International Nuclear Information System (INIS)

Wu, P; Mao, T; Gong, S; Wang, J; Niu, T; Sheng, K; Xie, Y

2016-01-01

Purpose: Total Variation (TV) based iterative reconstruction (IR) methods enable accurate CT image reconstruction from low-dose measurements with sparse projection acquisition, due to the sparsifiable feature of most CT images using gradient operator. However, conventional solutions require large amount of iterations to generate a decent reconstructed image. One major reason is that the expected piecewise constant property is not taken into consideration at the optimization starting point. In this work, we propose an iterative reconstruction method for cone-beam CT (CBCT) using image segmentation to guide the optimization path more efficiently on the regularization term at the beginning of the optimization trajectory. Methods: Our method applies general knowledge that one tissue component in the CT image contains relatively uniform distribution of CT number. This general knowledge is incorporated into the proposed reconstruction using image segmentation technique to generate the piecewise constant template on the first-pass low-quality CT image reconstructed using analytical algorithm. The template image is applied as an initial value into the optimization process. Results: The proposed method is evaluated on the Shepp-Logan phantom of low and high noise levels, and a head patient. The number of iterations is reduced by overall 40%. Moreover, our proposed method tends to generate a smoother reconstructed image with the same TV value. Conclusion: We propose a computationally efficient iterative reconstruction method for CBCT imaging. Our method achieves a better optimization trajectory and a faster convergence behavior. It does not rely on prior information and can be readily incorporated into existing iterative reconstruction framework. Our method is thus practical and attractive as a general solution to CBCT iterative reconstruction. This work is supported by the Zhejiang Provincial Natural Science Foundation of China (Grant No. LR16F010001), National High-tech R

SU-D-206-03: Segmentation Assisted Fast Iterative Reconstruction Method for Cone-Beam CT

Energy Technology Data Exchange (ETDEWEB)

Wu, P; Mao, T; Gong, S; Wang, J; Niu, T [Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Institute of Translational Medicine, Zhejiang University, Hangzhou, Zhejiang (China); Sheng, K [Department of Radiation Oncology, University of California, Los Angeles, Los Angeles, CA (United States); Xie, Y [Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, Guangdong (China)

2016-06-15

Purpose: Total Variation (TV) based iterative reconstruction (IR) methods enable accurate CT image reconstruction from low-dose measurements with sparse projection acquisition, due to the sparsifiable feature of most CT images using gradient operator. However, conventional solutions require large amount of iterations to generate a decent reconstructed image. One major reason is that the expected piecewise constant property is not taken into consideration at the optimization starting point. In this work, we propose an iterative reconstruction method for cone-beam CT (CBCT) using image segmentation to guide the optimization path more efficiently on the regularization term at the beginning of the optimization trajectory. Methods: Our method applies general knowledge that one tissue component in the CT image contains relatively uniform distribution of CT number. This general knowledge is incorporated into the proposed reconstruction using image segmentation technique to generate the piecewise constant template on the first-pass low-quality CT image reconstructed using analytical algorithm. The template image is applied as an initial value into the optimization process. Results: The proposed method is evaluated on the Shepp-Logan phantom of low and high noise levels, and a head patient. The number of iterations is reduced by overall 40%. Moreover, our proposed method tends to generate a smoother reconstructed image with the same TV value. Conclusion: We propose a computationally efficient iterative reconstruction method for CBCT imaging. Our method achieves a better optimization trajectory and a faster convergence behavior. It does not rely on prior information and can be readily incorporated into existing iterative reconstruction framework. Our method is thus practical and attractive as a general solution to CBCT iterative reconstruction. This work is supported by the Zhejiang Provincial Natural Science Foundation of China (Grant No. LR16F010001), National High-tech R

Ultrasound and PET-CT image fusion for prostate brachytherapy image guidance

International Nuclear Information System (INIS)

Hasford, F.

2015-01-01

Fusion of medical images between different cross-sectional modalities is widely used, mostly where functional images are fused with anatomical data. Ultrasound has for some time now been the standard imaging technique used for treatment planning of prostate cancer cases. While this approach is laudable and has yielded some positive results, latest developments have been the integration of images from ultrasound and other modalities such as PET-CT to compliment missing properties of ultrasound images. This study has sought to enhance diagnosis and treatment of prostate cancers by developing MATLAB algorithms to fuse ultrasound and PET-CT images. The fused ultrasound-PET-CT image has shown to contain improved quality of information than the individual input images. The fused image has the property of reduced uncertainty, increased reliability, robust system performance, and compact representation of information. The objective of co-registering the ultrasound and PET-CT images was achieved by conducting performance evaluation of the ultrasound and PET-CT imaging systems, developing image contrast enhancement algorithm, developing MATLAB image fusion algorithm, and assessing accuracy of the fusion algorithm. Performance evaluation of the ultrasound brachytherapy system produced satisfactory results in accordance with set tolerances as recommended by AAPM TG 128. Using an ultrasound brachytherapy quality assurance phantom, average axial distance measurement of 10.11 ± 0.11 mm was estimated. Average lateral distance measurements of 10.08 ± 0.07 mm, 20.01 ± 0.06 mm, 29.89 ± 0.03 mm and 39.84 ± 0.37 mm were estimated for the inter-target distances corresponding to 10 mm, 20 mm, 30 mm and 40 mm respectively. Volume accuracy assessment produced measurements of 3.97 cm 3 , 8.86 cm 3 and 20.11 cm 3 for known standard volumes of 4 cm 3 , 9 cm 3 and 20 cm 3 respectively. Depth of penetration assessment of the ultrasound system produced an estimate of 5.37 ± 0.02 cm

TU-E-BRA-11: Volume of Interest Cone Beam CT with a Low-Z Linear Accelerator Target: Proof-of-Concept.

Science.gov (United States)

Robar, J; Parsons, D; Berman, A; MacDonald, A

2012-06-01

This study demonstrates feasibility and advantages of volume of interest (VOI) cone beam CT (CBCT) imaging performed with an x-ray beam generated from 2.35 MeV electrons incident on a carbon linear accelerator target. The electron beam energy was reduced to 2.35 MeV in a Varian 21EX linear accelerator containing a 7.6 mm thick carbon x-ray target. Arbitrary imaging volumes were defined in the planning system to produce dynamic MLC sequences capable of tracking off-axis VOIs in phantoms. To reduce truncation artefacts, missing data in projection images were completed using a priori DRR information from the planning CT set. The feasibility of the approach was shown through imaging of an anthropomorphic phantom and the head-and-neck section of a lamb. TLD800 and EBT2 radiochromic film measurements were used to compare the VOI dose distributions with those for full-field techniques. CNR was measured for VOIs ranging from 4 to 15 cm diameter. The 2.35 MV/Carbon beam provides favorable CNR characteristics, although marked boundary and cupping artefacts arise due to truncation of projection data. These artefacts are largely eliminated using the DRR filling technique. Imaging dose was reduced by 5-10% and 75% inside and outside of the VOI, respectively, compared to full-field imaging for a cranial VOI. For the 2.35 MV/Carbon beam, CNR was shown to be approximately invariant with VOI dimension for bone and lung objects. This indicates that the advantage of the VOI approach with the low-Z target beam is substantial imaging dose reduction, not improvement of image quality. VOI CBCT using a 2.35 MV/Carbon beam is a feasible technique whereby a chosen imaging volume can be defined in the planning system and tracked during acquisition. The novel x-ray beam affords good CNR characteristics while imaging dose is localized to the chosen VOI. Funding for this project has been received from Varian Medical, Incorporated. © 2012 American Association of Physicists in Medicine.

SU-F-J-109: Generate Synthetic CT From Cone Beam CT for CBCT-Based Dose Calculation

Energy Technology Data Exchange (ETDEWEB)

Wang, H; Barbee, D; Wang, W; Pennell, R; Hu, K; Osterman, K [Department of Radiation Oncology, NYU Langone Medical Center, New York, NY (United States)

2016-06-15

Purpose: The use of CBCT for dose calculation is limited by its HU inaccuracy from increased scatter. This study presents a method to generate synthetic CT images from CBCT data by a probabilistic classification that may be robust to CBCT noise. The feasibility of using the synthetic CT for dose calculation is evaluated in IMRT for unilateral H&N cancer. Methods: In the training phase, a fuzzy c-means classification was performed on HU vectors (CBCT, CT) of planning CT and registered day-1 CBCT image pair. Using the resulting centroid CBCT and CT values for five classified “tissue” types, a synthetic CT for a daily CBCT was created by classifying each CBCT voxel to obtain its probability belonging to each tissue class, then assigning a CT HU with a probability-weighted summation of the classes’ CT centroids. Two synthetic CTs from a CBCT were generated: s-CT using the centroids from classification of individual patient CBCT/CT data; s2-CT using the same centroids for all patients to investigate the applicability of group-based centroids. IMRT dose calculations for five patients were performed on the synthetic CTs and compared with CT-planning doses by dose-volume statistics. Results: DVH curves of PTVs and critical organs calculated on s-CT and s2-CT agree with those from planning-CT within 3%, while doses calculated with heterogeneity off or on raw CBCT show DVH differences up to 15%. The differences in PTV D95% and spinal cord max are 0.6±0.6% and 0.6±0.3% for s-CT, and 1.6±1.7% and 1.9±1.7% for s2-CT. Gamma analysis (2%/2mm) shows 97.5±1.6% and 97.6±1.6% pass rates for using s-CTs and s2-CTs compared with CT-based doses, respectively. Conclusion: CBCT-synthesized CTs using individual or group-based centroids resulted in dose calculations that are comparable to CT-planning dose for unilateral H&N cancer. The method may provide a tool for accurate dose calculation based on daily CBCT.

SU-F-J-109: Generate Synthetic CT From Cone Beam CT for CBCT-Based Dose Calculation

International Nuclear Information System (INIS)

Wang, H; Barbee, D; Wang, W; Pennell, R; Hu, K; Osterman, K

2016-01-01

Purpose: The use of CBCT for dose calculation is limited by its HU inaccuracy from increased scatter. This study presents a method to generate synthetic CT images from CBCT data by a probabilistic classification that may be robust to CBCT noise. The feasibility of using the synthetic CT for dose calculation is evaluated in IMRT for unilateral H&N cancer. Methods: In the training phase, a fuzzy c-means classification was performed on HU vectors (CBCT, CT) of planning CT and registered day-1 CBCT image pair. Using the resulting centroid CBCT and CT values for five classified “tissue” types, a synthetic CT for a daily CBCT was created by classifying each CBCT voxel to obtain its probability belonging to each tissue class, then assigning a CT HU with a probability-weighted summation of the classes’ CT centroids. Two synthetic CTs from a CBCT were generated: s-CT using the centroids from classification of individual patient CBCT/CT data; s2-CT using the same centroids for all patients to investigate the applicability of group-based centroids. IMRT dose calculations for five patients were performed on the synthetic CTs and compared with CT-planning doses by dose-volume statistics. Results: DVH curves of PTVs and critical organs calculated on s-CT and s2-CT agree with those from planning-CT within 3%, while doses calculated with heterogeneity off or on raw CBCT show DVH differences up to 15%. The differences in PTV D95% and spinal cord max are 0.6±0.6% and 0.6±0.3% for s-CT, and 1.6±1.7% and 1.9±1.7% for s2-CT. Gamma analysis (2%/2mm) shows 97.5±1.6% and 97.6±1.6% pass rates for using s-CTs and s2-CTs compared with CT-based doses, respectively. Conclusion: CBCT-synthesized CTs using individual or group-based centroids resulted in dose calculations that are comparable to CT-planning dose for unilateral H&N cancer. The method may provide a tool for accurate dose calculation based on daily CBCT.

SU-F-J-71: Improving CT Quality for Radiation Therapy Planning and Delivery Guidance Using a Non-Linear Contrast Enhancement Technique

Energy Technology Data Exchange (ETDEWEB)

Noid, G; Tai, A; Li, X [Medical College of Wisconsin, Milwaukee, WI (United States)

2016-06-15

Purpose: Advanced image post-processing techniques which enhance soft-tissue contrast in CT have not been widely employed for RT planning or delivery guidance. The purpose of this work is to assess the soft-tissue contrast enhancement from non-linear contrast enhancing filters and its impact in RT. The contrast enhancement reduces patient alignment uncertainties. Methods: Non-linear contrast enhancing methods, such as Best Contrast (Siemens), amplify small differences in X-ray attenuation between two adjacent structure without significantly increasing noise. Best Contrast (BC) separates a CT into two frequency bands. The low frequency band is modified by a non-linear scaling function before recombination with the high frequency band. CT data collected using a CT-on-rails (Definition AS Open, Siemens) during daily CT-guided RT for 6 prostate cancer patients and an image quality phantom (The Phantom Laboratory) were analyzed. Images acquired with a standard protocol (120 kVp, 0.6 pitch, 18 mGy CTDIvol) were processed before comparison to the unaltered images. Contrast and noise were measured in the the phantom. Inter-observer variation was assessed by placing prostate contours on the 12 CT study sets, 6 enhanced and 6 unaltered, in a blinded study involving 8 observers. Results: The phantom data demonstrate that BC increased the contrast between the 1.0% supra-slice element and the background substrate by 46.5 HU while noise increased by only 2.3 HU. Thus the contrast to noise ratio increased from 1.28 to 6.71. Furthermore, the variation in centroid position of the prostate contours was decreased from 1.3±0.4 mm to 0.8±0.3 mm. Thus the CTV-to-PTV margin was reduced by 1.1 mm. The uncertainty in delineation of the prostate/rectum edge decreased by 0.5 mm. Conclusion: As demonstrated in phantom and patient scans the BC filter accentuates soft-tissue contrast. This enhancement leads to reduced inter-observer variation, which should improve RT planning and delivery

Monte Carlo simulations in multi-detector CT (MDCT) for two PET/CT scanner models using MASH and FASH adult phantoms

Energy Technology Data Exchange (ETDEWEB)

Belinato, W., E-mail: wbfisica@gmail.com [Bahia Federal Institute of Education, Science and Technology – IFBA, Vitória da Conquista, 45.100-000 (Brazil); Department of Physics, Federal University of Sergipe – UFS, São Cristóvão, 49.100-000 (Brazil); Santos, W.S. [Department of Physics, Federal University of Sergipe – UFS, São Cristóvão, 49.100-000 (Brazil); Paschoal, C.M.M., E-mail: cinthiam.paschoal@gmail.com [Department of Civil Engineering, Vale do Acarau State University – UVA, Sobral 62.040-730 (Brazil); Souza, D.N. [Department of Physics, Federal University of Sergipe – UFS, São Cristóvão, 49.100-000 (Brazil)

2015-06-01

The combination of positron emission tomography (PET) and computed tomography (CT) has been extensively used in oncology for diagnosis and staging of tumors, radiotherapy planning and follow-up of patients with cancer, as well as in cardiology and neurology. This study determines by the Monte Carlo method the internal organ dose deposition for computational phantoms created by multidetector CT (MDCT) beams of two PET/CT devices operating with different parameters. The different MDCT beam parameters were largely related to the total filtration that provides a beam energetic change inside the gantry. This parameter was determined experimentally with the Accu-Gold Radcal measurement system. The experimental values of the total filtration were included in the simulations of two MCNPX code scenarios. The absorbed organ doses obtained in MASH and FASH phantoms indicate that bowtie filter geometry and the energy of the X-ray beam have significant influence on the results, although this influence can be compensated by adjusting other variables such as the tube current–time product (mAs) and pitch during PET/CT procedures.

High-fidelity artifact correction for cone-beam CT imaging of the brain

Science.gov (United States)

Sisniega, A.; Zbijewski, W.; Xu, J.; Dang, H.; Stayman, J. W.; Yorkston, J.; Aygun, N.; Koliatsos, V.; Siewerdsen, J. H.

2015-02-01

CT is the frontline imaging modality for diagnosis of acute traumatic brain injury (TBI), involving the detection of fresh blood in the brain (contrast of 30-50 HU, detail size down to 1 mm) in a non-contrast-enhanced exam. A dedicated point-of-care imaging system based on cone-beam CT (CBCT) could benefit early detection of TBI and improve direction to appropriate therapy. However, flat-panel detector (FPD) CBCT is challenged by artifacts that degrade contrast resolution and limit application in soft-tissue imaging. We present and evaluate a fairly comprehensive framework for artifact correction to enable soft-tissue brain imaging with FPD CBCT. The framework includes a fast Monte Carlo (MC)-based scatter estimation method complemented by corrections for detector lag, veiling glare, and beam hardening. The fast MC scatter estimation combines GPU acceleration, variance reduction, and simulation with a low number of photon histories and reduced number of projection angles (sparse MC) augmented by kernel de-noising to yield a runtime of ~4 min per scan. Scatter correction is combined with two-pass beam hardening correction. Detector lag correction is based on temporal deconvolution of the measured lag response function. The effects of detector veiling glare are reduced by deconvolution of the glare response function representing the long range tails of the detector point-spread function. The performance of the correction framework is quantified in experiments using a realistic head phantom on a testbench for FPD CBCT. Uncorrected reconstructions were non-diagnostic for soft-tissue imaging tasks in the brain. After processing with the artifact correction framework, image uniformity was substantially improved, and artifacts were reduced to a level that enabled visualization of ~3 mm simulated bleeds throughout the brain. Non-uniformity (cupping) was reduced by a factor of 5, and contrast of simulated bleeds was improved from ~7 to 49.7 HU, in good agreement

Diagnostic accuracy of the detection of bone change using panoramic TMJ projection. Comparative study with limited cone-beam CT

International Nuclear Information System (INIS)

Araki, Kazuyuki; Okano, Tomohiro; Kataoka, Ryuta; Honda, Kazuya; Endo, Atsushi; Kaneko, Norikazu; Funahashi, Itsuo

2008-01-01

Panoramic temporoman joint (TMJ) projection is one of the alternative methods of conventional radiography, such as transcranial projection, for diagnosing temporomandibular joint disorder. There have been a few reports describing the diagnostic ability of this method. We evaluated the diagnostic accuracy of detecting bone change with panoramic TMJ projection. Fifty TMJs in 25 patients were examined. All TMJs were examined by panoramic TMJ projection (Hyper XF) and limited cone-beam CT (3D Accuitomo FPD; 3DX). Two observers evaluated the presence of bone change in the TMJ region using panoramic TMJ projection. One other observer evaluated the limited cone-beam CT for the presence and the pattern of bone changes in the TMJ region as the gold standard. Panoramic TMJ findings were evaluated with regard to sensitivity, specificity, and accuracy. Sensitivity, specificity and accuracy of the panoramic TMJ projection were 0.86, 0.76, and 0.82, respectively. These results and those of previous reports on other radiographic methods for TMJ suggest that panoramic TMJ projection is a useful method of screening for bone change due to TMJ disorder. (author)

Comprehensive evaluation of ten deformable image registration algorithms for contour propagation between CT and cone-beam CT images in adaptive head & neck radiotherapy.

Directory of Open Access Journals (Sweden)

Xin Li

Full Text Available Deformable image registration (DIR is a critical technic in adaptive radiotherapy (ART for propagating contours between planning computerized tomography (CT images and treatment CT/cone-beam CT (CBCT images to account for organ deformation for treatment re-planning. To validate the ability and accuracy of DIR algorithms in organ at risk (OAR contour mapping, ten intensity-based DIR strategies, which were classified into four categories-optical flow-based, demons-based, level-set-based and spline-based-were tested on planning CT and fractional CBCT images acquired from twenty-one head & neck (H&N cancer patients who underwent 6~7-week intensity-modulated radiation therapy (IMRT. Three similarity metrics, i.e., the Dice similarity coefficient (DSC, the percentage error (PE and the Hausdorff distance (HD, were employed to measure the agreement between the propagated contours and the physician-delineated ground truths of four OARs, including the vertebra (VTB, the vertebral foramen (VF, the parotid gland (PG and the submandibular gland (SMG. It was found that the evaluated DIRs in this work did not necessarily outperform rigid registration. DIR performed better for bony structures than soft-tissue organs, and the DIR performance tended to vary for different ROIs with different degrees of deformation as the treatment proceeded. Generally, the optical flow-based DIR performed best, while the demons-based DIR usually ranked last except for a modified demons-based DISC used for CT-CBCT DIR. These experimental results suggest that the choice of a specific DIR algorithm depends on the image modality, anatomic site, magnitude of deformation and application. Therefore, careful examinations and modifications are required before accepting the auto-propagated contours, especially for automatic re-planning ART systems.

WE-FG-207A-03: Low-Dose Cone-Beam Breast CT: Physics and Technology Development

International Nuclear Information System (INIS)

Boone, J.

2016-01-01

investigating dedicated breast CT. The development of large-area flat-panel detectors with field-of-view sufficient to image the entire breast in each projection enabled development of flat-panel cone-beam breast CT. More recently, the availability of complimentary metal-oxide semiconductor (CMOS) detectors with lower system noise and finer pixel pitch, combined with the development of x-ray tubes with focal spot dimensions similar to mammography systems, has shown improved spatial resolution and could improve visualization of microcalcifications. These technological developments promise clinical translation of low-dose cone-beam breast CT. Dedicated photon-counting breast CT (pcBCT) systems represent a novel detector design, which provide high spatial resolution (∼ 100µm) and low mean glandular dose (MGD). The CdTe-based direct conversion detector technology was previously evaluated and confirmed by simulations and basic experiments on laboratory setups [Kalender et al., Eur Radiol 22: 1–8, 2012]. Measurements of dose, technical image quality parameters, and surgical specimens on a pcBCT scanner have been completed. Comparative evaluation of surgical specimens showed that pcBCT outperformed mammography and digital breast tomosynthesis with respect to 3D spatial resolution, detectability of calcifications, and soft tissue delineation. Major barriers to widespread clinical use of BCT relate to radiation dose, imaging of microcalcifications, and adequate coverage of breast tissue near the chest wall. Adequate chest wall coverage is also technically challenging but recent progress in x-ray tube, detector and table design now enables full breast coverage in the majority of patients. At this time, BCT has been deemed to be suitable for diagnostic imaging but not yet for screening. The mean glandular dose (MGD) from BCT has been reported to be between 5.7 to 27.8 mGy, and this range is comparable to, and within the range of, the MGD of 2.6 to 31.6 mGy in diagnostic mammography

WE-FG-207A-03: Low-Dose Cone-Beam Breast CT: Physics and Technology Development

Energy Technology Data Exchange (ETDEWEB)

Boone, J. [UC Davis Medical Center (United States)

2016-06-15

investigating dedicated breast CT. The development of large-area flat-panel detectors with field-of-view sufficient to image the entire breast in each projection enabled development of flat-panel cone-beam breast CT. More recently, the availability of complimentary metal-oxide semiconductor (CMOS) detectors with lower system noise and finer pixel pitch, combined with the development of x-ray tubes with focal spot dimensions similar to mammography systems, has shown improved spatial resolution and could improve visualization of microcalcifications. These technological developments promise clinical translation of low-dose cone-beam breast CT. Dedicated photon-counting breast CT (pcBCT) systems represent a novel detector design, which provide high spatial resolution (∼ 100µm) and low mean glandular dose (MGD). The CdTe-based direct conversion detector technology was previously evaluated and confirmed by simulations and basic experiments on laboratory setups [Kalender et al., Eur Radiol 22: 1–8, 2012]. Measurements of dose, technical image quality parameters, and surgical specimens on a pcBCT scanner have been completed. Comparative evaluation of surgical specimens showed that pcBCT outperformed mammography and digital breast tomosynthesis with respect to 3D spatial resolution, detectability of calcifications, and soft tissue delineation. Major barriers to widespread clinical use of BCT relate to radiation dose, imaging of microcalcifications, and adequate coverage of breast tissue near the chest wall. Adequate chest wall coverage is also technically challenging but recent progress in x-ray tube, detector and table design now enables full breast coverage in the majority of patients. At this time, BCT has been deemed to be suitable for diagnostic imaging but not yet for screening. The mean glandular dose (MGD) from BCT has been reported to be between 5.7 to 27.8 mGy, and this range is comparable to, and within the range of, the MGD of 2.6 to 31.6 mGy in diagnostic mammography

The CT scanner as a therapy machine

International Nuclear Information System (INIS)

Iwamoto, K.S.; Norman, A.

1990-01-01

Many tumors in the brain and in other tissues can be delineated precisely in images obtained with a CT scanner. After the scan is obtained the patient is taken to another room for radiation therapy and is positioned in the beam with the aid of external markers, simulators or stereotactic devices. This procedure is time consuming and subject to error when precise localization of the beam is desired. The CT scanner itself, with the addition of the collimator, is capable of delivering radiation therapy with great precision without the need for external markers. The patient can be scanned and treated on the same table, the isocenter of the beam can be placed precisely in the center of the lesion, the beam can be restricted to just those planes in which the lesion appears, several arcs can be obtained by simply tilting the gantry, and the position of the patient in the beam can be monitored continuously during therapy. The authors describe the properties of the CTX, the CT scanner modified for therapy. (author). 6 refs.; 6 figs

A feasibility study for image guided radiotherapy using low dose, high speed, cone beam X-ray volumetric imaging

International Nuclear Information System (INIS)

Sykes, Jonathan R.; Amer, Ali; Czajka, Jadwiga; Moore, Christopher J.

2005-01-01

Background and purpose: Image Guidance of patient set-up for radiotherapy can be achieved by acquiring X-ray volumetric images (XVI) with Elekta Synergy and registering these to the planning CT scan. This enables full 3D registration of structures from similar 3D imaging modalities and offers superior image quality, rotational set-up information and a large field of view. This study uses the head section of the Rando phantom to demonstrate a new paradigm of faster, lower dose XVI that still allows registration to high precision. Materials and methods: One high exposure XVI scan and one low exposure XVI scan were performed with a Rando Head Phantom. The second scan was used to simulate ultra low dose, fast acquisition, full and half scans by discarding a large number of projections before reconstruction. Dose measurements were performed using Thermo Luminescent Dosimeters (TLD) and an ion chamber. The reconstructed XVI scans were automatically registered with a helical CT scan of the Rando Head using the volumetric, grey-level, cross-correlation algorithm implemented in the Syntegra software package (Philips Medical Systems). Reproducibility of the registration process was investigated. Results: In both XVI scans the body surface, bone-tissue and tissue air interfaces were clearly visible. Although the subjective image quality of the low dose cone beam scan was reduced, registration of both cone beam scans with the planning CT scan agreed within 0.1 mm and 0.1 deg. Dose to the patient was reduced from 28 mGy to less than 1 mGy and the equivalent scan speed reduced to one minute or less. Conclusions: Automatic 3D registration of high speed, ultra low dose XVI scans with the planning CT scan can be used for precision 3D patient set-up verification/image guidance on a daily basis with out loss of accuracy when compared to higher dose XVI scans

The Reconstruction Toolkit (RTK), an open-source cone-beam CT reconstruction toolkit based on the Insight Toolkit (ITK)

International Nuclear Information System (INIS)

Rit, S; Vila Oliva, M; Sarrut, D; Brousmiche, S; Labarbe, R; Sharp, G C

2014-01-01

We propose the Reconstruction Toolkit (RTK, http://www.openrtk.org), an open-source toolkit for fast cone-beam CT reconstruction, based on the Insight Toolkit (ITK) and using GPU code extracted from Plastimatch. RTK is developed by an open consortium (see affiliations) under the non-contaminating Apache 2.0 license. The quality of the platform is daily checked with regression tests in partnership with Kitware, the company supporting ITK. Several features are already available: Elekta, Varian and IBA inputs, multi-threaded Feldkamp-David-Kress reconstruction on CPU and GPU, Parker short scan weighting, multi-threaded CPU and GPU forward projectors, etc. Each feature is either accessible through command line tools or C++ classes that can be included in independent software. A MIDAS community has been opened to share CatPhan datasets of several vendors (Elekta, Varian and IBA). RTK will be used in the upcoming cone-beam CT scanner developed by IBA for proton therapy rooms. Many features are under development: new input format support, iterative reconstruction, hybrid Monte Carlo / deterministic CBCT simulation, etc. RTK has been built to freely share tomographic reconstruction developments between researchers and is open for new contributions.

Cone Beam CT Imaging Analysis of Interfractional Variations in Bladder Volume and Position During Radiotherapy for Bladder Cancer

International Nuclear Information System (INIS)

Yee, Don; Parliament, Matthew; Rathee, Satyapal; Ghosh, Sunita; Ko, Lawrence; Murray, Brad

2010-01-01

Purpose: To quantify daily bladder size and position variations during bladder cancer radiotherapy. Methods and Materials: Ten bladder cancer patients underwent daily cone beam CT (CBCT) imaging of the bladder during radiotherapy. Bladder and planning target volumes (bladder/PTV) from CBCT and planning CT scans were compared with respect to bladder center-of-mass shifts in the x (lateral), y (anterior-posterior), and z (superior-inferior) coordinates, bladder/PTV size, bladder/PTV margin positions, overlapping areas, and mutually exclusive regions. Results: A total of 262 CBCT images were obtained from 10 bladder cancer patients. Bladder center of mass shifted most in the y coordinate (mean, -0.32 cm). The anterior bladder wall shifted the most (mean, -0.58 cm). Mean ratios of CBCT-derived bladder and PTV volumes to planning CT-derived counterparts were 0.83 and 0.88. The mean CBCT-derived bladder volume (± standard deviation [SD]) outside the planning CT counterpart was 29.24 cm 3 (SD, 29.71 cm 3 ). The mean planning CT-derived bladder volume outside the CBCT counterpart was 47.74 cm 3 (SD, 21.64 cm 3 ). The mean CBCT PTV outside the planning CT-derived PTV was 47.35 cm 3 (SD, 36.51 cm 3 ). The mean planning CT-derived PTV outside the CBCT-derived PTV was 93.16 cm 3 (SD, 50.21). The mean CBCT-derived bladder volume outside the planning PTV was 2.41 cm 3 (SD, 3.97 cm 3 ). CBCT bladder/ PTV volumes significantly differed from planning CT counterparts (p = 0.047). Conclusions: Significant variations in bladder and PTV volume and position occurred in patients in this trial.

Three-dimensional image analysis of a head of the giant panda by the cone-beam type CT

International Nuclear Information System (INIS)

Endo, H.; Komiya, T.; Narushima, E.; Suzuki, N.

2002-01-01

The cone-beam type CT (Computed Tomography) enabled us to collect the three-dimensional (3D) digitalized data directly from the animal carcass. In this study, we applied the techniques of the cone-beam type CT for a carcass head of the giant panda (Ailuropoda melanoleuca) to obtain the 3D images easily without reconstruction process, and could morphologically examine the sections from the 3D data by means of non-destructive observations. The important results of the study represent the two following points. 1) We could show the morphological relationships between the muscles of mastication and the mandible in non-destructive status from the 3D data. The exact position of the coronoid process could be recognized in the rostro-lateral space of the temporal fossa. 2) By the serial sections from the 3D data sets, the morphological characteristics in the nasal cavity were detailed with high resolution in this rare species. The nasal concha was well-developed in the nasal cavity. The ethmoidal labyrinth was encountered immediately caudal to the nasal cavity and close to the region of the olfactory bulb. The ethmoidal labyrinth consisted of the complicated osseous structure in this area. The data will be useful to discuss the olfactory function in the reproduction behavior of this species

[The reliability of dento-maxillary models created by cone-beam CT and rapid prototyping:a comparative study].

Science.gov (United States)

Lv, Yan; Yan, Bin; Wang, Lin; Lou, Dong-hua

2012-04-01

To analyze the reliability of the dento-maxillary models created by cone-beam CT and rapid prototyping (RP). Plaster models were obtained from 20 orthodontic patients who had been scanned by cone-beam CT and 3-D models were formed after the calculation and reconstruction of software. Then, computerized composite models (RP models) were produced by rapid prototyping technique. The crown widths, dental arch widths and dental arch lengths on each plaster model, 3-D model and RP model were measured, followed by statistical analysis with SPSS17.0 software package. For crown widths, dental arch lengths and crowding, there were significant differences(Pmodels, but the dental arch widths were on the contrary. Measurements on 3-D models were significantly smaller than those on other two models(Pmodels, RP models had more numbers which were not significantly different from those on plaster models(P>0.05). The regression coefficient among three models were significantly different(Pmodels was bigger than that between 3-D and plaster models. There is high consistency within 3 models, while some differences were accepted in clinic. Therefore, it is possible to substitute 3-D and RP models for plaster models in order to save storage space and improve efficiency.

GPU-based streaming architectures for fast cone-beam CT image reconstruction and demons deformable registration

International Nuclear Information System (INIS)

Sharp, G C; Kandasamy, N; Singh, H; Folkert, M

2007-01-01

This paper shows how to significantly accelerate cone-beam CT reconstruction and 3D deformable image registration using the stream-processing model. We describe data-parallel designs for the Feldkamp, Davis and Kress (FDK) reconstruction algorithm, and the demons deformable registration algorithm, suitable for use on a commodity graphics processing unit. The streaming versions of these algorithms are implemented using the Brook programming environment and executed on an NVidia 8800 GPU. Performance results using CT data of a preserved swine lung indicate that the GPU-based implementations of the FDK and demons algorithms achieve a substantial speedup-up to 80 times for FDK and 70 times for demons when compared to an optimized reference implementation on a 2.8 GHz Intel processor. In addition, the accuracy of the GPU-based implementations was found to be excellent. Compared with CPU-based implementations, the RMS differences were less than 0.1 Hounsfield unit for reconstruction and less than 0.1 mm for deformable registration

SU-E-J-92: On-Line Cone Beam CT Based Planning for Emergency and Palliative Radiation Therapy

Energy Technology Data Exchange (ETDEWEB)

Held, M; Morin, O; Pouliot, J [UC San Francisco, San Francisco, CA (United States)

2014-06-01

Purpose: To evaluate and develop the feasibility of on-line cone beam CT based planning for emergency and palliative radiotherapy treatments. Methods: Subsequent to phantom studies, a case library of 28 clinical megavoltage cone beam CT (MVCBCT) was built to assess dose-planning accuracies on MVCBCT for all anatomical sites. A simple emergency treatment plan was created on the MVCBCT and copied to its reference CT. The agreement between the dose distributions of each image pair was evaluated by the mean dose difference of the dose volume and the gamma index of the central 2D axial plane. An array of popular urgent and palliative cases was also evaluated for imaging component clearance and field-of-view. Results: The treatment cases were categorized into four groups (head and neck, thorax/spine, pelvis and extremities). Dose distributions for head and neck treatments were predicted accurately in all cases with a gamma index of >95% for 2% and 2 mm criteria. Thoracic spine treatments had a gamma index as low as 60% indicating a need for better uniformity correction and tissue density calibration. Small anatomy changes between CT and MVCBCT could contribute to local errors. Pelvis and sacral spine treatment cases had a gamma index between 90% and 98% for 3%/3 mm criteria. The limited FOV became an issue for large pelvis patients. Imaging clearance was difficult for cases where the tumor was positioned far off midline. Conclusion: The MVCBCT based dose planning and delivery approach is feasible in many treatment cases. Dose distributions for head and neck patients are unrestrictedly predictable. Some FOV restrictions apply to other treatment sites. Lung tissue is most challenging for accurate dose calculations given the current imaging filters and corrections. Additional clinical cases for extremities need to be included in the study to assess the full range of site-specific planning accuracies. This work is supported by Siemens.

TH-EF-207A-07: An Integrated X-Ray/bioluminescence Tomography System for Radiation Guidance and Tumor Evaluation

Energy Technology Data Exchange (ETDEWEB)

Shi, J; Udayakumar, T; Wang, Z; Dogan, N; Pollack, A; Yang, Y [University of Miami School of Medicine, Miami, FL (United States)

2016-06-15

Purpose: CT is not able to differentiate tumors from surrounding soft tissue. This study is to develop a bioluminescence tomography (BLT) system that is integrated onto our previously developed CT guided small animal arc radiation treatment system (iSMAART) to guide radiation, monitor tumor growth and evaluate therapeutic response. Methods: The BLT system employs a CCD camera coupled with a high speed lens, and is aligned orthogonally to the x-ray beam central axis. The two imaging modalities, CT and BLT, are physically registered through geometrical calibration. The CT anatomy provides an accurate contour of animal surface which is used to construct 3D mesh for BLT reconstruction. Bioluminescence projections are captured from multiple angles, once every 45 degree rotation. The diffusion equation based on analytical Kirchhoff approximation is adopted to model the photon propagation in tissues. A discrete cosine transform based reweighted L1-norm regularization (DCT-re-L1) algorithm is used for BLT reconstruction. Experiments are conducted on a mouse orthotopic prostate tumor model (n=12) to evaluate the BLT performance, in terms of its robustness and accuracy in locating and quantifying the bioluminescent tumor cells. Iodinated contrast agent was injected intravenously to delineate the tumor in CT. The tumor location and volume obtained from CT also serve as a benchmark against BLT. Results: With our cutting edge reconstruction algorithm, BLT is able to accurately reconstruct the orthotopic prostate tumors. The tumor center of mass in BLT is within 0.5 mm radial distance of that in CT. The tumor volume in BLT is significantly correlated with that in CT (R2 = 0.81). Conclusion: The BLT can differentiate, localize and quantify tumors. Together with CT, BLT will provide precision radiation guidance and reliable treatment assessment in preclinical cancer research.

Biopsy system for CT-guided biopsies

International Nuclear Information System (INIS)

Onik, G.; Cosman, E.; Wells, T.; Goldberg, H.I.; Moss, A.; Costello, P.; Kane, R.

1987-01-01

CT stereotaxic brain biopsies have made brain biopsies safe and minimally invasive. CT-guided biopsies of the body, however, have traditionally used a hand-guidance method. CT biopsy guidance systems for the body have recently become available that have similar capabilities as those of brain biopsy systems. To compare the clinical utility of stereotaxically guided biopsies with hand-guided biopsies, the authors prospectively compared 40 biopsies performed with each method. In the stereotaxic method, a localizor grid was placed on the patient to define a reference point, and a frame was used to guide the needle along the intended path. Computer software programs calculated complex paths from one scan plane to another. Although the results disclosed no significant differences in lesion size or path length between the two groups, the stereotaxically guided biopsies required 75% fewer needle manipulations to hit the intended target. Consequently, the stereotaxically guided biopsies required 40% less time and 80% fewer localization scans to find the biopsy needle than did the hand-guided biopsies

Multimodal system for the planning and guidance of bronchoscopy

Science.gov (United States)

Higgins, William E.; Cheirsilp, Ronnarit; Zang, Xiaonan; Byrnes, Patrick

2015-03-01

Many technical innovations in multimodal radiologic imaging and bronchoscopy have emerged recently in the effort against lung cancer. Modern X-ray computed-tomography (CT) scanners provide three-dimensional (3D) high-resolution chest images, positron emission tomography (PET) scanners give complementary molecular imaging data, and new integrated PET/CT scanners combine the strengths of both modalities. State-of-the-art bronchoscopes permit minimally invasive tissue sampling, with vivid endobronchial video enabling navigation deep into the airway-tree periphery, while complementary endobronchial ultrasound (EBUS) reveals local views of anatomical structures outside the airways. In addition, image-guided intervention (IGI) systems have proven their utility for CT-based planning and guidance of bronchoscopy. Unfortunately, no IGI system exists that integrates all sources effectively through the complete lung-cancer staging work flow. This paper presents a prototype of a computer-based multimodal IGI system that strives to fill this need. The system combines a wide range of automatic and semi-automatic image-processing tools for multimodal data fusion and procedure planning. It also provides a flexible graphical user interface for follow-on guidance of bronchoscopy/EBUS. Human-study results demonstrate the system's potential.

Time-resolved C-arm cone beam CT angiography (TR-CBCTA) imaging from a single short-scan C-arm cone beam CT acquisition with intra-arterial contrast injection

Science.gov (United States)

Li, Yinsheng; Garrett, John W.; Li, Ke; Wu, Yijing; Johnson, Kevin; Schafer, Sebastian; Strother, Charles; Chen, Guang-Hong

2018-04-01

Time-resolved C-arm cone-beam CT (CBCT) angiography (TR-CBCTA) images can be generated from a series of CBCT acquisitions that satisfy data sufficiency condition in analytical image reconstruction theory. In this work, a new technique was developed to generate TR-CBCTA images from a single short-scan CBCT data acquisition with contrast media injection. The reconstruction technique enabling this application is a previously developed image reconstruction technique, synchronized multi-artifact reduction with tomographic reconstruction (SMART-RECON). In this new application, the acquired short-scan CBCT projection data were sorted into a union of several sub-sectors of view angles and each sub-sector of view angles corresponds to an individual image volume to be reconstructed. The SMART-RECON method was then used to jointly reconstruct all of these individual image volumes under two constraints: (1) each individual image volume is maximally consistent with the measured cone-beam projection data within the corresponding view angle sector and (2) the nuclear norm of the image matrix is minimized. The difference between these reconstructed individual image volumes is used to generated the desired subtracted angiograms. To validate the technique, numerical simulation data generated from a fractal tree angiogram phantom were used to quantitatively study the accuracy of the proposed method and retrospective in vivo human subject studies were used to demonstrate the feasibility of generating TR-CBCTA in clinical practice.

Dosimetric variation due to CT inter-slice spacing in four-dimensional carbon beam lung therapy

International Nuclear Information System (INIS)

Kumagai, Motoki; Mori, Shinichiro; Kandatsu, Susumu; Baba, Masayuki; Sharp, Gregory C; Asakura, Hiroshi; Endo, Masahiro

2009-01-01

When CT data with thick slice thickness are used in treatment planning, geometrical uncertainty may induce dosimetric errors. We evaluated carbon ion dose variations due to different CT slice thicknesses using a four-dimensional (4D) carbon ion beam dose calculation, and compared results between ungated and gated respiratory strategies. Seven lung patients were scanned in 4D mode with a 0.5 mm slice thickness using a 256-multi-slice CT scanner. CT images were averaged with various numbers of images to simulate reconstructed images with various slice thicknesses (0.5-5.0 mm). Two scenarios were studied (respiratory-ungated and -gated strategies). Range compensators were designed for each of the CT volumes with coarse inter-slice spacing to cover the internal target volume (ITV), as defined from 4DCT. Carbon ion dose distribution was computed for each resulting ITV on the 0.5 mm slice 4DCT data. The accumulated dose distribution was then calculated using deformable registration for 4D dose assessment. The magnitude of over- and under-dosage was found to be larger with the use of range compensators designed with a coarser inter-slice spacing than those obtained with a 0.5 mm slice thickness. Although no under-dosage was observed within the clinical target volume (CTV) region, D95 remained at over 97% of the prescribed dose for the ungated strategy and 95% for the gated strategy for all slice thicknesses. An inter-slice spacing of less than 3 mm may be able to minimize dose variation between the ungated and gated strategies. Although volumes with increased inter-slice spacing may reduce geometrical accuracy at a certain respiratory phase, this does not significantly affect delivery of the accumulated dose to the target during the treatment course.

Noise simulation in cone beam CT imaging with parallel computing

International Nuclear Information System (INIS)

Tu, S.-J.; Shaw, Chris C; Chen, Lingyun

2006-01-01

We developed a computer noise simulation model for cone beam computed tomography imaging using a general purpose PC cluster. This model uses a mono-energetic x-ray approximation and allows us to investigate three primary performance components, specifically quantum noise, detector blurring and additive system noise. A parallel random number generator based on the Weyl sequence was implemented in the noise simulation and a visualization technique was accordingly developed to validate the quality of the parallel random number generator. In our computer simulation model, three-dimensional (3D) phantoms were mathematically modelled and used to create 450 analytical projections, which were then sampled into digital image data. Quantum noise was simulated and added to the analytical projection image data, which were then filtered to incorporate flat panel detector blurring. Additive system noise was generated and added to form the final projection images. The Feldkamp algorithm was implemented and used to reconstruct the 3D images of the phantoms. A 24 dual-Xeon PC cluster was used to compute the projections and reconstructed images in parallel with each CPU processing 10 projection views for a total of 450 views. Based on this computer simulation system, simulated cone beam CT images were generated for various phantoms and technique settings. Noise power spectra for the flat panel x-ray detector and reconstructed images were then computed to characterize the noise properties. As an example among the potential applications of our noise simulation model, we showed that images of low contrast objects can be produced and used for image quality evaluation

Development of the three dimensional image display program for limited cone beam X-ray CT for dental use (Ortho-CT)

International Nuclear Information System (INIS)

Arai, Yoshinori; Hashimoto, Koji; Shinoda, Koji

2000-01-01

We have already developed and reported a limited cone beam X-ray CT system for dental use (Ortho-CT). This system has been used clinically since 1997. In this study, we report a 3D surface display program for Ortho-CT which has been newly-developed by the authors. The 3D surface display software has been developed using visual C ++ (Microsoft Co. WA. USA) and a personal computer (Pentium 450MHz Intel Co. CA USA, Windows NT 4.0 Microsoft WA. USA). In this software, the 3D surface images are recorded as AVI files and can be displayed on the personal computer. The 3D images can be rotated and a stepwise change of the threshold voxel value for binary image formation can be automatically used. We have applied these 3D surface images to clinical studies from January 1999 to May 1999 at the Radiology section in our Dental hospital. The images can be displayed very easily in personal computers using AVI files. Thirty-five cases have been reconstructed using 3D surface images in this way. The 3D surface image is useful in the diagnosis of fractures of the mandibular head and impacted teeth. Only teeth are observed when a relative threshold voxel value is set at a high level such as about 0.37. When the threshold is changed to a lower value (about 0.3), we can observe both teeth and the surface of the bone. We have developed a 3D surface display program for personal computers. The images are useful for the diagnosis of the pathosis in the maxillofacial region. (author)

Combined Fluoroscopy- and CT-Guided Transthoracic Needle Biopsy Using a C-Arm Cone-Beam CT System: Comparison with Fluoroscopy-Guided Biopsy

Energy Technology Data Exchange (ETDEWEB)

Cheung, Joo Yeon; Kim, Yoo Kyung; Shim, Sung Shine; Lim, Soo Mee [School of Medicine, Ewha Womans University, Seoul (Korea, Republic of)

2011-02-15

The aim of this study was to evaluate the usefulness of combined fluoroscopy- and CT-guided transthoracic needle biopsy (FC-TNB) using a cone beam CT system in comparison to fluoroscopy-guided TNB (F-TNB). We retrospectively evaluated 74 FC-TNB cases (group A) and 97 F-TNB cases (group B) to compare their respective diagnostic accuracies according to the size and depth of the lesion, as well as complications, procedure time, and radiation dose. The sensitivity for malignancy and diagnostic accuracy for small (< 30 mm in size) and deep ({>=} 50 mm in depth) lesions were higher in group A (91% and 94%, 92% and 94%) than in group B (73% and 81%, 84% and 88%), however not statistically significant (p > 0.05). Concerning lesions {>=} 30 mm in size and < 50 mm in depth, both groups displayed similar results (group A, 91% and 92%, 80% and 87%: group B, 90% and 92%, 86% and 90%). Pneumothorax occurred 26% of the time in group A and 14% for group B. The mean procedure time and patient skin dose were significantly higher in group A (13.6 {+-} 4.0 minutes, 157.1 {+-} 76.5 mGy) than in group B (9.0 {+-} 3.5 minutes, 21.9 {+-} 15.2 mGy) (p < 0.05). Combined fluoroscopy- and CT-guided TNB allows the biopsy of small (< 30 mm) and deep lesions ({>=} 50 mm) with high diagnostic accuracy and short procedure times, whereas F-TNB is still a useful method for large and superficial lesions with a low radiation dose

WE-EF-207-01: FEATURED PRESENTATION and BEST IN PHYSICS (IMAGING): Task-Driven Imaging for Cone-Beam CT in Interventional Guidance

Energy Technology Data Exchange (ETDEWEB)

Gang, G; Stayman, J; Ouadah, S; Siewerdsen, J [Johns Hopkins University, Baltimore, MD (United States); Ehtiati, T [Siemens Healthcare AX Division, Erlangen, DE (Germany)

2015-06-15

Purpose: This work introduces a task-driven imaging framework that utilizes a patient-specific anatomical model, mathematical definition of the imaging task, and a model of the imaging system to prospectively design acquisition and reconstruction techniques that maximize task-based imaging performance. Utility of the framework is demonstrated in the joint optimization of tube current modulation and view-dependent reconstruction kernel in filtered-backprojection reconstruction and non-circular orbit design in model-based reconstruction. Methods: The system model is based on a cascaded systems analysis of cone-beam CT capable of predicting the spatially varying noise and resolution characteristics as a function of the anatomical model and a wide range of imaging parameters. Detectability index for a non-prewhitening observer model is used as the objective function in a task-driven optimization. The combination of tube current and reconstruction kernel modulation profiles were identified through an alternating optimization algorithm where tube current was updated analytically followed by a gradient-based optimization of reconstruction kernel. The non-circular orbit is first parameterized as a linear combination of bases functions and the coefficients were then optimized using an evolutionary algorithm. The task-driven strategy was compared with conventional acquisitions without modulation, using automatic exposure control, and in a circular orbit. Results: The task-driven strategy outperformed conventional techniques in all tasks investigated, improving the detectability of a spherical lesion detection task by an average of 50% in the interior of a pelvis phantom. The non-circular orbit design successfully mitigated photon starvation effects arising from a dense embolization coil in a head phantom, improving the conspicuity of an intracranial hemorrhage proximal to the coil. Conclusion: The task-driven imaging framework leverages a knowledge of the imaging task within

WE-EF-207-01: FEATURED PRESENTATION and BEST IN PHYSICS (IMAGING): Task-Driven Imaging for Cone-Beam CT in Interventional Guidance

International Nuclear Information System (INIS)

Gang, G; Stayman, J; Ouadah, S; Siewerdsen, J; Ehtiati, T

2015-01-01

Purpose: This work introduces a task-driven imaging framework that utilizes a patient-specific anatomical model, mathematical definition of the imaging task, and a model of the imaging system to prospectively design acquisition and reconstruction techniques that maximize task-based imaging performance. Utility of the framework is demonstrated in the joint optimization of tube current modulation and view-dependent reconstruction kernel in filtered-backprojection reconstruction and non-circular orbit design in model-based reconstruction. Methods: The system model is based on a cascaded systems analysis of cone-beam CT capable of predicting the spatially varying noise and resolution characteristics as a function of the anatomical model and a wide range of imaging parameters. Detectability index for a non-prewhitening observer model is used as the objective function in a task-driven optimization. The combination of tube current and reconstruction kernel modulation profiles were identified through an alternating optimization algorithm where tube current was updated analytically followed by a gradient-based optimization of reconstruction kernel. The non-circular orbit is first parameterized as a linear combination of bases functions and the coefficients were then optimized using an evolutionary algorithm. The task-driven strategy was compared with conventional acquisitions without modulation, using automatic exposure control, and in a circular orbit. Results: The task-driven strategy outperformed conventional techniques in all tasks investigated, improving the detectability of a spherical lesion detection task by an average of 50% in the interior of a pelvis phantom. The non-circular orbit design successfully mitigated photon starvation effects arising from a dense embolization coil in a head phantom, improving the conspicuity of an intracranial hemorrhage proximal to the coil. Conclusion: The task-driven imaging framework leverages a knowledge of the imaging task within

SU-D-12A-06: A Comprehensive Parameter Analysis for Low Dose Cone-Beam CT Reconstruction

International Nuclear Information System (INIS)

Lu, W; Yan, H; Gu, X; Jiang, S; Jia, X; Bai, T; Zhou, L

2014-01-01

Purpose: There is always a parameter in compressive sensing based iterative reconstruction (IR) methods low dose cone-beam CT (CBCT), which controls the weight of regularization relative to data fidelity. A clear understanding of the relationship between image quality and parameter values is important. The purpose of this study is to investigate this subject based on experimental data and a representative advanced IR algorithm using Tight-frame (TF) regularization. Methods: Three data sets of a Catphan phantom acquired at low, regular and high dose levels are used. For each tests, 90 projections covering a 200-degree scan range are used for reconstruction. Three different regions-of-interest (ROIs) of different contrasts are used to calculate contrast-to-noise ratios (CNR) for contrast evaluation. A single point structure is used to measure modulation transfer function (MTF) for spatial-resolution evaluation. Finally, we analyze CNRs and MTFs to study the relationship between image quality and parameter selections. Results: It was found that: 1) there is no universal optimal parameter. The optimal parameter value depends on specific task and dose level. 2) There is a clear trade-off between CNR and resolution. The parameter for the best CNR is always smaller than that for the best resolution. 3) Optimal parameters are also dose-specific. Data acquired under a high dose protocol require less regularization, yielding smaller optimal parameter values. 4) Comparing with conventional FDK images, TF-based CBCT images are better under a certain optimally selected parameters. The advantages are more obvious for low dose data. Conclusion: We have investigated the relationship between image quality and parameter values in the TF-based IR algorithm. Preliminary results indicate optimal parameters are specific to both the task types and dose levels, providing guidance for selecting parameters in advanced IR algorithms. This work is supported in part by NIH (1R01CA154747-01)

Investigation of the HU-density conversion method and comparison of dose distribution for dose calculation on MV cone beam CT images

Energy Technology Data Exchange (ETDEWEB)

Kim, Min Joo; Lee, Seu Ran; Suh, Tae Suk [Dept. of Biomedical Engineering, The Catholic University of Korea, Bucheon (Korea, Republic of)

2011-11-15

Modern radiation therapy techniques, such as Image-guided radiation therapy (IGRT), Adaptive radiation therapy (ART) has become a routine clinical practice on linear accelerators for the increase the tumor dose conformity and improvement of normal tissue sparing at the same time. For these highly developed techniques, megavoltage cone beam computed tomography (MVCBCT) system produce volumetric images at just one rotation of the x-ray beam source and detector on the bottom of conventional linear accelerator for real-time application of patient condition into treatment planning. MV CBCT image scan be directly registered to a reference CT data set which is usually kilo-voltage fan-beam computed tomography (kVFBCT) on treatment planning system and the registered image scan be used to adjust patient set-up error. However, to use MV CBCT images in radiotherapy, reliable electron density (ED) distribution are required. Patients scattering, beam hardening and softening effect caused by different energy application between kVCT, MV CBCT can cause cupping artifacts in MV CBCT images and distortion of Houns field Unit (HU) to ED conversion. The goal of this study, for reliable application of MV CBCT images into dose calculation, MV CBCT images was modified to correct distortion of HU to ED using the relationship of HU and ED from kV FBCT and MV CBCT images. The HU-density conversion was performed on MV CBCT image set using Dose difference map was showing in Figure 1. Finally, percentage differences above 3% were reduced depending on applying density calibration method. As a result, total error co uld be reduced to under 3%. The present study demonstrates that dose calculation accuracy using MV CBCT image set can be improved my applying HU-density conversion method. The dose calculation and comparison of dose distribution from MV CBCT image set with/without HU-density conversion method was performed. An advantage of this study compared to other approaches is that HU

Assessment of contrast enhanced respiration managed cone-beam CT for image guided radiotherapy of intrahepatic tumors

International Nuclear Information System (INIS)

Jensen, Nikolaj K. G.; Stewart, Errol; Lock, Michael; Fisher, Barbara; Kozak, Roman; Chen, Jeff; Lee, Ting-Yim; Wong, Eugene

2014-01-01

Purpose: Contrast enhancement and respiration management are widely used during image acquisition for radiotherapy treatment planning of liver tumors along with respiration management at the treatment unit. However, neither respiration management nor intravenous contrast is commonly used during cone-beam CT (CBCT) image acquisition for alignment prior to radiotherapy. In this study, the authors investigate the potential gains of injecting an iodinated contrast agent in combination with respiration management during CBCT acquisition for liver tumor radiotherapy. Methods: Five rabbits with implanted liver tumors were subjected to CBCT with and without motion management and contrast injection. The acquired CBCT images were registered to the planning CT to determine alignment accuracy and dosimetric impact. The authors developed a simulation tool for simulating contrast-enhanced CBCT images from dynamic contrast enhanced CT imaging (DCE-CT) to determine optimal contrast injection protocols. The tool was validated against contrast-enhanced CBCT of the rabbit subjects and was used for five human patients diagnosed with hepatocellular carcinoma. Results: In the rabbit experiment, when neither motion management nor contrast was used, tumor centroid misalignment between planning image and CBCT was 9.2 mm. This was reduced to 2.8 mm when both techniques were employed. Tumors were not visualized in clinical CBCT images of human subjects. Simulated contrast-enhanced CBCT was found to improve tumor contrast in all subjects. Different patients were found to require different contrast injections to maximize tumor contrast. Conclusions: Based on the authors’ animal study, respiration managed contrast enhanced CBCT improves IGRT significantly. Contrast enhanced CBCT benefits from patient specific tracer kinetics determined from DCE-CT

Assessment of contrast enhanced respiration managed cone-beam CT for image guided radiotherapy of intrahepatic tumors

Energy Technology Data Exchange (ETDEWEB)

Jensen, Nikolaj K. G., E-mail: nkyj@regionsjaelland.dk [Physics and Engineering, London Regional Cancer Program, London, Ontario N6A3K7 (Canada); Stewart, Errol [Radiology, St. Joseph' s Health Care, London, Ontario N6A 4V2 (Canada); Imaging Research Lab, Robarts Research Institute, London, Ontario N6A 5B7 (Canada); Imaging Program, Lawson Health Research Institute, London, Ontario N6C 2R5 (Canada); Lock, Michael; Fisher, Barbara [Radiation Oncology, London Regional Cancer Program, London, Ontario N6A3K7 (Canada); Department of Oncology, University of Western Ontario, London, Ontario N6A 4L6 (Canada); Kozak, Roman [Radiology, St. Joseph' s Health Care, London, Ontario N6A 4V2 (Canada); Chen, Jeff [Physics and Engineering, London Regional Cancer Program, London, Ontario N6A3K7 (Canada); Department of Oncology, University of Western Ontario, London, Ontario N6A 4L6 (Canada); Department of Medical Biophysics, University of Western Ontario, London, Ontario N6A 5C1 (Canada); Lee, Ting-Yim [Radiology, St. Joseph' s Health Care, London, Ontario N6A 4V2 (Canada); Imaging Research Lab, Robarts Research Institute, London, Ontario N6A 5B7 (Canada); Imaging Program, Lawson Health Research Institute, London, Ontario N6C 2R5 (Canada); Department of Oncology, University of Western Ontario, London, Ontario N6A 4L6 (Canada); Department of Medical Biophysics, University of Western Ontario, London, Ontario N6A 5C1 (Canada); Wong, Eugene [Physics and Engineering, London Regional Cancer Program, London, Ontario N6A3K7 (Canada); Department of Oncology, University of Western Ontario, London, Ontario N6A 4L6 (Canada); Department of Medical Biophysics, University of Western Ontario, London, Ontario N6A 5C1 (Canada); Department of Physics and Astronomy, University of Western Ontario, London, Ontario N6A 3K7 (Canada)

2014-05-15

Purpose: Contrast enhancement and respiration management are widely used during image acquisition for radiotherapy treatment planning of liver tumors along with respiration management at the treatment unit. However, neither respiration management nor intravenous contrast is commonly used during cone-beam CT (CBCT) image acquisition for alignment prior to radiotherapy. In this study, the authors investigate the potential gains of injecting an iodinated contrast agent in combination with respiration management during CBCT acquisition for liver tumor radiotherapy. Methods: Five rabbits with implanted liver tumors were subjected to CBCT with and without motion management and contrast injection. The acquired CBCT images were registered to the planning CT to determine alignment accuracy and dosimetric impact. The authors developed a simulation tool for simulating contrast-enhanced CBCT images from dynamic contrast enhanced CT imaging (DCE-CT) to determine optimal contrast injection protocols. The tool was validated against contrast-enhanced CBCT of the rabbit subjects and was used for five human patients diagnosed with hepatocellular carcinoma. Results: In the rabbit experiment, when neither motion management nor contrast was used, tumor centroid misalignment between planning image and CBCT was 9.2 mm. This was reduced to 2.8 mm when both techniques were employed. Tumors were not visualized in clinical CBCT images of human subjects. Simulated contrast-enhanced CBCT was found to improve tumor contrast in all subjects. Different patients were found to require different contrast injections to maximize tumor contrast. Conclusions: Based on the authors’ animal study, respiration managed contrast enhanced CBCT improves IGRT significantly. Contrast enhanced CBCT benefits from patient specific tracer kinetics determined from DCE-CT.

Percutaneous targeted argon-helium cryoablation for renal carcinoma under CT guidance

International Nuclear Information System (INIS)

Xu Jian; Cao Jianmin; Lu Guangming; Shi Donghong; Kong Weidong; Gao Dazhi

2008-01-01

Objective: To establish initially the technique and evaluate the principle, safety and short term efficacy of argon-helium superconductor operation system (or Ar-He knife) targeted cryotherapy for renal carcinoma. Methods: Seven patients with renal carcinoma were treated with CT-guided percutaneous Ar-He knife targeted cryotherapy. Results: After cryotherapy, no serious complications, such as bleeding, skin cold injury, infection, implantation metastasis inside the puncture path occurred, and one month later, CT scans showed low-density local necrosis in all tumors of the 7 cases, but the tumor reduction in size was found only in 2 cases. Conclusion: CT guiding percutaneous Ar-He knife targeted cryoablation for renal carcinoma is a safe, effective and minimally invasive therapeutic method, particularly for inoperable cases. (authors)

Intraoperative imaging for patient safety and QA: detection of intracranial hemorrhage using C-arm cone-beam CT

Science.gov (United States)

Schafer, Sebastian; Wang, Adam; Otake, Yoshito; Stayman, J. W.; Zbijewski, Wojciech; Kleinszig, Gerhard; Xia, Xuewei; Gallia, Gary L.; Siewerdsen, Jeffrey H.

2013-03-01

Intraoperative imaging could improve patient safety and quality assurance (QA) via the detection of subtle complications that might otherwise only be found hours after surgery. Such capability could therefore reduce morbidity and the need for additional intervention. Among the severe adverse events that could be more quickly detected by high-quality intraoperative imaging is acute intracranial hemorrhage (ICH), conventionally assessed using post-operative CT. A mobile C-arm capable of high-quality cone-beam CT (CBCT) in combination with advanced image reconstruction techniques is reported as a means of detecting ICH in the operating room. The system employs an isocentric C-arm with a flat-panel detector in dual gain mode, correction of x-ray scatter and beam-hardening, and a penalized likelihood (PL) iterative reconstruction method. Performance in ICH detection was investigated using a quantitative phantom focusing on (non-contrast-enhanced) blood-brain contrast, an anthropomorphic head phantom, and a porcine model with injection of fresh blood bolus. The visibility of ICH was characterized in terms of contrast-to-noise ratio (CNR) and qualitative evaluation of images by a neurosurgeon. Across a range of size and contrast of the ICH as well as radiation dose from the CBCT scan, the CNR was found to increase from ~2.2-3.7 for conventional filtered backprojection (FBP) to ~3.9-5.4 for PL at equivalent spatial resolution. The porcine model demonstrated superior ICH detectability for PL. The results support the role of high-quality mobile C-arm CBCT employing advanced reconstruction algorithms for detecting subtle complications in the operating room at lower radiation dose and lower cost than intraoperative CT scanners and/or fixedroom C-arms. Such capability could present a potentially valuable aid to patient safety and QA.

SU-F-J-23: Field-Of-View Expansion in Cone-Beam CT Reconstruction by Use of Prior Information

Energy Technology Data Exchange (ETDEWEB)

Haga, A; Magome, T; Nakano, M; Nakagawa, K [University of Tokyo Hospital, Tokyo (Japan); Kotoku, J [Teikyo University, Tokyo (Japan)

2016-06-15

Purpose: Cone-beam CT (CBCT) has become an integral part of online patient setup in an image-guided radiation therapy (IGRT). In addition, the utility of CBCT for dose calculation has actively been investigated. However, the limited size of field-of-view (FOV) and resulted CBCT image with a lack of peripheral area of patient body prevents the reliability of dose calculation. In this study, we aim to develop an FOV expanded CBCT in IGRT system to allow the dose calculation. Methods: Three lung cancer patients were selected in this study. We collected the cone-beam projection images in the CBCT-based IGRT system (X-ray volume imaging unit, ELEKTA), where FOV size of the provided CBCT with these projections was 410 × 410 mm{sup 2} (normal FOV). Using these projections, CBCT with a size of 728 × 728 mm{sup 2} was reconstructed by a posteriori estimation algorithm including a prior image constrained compressed sensing (PICCS). The treatment planning CT was used as a prior image. To assess the effectiveness of FOV expansion, a dose calculation was performed on the expanded CBCT image with region-of-interest (ROI) density mapping method, and it was compared with that of treatment planning CT as well as that of CBCT reconstructed by filtered back projection (FBP) algorithm. Results: A posteriori estimation algorithm with PICCS clearly visualized an area outside normal FOV, whereas the FBP algorithm yielded severe streak artifacts outside normal FOV due to under-sampling. The dose calculation result using the expanded CBCT agreed with that using treatment planning CT very well; a maximum dose difference was 1.3% for gross tumor volumes. Conclusion: With a posteriori estimation algorithm, FOV in CBCT can be expanded. Dose comparison results suggested that the use of expanded CBCTs is acceptable for dose calculation in adaptive radiation therapy. This study has been supported by KAKENHI (15K08691).

Performance evaluation of the General Electric eXplore CT 120 micro-CT using the vmCT phantom

Energy Technology Data Exchange (ETDEWEB)

Bahri, M.A., E-mail: M.Bahri@ulg.ac.be [ULg-Liege University, Cyclotron Research Centre, Liege, Bat. 30, Allee du 6 aout, 8 (Belgium); Warnock, G.; Plenevaux, A. [ULg-Liege University, Cyclotron Research Centre, Liege, Bat. 30, Allee du 6 aout, 8 (Belgium); Choquet, P.; Constantinesco, A. [Biophysique et Medecine Nucleaire, Hopitaux universitaires de Strasbourg, Strasbourg (France); Salmon, E.; Luxen, A. [ULg-Liege University, Cyclotron Research Centre, Liege, Bat. 30, Allee du 6 aout, 8 (Belgium); Seret, A. [ULg-Liege University, Cyclotron Research Centre, Liege, Bat. 30, Allee du 6 aout, 8 (Belgium); ULg-Liege University, Experimental Medical Imaging, Liege (Belgium)

2011-08-21

The eXplore CT 120 is the latest generation micro-CT from General Electric. It is equipped with a high-power tube and a flat-panel detector. It allows high resolution and high contrast fast CT scanning of small animals. The aim of this study was to compare the performance of the eXplore CT 120 with that of the eXplore Ultra, its predecessor for which the methodology using the vmCT phantom has already been described . The phantom was imaged using typical a rat (fast scan or F) or mouse (in vivo bone scan or H) scanning protocols. With the slanted edge method, a 10% modulation transfer function (MTF) was observed at 4.4 (F) and 3.9-4.4 (H) mm{sup -1} corresponding to 114 {mu}m resolution. A fairly larger MTF was obtained by the coil method with the MTF for the thinnest coil (3.3 mm{sup -1}) equal to 0.32 (F) and 0.34 (H). The geometric accuracy was better than 0.3%. There was a highly linear (R{sup 2}>0.999) relationship between measured and expected CT numbers for both the CT number accuracy and linearity sections of the phantom. A cupping effect was clearly seen on the uniform slices and the uniformity-to-noise ratio ranged from 0.52 (F) to 0.89 (H). The air CT number depended on the amount of polycarbonate surrounding the area where it was measured; a difference as high as approximately 200 HU was observed. This hindered the calibration of this scanner in HU. This is likely due to the absence of corrections for beam hardening and scatter in the reconstruction software. However in view of the high linearity of the system, the implementation of these corrections would allow a good quality calibration of the scanner in HU. In conclusion, the eXplore CT 120 achieved a better spatial resolution than the eXplore Ultra (based on previously reported specifications) and future software developments will include beam hardening and scatter corrections that will make the new generation CT scanner even more promising.

Iterative CT shading correction with no prior information

Science.gov (United States)

Wu, Pengwei; Sun, Xiaonan; Hu, Hongjie; Mao, Tingyu; Zhao, Wei; Sheng, Ke; Cheung, Alice A.; Niu, Tianye

2015-11-01

Shading artifacts in CT images are caused by scatter contamination, beam-hardening effect and other non-ideal imaging conditions. The purpose of this study is to propose a novel and general correction framework to eliminate low-frequency shading artifacts in CT images (e.g. cone-beam CT, low-kVp CT) without relying on prior information. The method is based on the general knowledge of the relatively uniform CT number distribution in one tissue component. The CT image is first segmented to construct a template image where each structure is filled with the same CT number of a specific tissue type. Then, by subtracting the ideal template from the CT image, the residual image from various error sources are generated. Since forward projection is an integration process, non-continuous shading artifacts in the image become continuous signals in a line integral. Thus, the residual image is forward projected and its line integral is low-pass filtered in order to estimate the error that causes shading artifacts. A compensation map is reconstructed from the filtered line integral error using a standard FDK algorithm and added back to the original image for shading correction. As the segmented image does not accurately depict a shaded CT image, the proposed scheme is iterated until the variation of the residual image is minimized. The proposed method is evaluated using cone-beam CT images of a Catphan©600 phantom and a pelvis patient, and low-kVp CT angiography images for carotid artery assessment. Compared with the CT image without correction, the proposed method reduces the overall CT number error from over 200 HU to be less than 30 HU and increases the spatial uniformity by a factor of 1.5. Low-contrast object is faithfully retained after the proposed correction. An effective iterative algorithm for shading correction in CT imaging is proposed that is only assisted by general anatomical information without relying on prior knowledge. The proposed method is thus practical

Bowtie filter and water calibration in the improvement of cone beam CT image quality

International Nuclear Information System (INIS)

Li Minghui; Dai Jianrong; Zhang Ke

2010-01-01

Objective: To evaluate the improvement of cone beam CT (CBCT) image quality by using bewtie filter (F 1 ) and water calibration. Methods: First the multi-level gain calibration of the detector panel with the method of Cal 2 calibration was performed, and the CT images of CATPHAN503 with F 0 and bowtie filter were collected, respectively. Then the detector panel using water calibration kit was calibrated, and images were acquired again. Finally, the change of image quality after using F 1 and (or) water calibration method was observed. The observed indexes included low contrast visibility, spatial uniformity, ring artifact, spatial resolution and geometric accuracy. Results: Comparing with the traditional combination of F 0 filter and Cal 2 calibration, the combination of bowtie filter F 1 and water calibration improves low contrast visibility by 13.71%, and spatial uniformity by 54. 42%. Water calibration removes ring artifacts effectively. However, none of them improves spatial resolution and geometric accuracy. Conclusions: The combination of F 1 and water calibration improves CBCT image quality effectively. This improvement is aid to the registration of CBCT images and localization images. (authors)

Iterative image-domain ring artifact removal in cone-beam CT

Science.gov (United States)

Liang, Xiaokun; Zhang, Zhicheng; Niu, Tianye; Yu, Shaode; Wu, Shibin; Li, Zhicheng; Zhang, Huailing; Xie, Yaoqin

2017-07-01

Ring artifacts in cone beam computed tomography (CBCT) images are caused by pixel gain variations using flat-panel detectors, and may lead to structured non-uniformities and deterioration of image quality. The purpose of this study is to propose a method of general ring artifact removal in CBCT images. This method is based on the polar coordinate system, where the ring artifacts manifest as stripe artifacts. Using relative total variation, the CBCT images are first smoothed to generate template images with fewer image details and ring artifacts. By subtracting the template images from the CBCT images, residual images with image details and ring artifacts are generated. As the ring artifact manifests as a stripe artifact in a polar coordinate system, the artifact image can be extracted by mean value from the residual image; the image details are generated by subtracting the artifact image from the residual image. Finally, the image details are compensated to the template image to generate the corrected images. The proposed framework is iterated until the differences in the extracted ring artifacts are minimized. We use a 3D Shepp-Logan phantom, Catphan©504 phantom, uniform acrylic cylinder, and images from a head patient to evaluate the proposed method. In the experiments using simulated data, the spatial uniformity is increased by 1.68 times and the structural similarity index is increased from 87.12% to 95.50% using the proposed method. In the experiment using clinical data, our method shows high efficiency in ring artifact removal while preserving the image structure and detail. The iterative approach we propose for ring artifact removal in cone-beam CT is practical and attractive for CBCT guided radiation therapy.

SU-F-J-108: TMR Correction Factor Based Online Adaptive Radiotherapy for Stereotactic Radiosurgery (SRS) of L-Spine Tumors Using Cone Beam CT

Energy Technology Data Exchange (ETDEWEB)

Ghaffar, I; Balik, S; Zhuang, T; Chao, S; Xia, P [The Cleveland Clinic Foundation, Cleveland, OH (United States)

2016-06-15

Purpose: To investigate the feasibility of using TMR ratio correction factors for a fast online adaptive plan to compensate for anatomical changes in stereotactic radiosurgery (SRS) of L-spine tumors. Methods: Three coplanar treatment plans were made for 11 patients: Uniform (9 IMRT beams equally distributed around the patient); Posterior (IMRT with 9 posterior beams every 20 degree) and VMAT (2 360° arcs). For each patient, the external body and bowel gas were contoured on the planning CT and pre-treatment CBCT. After registering CBCT and the planning CT by aligning to the tumor, the CBCT contours were transferred to the planning CT. To estimate the actual delivered dose while considering patient’s anatomy of the treatment day, a hybrid CT was created by overriding densities in planning CT using the differences between CT and CBCT external and bowel gas contours. Correction factors (CF) were calculated using the effective depth information obtained from the planning system using the hybrid CT: CF = TMR (delivery)/TMR (planning). The adaptive plan was generated by multiplying the planned Monitor Units with the CFs. Results: The mean absolute difference (MAD) in V16Gy of the target between planned and estimated delivery with and without TMR correction was 0.8 ± 0.7% vs. 2.4 ± 1.3% for Uniform and 1.0 ± 0.9% vs. 2.6 ± 1.3% for VMAT plans(p<0.05), respectively. For V12Gy of cauda-equina with and without TMR correction, MAD was 0.24 ± 0.19% vs. 1.2 ± 1.02% for Uniform and 0.23 ± 0.20% vs. 0.78 ± 0.79% for VMAT plans(p<0.05), respectively. The differences between adaptive and original plans were not significant for posterior plans. Conclusion: The online adaptive strategy using TMR ratios and pre-treatment CBCT information was feasible strategy to compensate for anatomical changes for the patients treated for L-spine tumors, particularly for equally spaced IMRT and VMAT plans.

Comparative study of CT and MR guided cryoablation for hepatic tumors

International Nuclear Information System (INIS)

Wu Bin; Xiao Yueyong; Zhang Xiao; Li Hongjun; Li Jie; Yu Da

2010-01-01

Objective: To compare CT and MR imaging in guiding and monitor/ng cryoablation of hepatic tumors. Methods: A total of 131 lesions in 121 patients with malignant tumors of liver were treated with imaging-guided percutaneous cryotherapy. There were 73 males and 48 females, mean age 60 years. Of the 121 patients, 61 patients had cryoablation under CT guidance and 60 patients under the guidance of MRI. CT-guidance was performed with the Philips big-bore CT in spiral mode, with 5 mm slice thickness. The MR guidance was performed with GE 0.35 T scanner assisted with infrared navigator (Xinaomdt), and both fast gradient echo sequence and fast spin-echo sequence were used. The cryoablation system is a magnetic resonance compatible system (Galil, Israel), equipped with 17 G cryoprobes that are 1.47 mm in outside diameter. A combination of multiple cryo-probes and conformal cryoablation were adopted in accordance with the location, the shape and the adjacent structure of each lesion. Each cryoablation included two freezing-thawing cycles. Scanning was performed intermittently during the operation to monitor the degree of ablation. The mean scanning time, the lesion depiction and ablation process monitoring, the efficacies of lesion ablation, complications,and survival time were analyzed with χ 2 test. Results: The mean scanning time was (5.6±1.8) min for CT and (22.0±2.6) min for MR. CT provided a good depiction of the lesion and the ribs which were poorly displayed on MR images. The metal probe could create artifacts on the CT images and it was difficult for CT to show the formation of ice ball of the lesion formed after embolization with lipiodol. MR was superior to CT in displaying, guiding and monitoring of ablation of lesions near such special regions as the diaphragm dome, the hepatic hilum, and the gallbladder. MR was not affected by high-density embolization material and the metal probes, and thus was superior to CT in depicting the lesion, and monitoring the

Cone beam breast CT with a high pitch (75 μm), thick (500 μm) scintillator CMOS flat panel detector: Visibility of simulated microcalcifications

OpenAIRE

Shen, Youtao; Zhong, Yuncheng; Lai, Chao-Jen; Wang, Tianpeng; Shaw, Chris C.

2013-01-01

Purpose: To measure and investigate the improvement of microcalcification (MC) visibility in cone beam breast CT with a high pitch (75 μm), thick (500 μm) scintillator CMOS/CsI flat panel detector (Dexela 2923, Perkin Elmer).

SU-G-206-16: Investigation of Dosimetric Consequence Via Cone-Beam CT Based Dose Reconstruction in Hepatocellular Carcinoma Radiotherapy

Energy Technology Data Exchange (ETDEWEB)

Huang, P; Gang, Y; Qin, S; Li, D [Shandong Province Key Laboratory of Medical Physics and Image Processing Technology, School of Physics and Electronics, Shandong Normal University (China); Li, H; Chen, J; Ma, C; Yin, Y [Department of Radiation Oncology, Shandong Cancer Hospital and Institute (China)

2016-06-15

Purpose: Many patients with technically unresectable or medically inoperable hepatocellular carcinoma (HCC) had hepatic dosimetric variations as a result of inter-fraction anatomical deformation. This study was conducted to assess the hepatic dosimetric consequences via reconstructing weekly dose in HCC patients receiving three dimensional conformal radiation therapy. Methods: Twenty-one HCC patients with 21 planning CT (pCT) scans and 63 weekly Cone-beam CT (CBCT) scans were enrolled in this investigation. Among them, six patients had been diagnosed of radiation induced liver disease (RILD) and the other fifteen patients had good prognosis after treatment. And each patient had three weekly CBCT before re-planning. In reconstructing CBCT-based weekly dose, we registered pCT to CBCT to provide the correct Hounsfield units for the CBCT using gradient-based deformable image registration (DIR), and this modified CBCT (mCBCT) were introduced to enable dose calculation.To obtain the weekly dosimetric consequences, the initial plan beam configurations and dose constraints were re-applied to mCBCT for performing dose calculation, and the mCBCT were extrapolated to 25 fractions. Besides, the manually delineated contour was propagated automatically onto the mCBCT of the new patient by exploiting the deformation vectors field, and the reconstructed weekly dose was mapped back to pCT to understand the dose distribution difference. Also, weekly dosimetric variations were compared with the hepatic radiation tolerance in terms of D50 and Dmean. Results: Among the twenty-one patients, the three weekly D50 increased by 0.7Gy, 5.1Gy and 6.1Gy, respectively, and Dmean increased by 0.9%, 4.7% and 5.5%, respectively. For patients with RILD, the average values of the third weekly D50 and Dmean were both high than hepatic radiation tolerance, while the values of patients without RILD were below. Conclusion: The planned dose on pCT was not a real dose to the liver, and the liver overdose

WE-AB-207A-08: BEST IN PHYSICS (IMAGING): Advanced Scatter Correction and Iterative Reconstruction for Improved Cone-Beam CT Imaging On the TrueBeam Radiotherapy Machine

Energy Technology Data Exchange (ETDEWEB)

Wang, A; Paysan, P; Brehm, M; Maslowski, A; Lehmann, M; Messmer, P; Munro, P; Yoon, S; Star-Lack, J; Seghers, D [Varian Medical Systems, Palo Alto, CA (United States)

2016-06-15

Purpose: To improve CBCT image quality for image-guided radiotherapy by applying advanced reconstruction algorithms to overcome scatter, noise, and artifact limitations Methods: CBCT is used extensively for patient setup in radiotherapy. However, image quality generally falls short of diagnostic CT, limiting soft-tissue based positioning and potential applications such as adaptive radiotherapy. The conventional TrueBeam CBCT reconstructor uses a basic scatter correction and FDK reconstruction, resulting in residual scatter artifacts, suboptimal image noise characteristics, and other artifacts like cone-beam artifacts. We have developed an advanced scatter correction that uses a finite-element solver (AcurosCTS) to model the behavior of photons as they pass (and scatter) through the object. Furthermore, iterative reconstruction is applied to the scatter-corrected projections, enforcing data consistency with statistical weighting and applying an edge-preserving image regularizer to reduce image noise. The combined algorithms have been implemented on a GPU. CBCT projections from clinically operating TrueBeam systems have been used to compare image quality between the conventional and improved reconstruction methods. Planning CT images of the same patients have also been compared. Results: The advanced scatter correction removes shading and inhomogeneity artifacts, reducing the scatter artifact from 99.5 HU to 13.7 HU in a typical pelvis case. Iterative reconstruction provides further benefit by reducing image noise and eliminating streak artifacts, thereby improving soft-tissue visualization. In a clinical head and pelvis CBCT, the noise was reduced by 43% and 48%, respectively, with no change in spatial resolution (assessed visually). Additional benefits include reduction of cone-beam artifacts and reduction of metal artifacts due to intrinsic downweighting of corrupted rays. Conclusion: The combination of an advanced scatter correction with iterative reconstruction

MicroCT Bone Densitometry: Context Sensitivity, Beam Hardening Correction and the Effect of Surrounding Media

Directory of Open Access Journals (Sweden)

Philip L. Salmon

2014-12-01

Full Text Available The context-sensitivity of microCT bone densitometry due to beam hardening artefacts was assessed. Bones and teeth are scanned with varying thickness of surrounding media (water, alcohol, biological tissue and it is important to understand how this affects reconstructed attenuation (“density” of the mineralized tissue. Aluminium tubes and rods with thickness 0.127mm–5mm were scanned both in air or surrounded by up to 2cm of water. Scans were performed with different energy filters and degrees of software beam hardening correction (BHC. Also tested were the effects of signal-to-noise ratio, magnification and truncation. The thickness of an aluminium tube significantly affected its mean reconstructed attenuation. This effect of thickness could be reduced substantially by BHC for scans in air, but not for scans in water. Varying thickness of surrounding water also changed the mean attenuation of an aluminium tube. This artefact could be almost eliminated by an optimal BHC value. The “cupping” artefact of heterogeneous attenuation (elevated at outer surfaces could be corrected if aluminium was scanned in air, but in water BHC was much less effective. Scan truncation, changes to magnification and signal-to-noise ratio also caused artificial changes to measured attenuation. Measurement of bone mineral density by microCT is highly context sensitive. A surrounding layer of liquid or biological tissue reduces the ability of software BHC to remove bone density artefacts. Sample thickness, truncation, magnification and signal to noise ratio also affect reconstructed attenuation. Thus it is important for densitometry that sample and calibration phantom dimensions and mounting materials are standardised.

A reconstruction method for cone-beam differential x-ray phase-contrast computed tomography.

Science.gov (United States)

Fu, Jian; Velroyen, Astrid; Tan, Renbo; Zhang, Junwei; Chen, Liyuan; Tapfer, Arne; Bech, Martin; Pfeiffer, Franz

2012-09-10

Most existing differential phase-contrast computed tomography (DPC-CT) approaches are based on three kinds of scanning geometries, described by parallel-beam, fan-beam and cone-beam. Due to the potential of compact imaging systems with magnified spatial resolution, cone-beam DPC-CT has attracted significant interest. In this paper, we report a reconstruction method based on a back-projection filtration (BPF) algorithm for cone-beam DPC-CT. Due to the differential nature of phase contrast projections, the algorithm restrains from differentiation of the projection data prior to back-projection, unlike BPF algorithms commonly used for absorption-based CT data. This work comprises a numerical study of the algorithm and its experimental verification using a dataset measured with a three-grating interferometer and a micro-focus x-ray tube source. Moreover, the numerical simulation and experimental results demonstrate that the proposed method can deal with several classes of truncated cone-beam datasets. We believe that this feature is of particular interest for future medical cone-beam phase-contrast CT imaging applications.

Report of questionnaire concerning the conditions and exposure doses at thoracoabdominal radiography and CT

International Nuclear Information System (INIS)

2009-01-01

Japan Association of Radiological Technologists, at 2 years after its presentation of the Guideline for Medical Radiation Exposure (2006), made a questionnaire in the title on its homepage on Nov. 6-Dec. 5, 2008, and this paper is its report. The questionnaire asked the conditions and exposure doses at thoracoabdominal radiography and CT: in the former, asked were conditions like the machine/detector, tube voltage, filter, incident angle, entrance plane dose (EPD) (mGy) etc., and 237 facilities including 56 public hospitals and 15 universities answered. EPD calculated by numerical dose determination was found to be 0.22 and 0.76 mGy at the frontal and lateral thoracic projection, respectively, which were less than the upper limit defined in International Atomic Energy Agency (IAEA) guidance (0.4 and 1.5 mGy). However, doses in 6 and 2.6% of facilities at the respective projection exceeded the IAEA levels. EPD at the frontal abdominal projection calculated was 2.22 mGy, and all facilities met with the IAEA demand level (<10 mGy). In the CT questionnaire, conditions asked were the machine manufacturer/brand, scanning mode and range, tube voltage, rotation time, beam width and pitch, slice width, CTDIvol (CT Dose Index weighted/pitch) (mGy) and so on, which 212 facilities involving 58 public hospitals and 14 universities answered. CTDIvol was found to be 91.7 mGy at head CT which greatly exceeded the maximal levels of International Commission of Radiological Protection (ICRP), IAEA and the Association (60, 50 and 65 mGy, respectively). CTDIvol at thoracic CT was 15.2 mGy (no standard upper limit at present), and at abdominal CT, 20.0 mGy (the same as the Association level). The latter suggested the suitable dose setting at this CT. Thus the problem at head CT was much highlighted here. (K.T.)

Implications of CT noise and artifacts for quantitative 99mTc SPECT/CT imaging

International Nuclear Information System (INIS)

Hulme, K. W.; Kappadath, S. C.

2014-01-01

Purpose: This paper evaluates the effects of computed tomography (CT) image noise and artifacts on quantitative single-photon emission computed-tomography (SPECT) imaging, with the aim of establishing an appropriate range of CT acquisition parameters for low-dose protocols with respect to accurate SPECT attenuation correction (AC). Methods: SPECT images of two geometric and one anthropomorphic phantom were reconstructed iteratively using CT scans acquired at a range of dose levels (CTDI vol = 0.4 to 46 mGy). Resultant SPECT image quality was evaluated by comparing mean signal, background noise, and artifacts to SPECT images reconstructed using the highest dose CT for AC. Noise injection was performed on linear-attenuation (μ) maps to determine the CT noise threshold for accurate AC. Results: High levels of CT noise (σ ∼ 200–400 HU) resulted in low μ-maps noise (σ ∼ 1%–3%). Noise levels greater than ∼10% in 140 keV μ-maps were required to produce visibly perceptible increases of ∼15% in 99m Tc SPECT images. These noise levels would be achieved at low CT dose levels (CTDI vol = 4 μGy) that are over 2 orders of magnitude lower than the minimum dose for diagnostic CT scanners. CT noise could also lower (bias) the expected μ values. The relative error in reconstructed SPECT signal trended linearly with the relative shift in μ. SPECT signal was, on average, underestimated in regions corresponding with beam-hardening artifacts in CT images. Any process that has the potential to change the CT number of a region by ∼100 HU (e.g., misregistration between CT images and SPECT images due to motion, the presence of contrast in CT images) could introduce errors in μ 140 keV on the order of 10%, that in turn, could introduce errors on the order of ∼10% into the reconstructed 99m Tc SPECT image. Conclusions: The impact of CT noise on SPECT noise was demonstrated to be negligible for clinically achievable CT parameters. Because CT dose levels that affect

Cone beam CT with zonal filters for simultaneous dose reduction, improved target contrast and automated set-up in radiotherapy

International Nuclear Information System (INIS)

Moore, C J; Marchant, T E; Amer, A M

2006-01-01

Cone beam CT (CBCT) using a zonal filter is introduced. The aims are reduced concomitant imaging dose to the patient, simultaneous control of body scatter for improved image quality in the tumour target zone and preserved set-up detail for radiotherapy. Aluminium transmission diaphragms added to the CBCT x-ray tube of the Elekta Synergy TM linear accelerator produced an unattenuated beam for a central 'target zone' and a partially attenuated beam for an outer 'set-up zone'. Imaging doses and contrast noise ratios (CNR) were measured in a test phantom for transmission diaphragms 12 and 24 mm thick, for 5 and 10 cm long target zones. The effect on automatic registration of zonal CBCT to conventional CT was assessed relative to full-field and lead-collimated images of an anthropomorphic phantom. Doses along the axis of rotation were reduced by up to 50% in both target and set-up zones, and weighted dose (two thirds surface dose plus one third central dose) was reduced by 10-20% for a 10 cm long target zone. CNR increased by up to 15% in zonally filtered CBCT images compared to full-field images. Automatic image registration remained as robust as that with full-field images and was superior to CBCT coned down using lead-collimation. Zonal CBCT significantly reduces imaging dose and is expected to benefit radiotherapy through improved target contrast, required to assess target coverage, and wide-field edge detail, needed for robust automatic measurement of patient set-up error

Evaluation of patient dose using a virtual CT scanner: Applications to 4DCT simulation and Kilovoltage cone-beam imaging

International Nuclear Information System (INIS)

DeMarco, J J; Agazaryan, N; McNitt-Gray, M F; Cagnon, C H; Angel, E; Zankl, M

2008-01-01

This work evaluates the effects of patient size on radiation dose from simulation imaging studies such as four-dimensional computed tomography (4DCT) and kilovoltage cone-beam computed tomography (kV-CBCT). 4DCT studies are scans that include temporal information, frequently incorporating highly over-sampled imaging series necessary for retrospective sorting as a function of respiratory phase. This type of imaging study can result in a significant dose increase to the patient due to the slower table speed as compared with a conventional axial or helical scan protocol. Kilovoltage cone-beam imaging is a relatively new imaging technique that requires an on-board kilovoltage x-ray tube and a flat-panel detector. Instead of porting individual reference fields, the kV tube and flat-panel detector are rotated about the patient producing a cone-beam CT data set (kV-CBCT). To perform these investigations, we used Monte Carlo simulation methods with detailed models of adult patients and virtual source models of multidetector computed tomography (MDCT) scanners. The GSF family of three-dimensional, voxelized patient models, were implemented as input files using the Monte Carlo code MCNPX. The adult patient models represent a range of patient sizes and have all radiosensitive organs previously identified and segmented. Simulated 4DCT scans of each voxelized patient model were performed using a multi-detector CT source model that includes scanner specific spectra, bow-tie filtration, and helical source path. Standard MCNPX tally functions were applied to each model to estimate absolute organ dose based upon an air-kerma normalization measurement for nominal scanner operating parameters

Upper airway alterations/abnormalities in a case series of obstructive sleep apnea patients identified with cone-beam CT

International Nuclear Information System (INIS)

Shigeta, Y.; Shintaku, W.H.; Clark, G.T.; Enciso, R.; Ogawa, T.

2007-01-01

There are many factors that influence the configuration of the upper airway and may contribute to the development of obstructive sleep apnea (OSA). This paper presents a series of 12 consecutive OSA cases where various upper airway alteration/abnormalities were identified using 3D anatomic reconstructions generated from cone-beam CT (CBCT) images. Some cases exhibited more than one type of abnormality and below we describe each of the six types identified with CBCT in this case series. (orig.)

Upper airway alterations/abnormalities in a case series of obstructive sleep apnea patients identified with cone-beam CT

Energy Technology Data Exchange (ETDEWEB)

Shigeta, Y; Shintaku, W H; Clark, G T [Orofacial Pain/Oral Medicine Center, Div. of Diagnostic Sciences, School of Dentistry, Univ. of Southern California, Los Angeles, CA (United States); Enciso, R [Div. of Craniofacial Sciences and Therapeutics, School of Dentistry, Univ. of Southern California, Los Angeles, CA (United States); Ogawa, T [Dept. of Fixed Prosthodontic Dentistry, Tsurumi Univ., School of Dental Medicine, Tsurumi (Japan)

2007-06-15

There are many factors that influence the configuration of the upper airway and may contribute to the development of obstructive sleep apnea (OSA). This paper presents a series of 12 consecutive OSA cases where various upper airway alteration/abnormalities were identified using 3D anatomic reconstructions generated from cone-beam CT (CBCT) images. Some cases exhibited more than one type of abnormality and below we describe each of the six types identified with CBCT in this case series. (orig.)

TU-AB-204-00: Advances in Cone-Beam CT and Emerging Applications

International Nuclear Information System (INIS)

2015-01-01

This symposium highlights advanced cone-beam CT (CBCT) technologies in four areas of emerging application in diagnostic imaging and image-guided interventions. Each area includes research that extends the spatial, temporal, and/or contrast resolution characteristics of CBCT beyond conventional limits through advances in scanner technology, acquisition protocols, and 3D image reconstruction techniques. Dr. G. Chen (University of Wisconsin) will present on the topic: Advances in C-arm CBCT for Brain Perfusion Imaging. Stroke is a leading cause of death and disability, and a fraction of people having an acute ischemic stroke are suitable candidates for endovascular therapy. Critical factors that affect both the likelihood of successful revascularization and good clinical outcome are: 1) the time between stroke onset and revascularization; and 2) the ability to distinguish patients who have a small volume of irreversibly injured brain (ischemic core) and a large volume of ischemic but salvageable brain (penumbra) from patients with a large ischemic core and little or no penumbra. Therefore, “time is brain” in the care of the stroke patients. C-arm CBCT systems widely available in angiography suites have the potential to generate non-contrast-enhanced CBCT images to exclude the presence of hemorrhage, time-resolved CBCT angiography to evaluate the site of occlusion and collaterals, and CBCT perfusion parametric images to assess the extent of the ischemic core and penumbra, thereby fulfilling the imaging requirements of a “one-stop-shop” in the angiography suite to reduce the time between onset and revascularization therapy. The challenges and opportunities to advance CBCT technology to fully enable the one-stop-shop C-arm CBCT platform for brain imaging will be discussed. Dr. R. Fahrig (Stanford University) will present on the topic: Advances in C-arm CBCT for Cardiac Interventions. With the goal of providing functional information during cardiac interventions

TU-AB-204-00: Advances in Cone-Beam CT and Emerging Applications

Energy Technology Data Exchange (ETDEWEB)

NONE

2015-06-15

This symposium highlights advanced cone-beam CT (CBCT) technologies in four areas of emerging application in diagnostic imaging and image-guided interventions. Each area includes research that extends the spatial, temporal, and/or contrast resolution characteristics of CBCT beyond conventional limits through advances in scanner technology, acquisition protocols, and 3D image reconstruction techniques. Dr. G. Chen (University of Wisconsin) will present on the topic: Advances in C-arm CBCT for Brain Perfusion Imaging. Stroke is a leading cause of death and disability, and a fraction of people having an acute ischemic stroke are suitable candidates for endovascular therapy. Critical factors that affect both the likelihood of successful revascularization and good clinical outcome are: 1) the time between stroke onset and revascularization; and 2) the ability to distinguish patients who have a small volume of irreversibly injured brain (ischemic core) and a large volume of ischemic but salvageable brain (penumbra) from patients with a large ischemic core and little or no penumbra. Therefore, “time is brain” in the care of the stroke patients. C-arm CBCT systems widely available in angiography suites have the potential to generate non-contrast-enhanced CBCT images to exclude the presence of hemorrhage, time-resolved CBCT angiography to evaluate the site of occlusion and collaterals, and CBCT perfusion parametric images to assess the extent of the ischemic core and penumbra, thereby fulfilling the imaging requirements of a “one-stop-shop” in the angiography suite to reduce the time between onset and revascularization therapy. The challenges and opportunities to advance CBCT technology to fully enable the one-stop-shop C-arm CBCT platform for brain imaging will be discussed. Dr. R. Fahrig (Stanford University) will present on the topic: Advances in C-arm CBCT for Cardiac Interventions. With the goal of providing functional information during cardiac interventions

Cardiac CT

International Nuclear Information System (INIS)

Dewey, Marc

2011-01-01

Computed tomography of the heart has become a highly accurate diagnostic modality that is attracting increasing attention. This extensively illustrated book aims to assist the reader in integrating cardiac CT into daily clinical practice, while also reviewing its current technical status and applications. Clear guidance is provided on the performance and interpretation of imaging using the latest technology, which offers greater coverage, better spatial resolution, and faster imaging. The specific features of scanners from all four main vendors, including those that have only recently become available, are presented. Among the wide range of applications and issues to be discussed are coronary artery bypass grafts, stents, plaques, and anomalies, cardiac valves, congenital and acquired heart disease, and radiation exposure. Upcoming clinical uses of cardiac CT, such as plaque imaging and functional assessment, are also explored. (orig.)

Cardiac CT

Energy Technology Data Exchange (ETDEWEB)

Dewey, Marc [Charite - Universitaetsmedizin Berlin (Germany). Inst. fuer Radiologie

2011-07-01

Computed tomography of the heart has become a highly accurate diagnostic modality that is attracting increasing attention. This extensively illustrated book aims to assist the reader in integrating cardiac CT into daily clinical practice, while also reviewing its current technical status and applications. Clear guidance is provided on the performance and interpretation of imaging using the latest technology, which offers greater coverage, better spatial resolution, and faster imaging. The specific features of scanners from all four main vendors, including those that have only recently become available, are presented. Among the wide range of applications and issues to be discussed are coronary artery bypass grafts, stents, plaques, and anomalies, cardiac valves, congenital and acquired heart disease, and radiation exposure. Upcoming clinical uses of cardiac CT, such as plaque imaging and functional assessment, are also explored. (orig.)

Verification of CTDI and Dlp values for a head tomography reported by the manufacturers of the CT scanners, using a CT dose profiler probe, a head phantom and a piranha electrometer

International Nuclear Information System (INIS)

Castillo C, E.; Garcia F, I. B.; Garcia H, J.; Roman L, S.; Salmeron C, O.

2015-10-01

The extensive use of Computed Tomography (CT) and the associated increase in patient dose calls for an accurate dose evaluation technique. The CT contributes up to 70% of the total dose given to patients during X-ray examinations. The rapid advancements in CT technology are placing new demands on the methods and equipment that are used for quality assurance. The wide beam widths found in CT scanners with multiple beam apertures make it impossible to use existing CT ionization chambers to measure the total dose given to the patient. Using a standard 10 cm CT ionization chamber may result in inaccurate measurements due to underestimation of the dose profile for wide beams. The use a CT dose profiler based on solid-state technology and the Piranha electrometer from RTI electronics provides a potential solution to the arising concerns over patient dose. This study intend to evaluate the feasibility and accuracy of CT Dose Index (CTDI) and Dose Length Product (Dlp) values for a head tomography reported by the manufacturers of the CT scanners at each study. (Author)

Verification of CTDI and Dlp values for a head tomography reported by the manufacturers of the CT scanners, using a CT dose profiler probe, a head phantom and a piranha electrometer

Energy Technology Data Exchange (ETDEWEB)

Castillo C, E.; Garcia F, I. B.; Garcia H, J.; Roman L, S. [Servicios de Salud de Michoacan, Centro Estatal de Atencion Oncologica, Gertrudis Bocanegra No. 300, Col. Cuauhtemoc, 58020 Morelia, Michoacan (Mexico); Salmeron C, O., E-mail: edithcastillocorona@gmail.com [Servicios de Salud de Michoacan, Hospital General Dr. Miguel Silva, Isidro Huarte s/n, Centro Historico, 58000 Morelia, Michoacan (Mexico)

2015-10-15

The extensive use of Computed Tomography (CT) and the associated increase in patient dose calls for an accurate dose evaluation technique. The CT contributes up to 70% of the total dose given to patients during X-ray examinations. The rapid advancements in CT technology are placing new demands on the methods and equipment that are used for quality assurance. The wide beam widths found in CT scanners with multiple beam apertures make it impossible to use existing CT ionization chambers to measure the total dose given to the patient. Using a standard 10 cm CT ionization chamber may result in inaccurate measurements due to underestimation of the dose profile for wide beams. The use a CT dose profiler based on solid-state technology and the Piranha electrometer from RTI electronics provides a potential solution to the arising concerns over patient dose. This study intend to evaluate the feasibility and accuracy of CT Dose Index (CTDI) and Dose Length Product (Dlp) values for a head tomography reported by the manufacturers of the CT scanners at each study. (Author)

Scattered radiation in fan beam imaging systems

International Nuclear Information System (INIS)

Johns, P.C.; Yaffe, M.

1982-01-01

Scatter-to-primary energy fluence ratios (S/P) have been studied for fan x-ray beams as used in CT scanners and slit projection radiography systems. The dependence of S/P on phantom diameter, distance from phantom to image receptor, and kilovoltage is presented. An empirical equation is given that predicts S/P over a wide range of fan beam imaging configurations. For CT body scans on a 4th-generation machine, S/P is approximately 5%. Scattered radiation can produce a significant cupping artefact in CT images which is similar to that due to beam hardening. When multiple slices are used in scanned slit radiography, they can be arranged such that the increase in S/P is negligible. Calculations of scatter-to-primary ratios for first order scattering showed that for fan beams the contribution of coherent scatter is comparable to or greater than that of incoherent first scatter

Automated volume of interest delineation and rendering of cone beam CT images in interventional cardiology

Science.gov (United States)

Lorenz, Cristian; Schäfer, Dirk; Eshuis, Peter; Carroll, John; Grass, Michael

2012-02-01

Interventional C-arm systems allow the efficient acquisition of 3D cone beam CT images. They can be used for intervention planning, navigation, and outcome assessment. We present a fast and completely automated volume of interest (VOI) delineation for cardiac interventions, covering the whole visceral cavity including mediastinum and lungs but leaving out rib-cage and spine. The problem is addressed in a model based approach. The procedure has been evaluated on 22 patient cases and achieves an average surface error below 2mm. The method is able to cope with varying image intensities, varying truncations due to the limited reconstruction volume, and partially with heavy metal and motion artifacts.

Assessment of CT numbers in limited and medium field-of-view scans taken using Accuitomo 170 and Veraviewepocs 3De cone-beam computed tomography scanners

Energy Technology Data Exchange (ETDEWEB)

Oliveira, Matheus L. [Dept. of Oral Diagnosis, Piracicaba Dental School, State University of Campinas, Campinas (Brazil); Tosoni, Guilherme M. [Dept. of Oral Diagnosis and Surgery, Araraquara Dental School, Sao Paulo State University, Araraquara (Brazil); Lindsey, David H.; Mendoza, Kristopher; Tetradis, Sotirios; Mallya, Sanjay M. [Section of Oral and Maxillofacial Radiology, School of Dentistry, University of California, Los Angeles (United States)

2014-12-15

To assess the influence of anatomic location on the relationship between computed tomography (CT) number and X-ray attenuation in limited and medium field-of-view (FOV) scans. Tubes containing solutions with different concentrations of K2HPO4 were placed in the tooth sockets of a human head phantom. Cone-beam computed tomography (CBCT) scans were acquired, and CT numbers of the K{sub 2}HPO{sub 4} solutions were measured. The relationship between CT number and K{sub 2}HPO{sub 4} concentration was examined by linear regression analyses. Then, the variation in CT number according to anatomic location was examined. The relationship between K{sub 2}HPO{sub 4} concentration and CT number was strongly linear. The slopes of the linear regressions for the limited FOVs were almost 2-fold lower than those for the medium FOVs. The absolute CT number differed between imaging protocols and anatomic locations. There is a strong linear relationship between X-ray attenuation and CT number. The specific imaging protocol and anatomic location of the object strongly influence this relationship.

Using condition and usefulness of dental cone-beam CT in endodontic treatment

International Nuclear Information System (INIS)

Kimura, Yuichi; Araki, Kazuyuki; Yamada, Yoshishige; Tagaya, Atsuko; Seki, Kenji; Okano, Tomohiro; Endo, Atsushi

2009-01-01

This study evaluated the condition and usefulness of the dental cone-beam CT (3DX) in clinical endodontic treatments. Images from 55 examinations of 49 patients obtained using 3DX during an 11-month period were evaluated retrospectively to identify the usefulness of this modality compared with periapical or panoramic radiographs. The main indication for using of 3DX was diagnosis of root fracture in 65% of the examinations, second was the presence and expansion of periapical lesion in 22%, and third was to detect the canal system or root abnormality in 13%. The 3DX visualizes bony anatomical structures precisely and detects the presence and expansion of periapical lesions and the canal system of each root of mulirooted teeth that cannot easily be observed by intraoral radiography or panoramic radiography. The results of this study suggest that 3DX is a useful and reliable tool for endodontic treatments. (author)

Reliability of implant placement after virtual planning of implant positions using cone beam CT data and surgical (guide) templates.

Science.gov (United States)

Nickenig, Hans-Joachim; Eitner, Stephan

2007-01-01

We assessed the reliability of implant placement after virtual planning of implant positions using cone-beam CT data and surgical guide templates. A total of 102 patients (250 implants, 55.4% mandibular; mean patient age, 40.4 years) who had undergone implant treatment therapy in an armed forces dental clinic (Cologne, Germany) between July 1, 2005 and December 1, 2005. They were treated with a system that allows transfer of virtual planning to surgical guide templates. Only in eight cases the surgical guides were not used because a delayed implant placement was necessary. In four posterior mandibular cases, handling was limited because of reduced interocclusal distance, requiring 50% shortening of the drill guides. The predictability of implant size was high: only one implant was changed to a smaller diameter (because of insufficient bone). In all cases, critical anatomical structures were protected and no complications were detected in postoperative panoramic radiographs. In 58.1% (147) of the 250 implants, a flapless surgery plan was realized. Implant placement after virtual planning of implant positions using cone beam CT data and surgical templates can be reliable for preoperative assessment of implant size, position, and anatomical complications. It is also indicative of cases amenable to flapless surgery.

Assessment of coronary artery stent patency by electron-beam CT

International Nuclear Information System (INIS)

Knollmann, Friedrich D.; Felix, Roland; Moeller, Joerg; Gebert, Axel; Bethge, Christian

2004-01-01

Following coronary angioplasty and stent implantation, restenosis remains common and its outcome difficult to predict. We set out to determine the diagnostic accuracy of electron-beam computed tomography (EBCT) for the non-invasive detection of stent obstruction. In a prospective, blinded investigation, we included 152 coronary artery segments in 117 patients treated with a stent implant. All segments were evaluated by a dynamic EBCT study that depicted contrast bolus passage distal to the stent and a CT angiographic study of the entire coronary arteries. It was found that delayed contrast enhancement in the distal segment correlated with angiographic stent obstruction (Spearman's rank correlation, P=0.008), while all other indicators of stent occlusion did not correlate with angiographic diagnosis. However, direct comparison of patients with obstruction of less vs. more than 75% of luminal diameter did not yield any statistically significant differences of distal enhancement delay, and for the detection of >90% occlusion, the sensitivity was 72% at a specificity of 60%. Although delayed contrast enhancement distal to the stent upon EBCT did correlate with angiographical obstruction, the correlation did not suffice to appear clinically satisfactory. (orig.)

Surgical stent for dental implant using cone beam CT images

International Nuclear Information System (INIS)

Choi, Hyung Soo; Kim, Gyu Tae; Choi, Yong Suk; Hwang, Eui Hwan

2010-01-01

The purpose of this study is to develop a surgical stent for dental implant procedure that can be easily applied and affordable by using cone beam computerized tomography (CBCT). Aluminum, Teflon-PFA (perfluoroalkoxy), and acetal (polyoxymethylene plastic) were selected as materials for the surgical stent. Among these three materials, the appropriate material was chosen using the CBCT images. The surgical stent, which could be easily placed into an oral cavity, was designed with chosen material. CBCT images of the new surgical stent on mandible were obtained using Alphard-3030 dental CT system (Asahi Roentgen Co., Ltd., Kyoto, Japan). The point of insertion was prescribed on the surgical stent with the multiplanar reconstruction software of OnDemand3D (CyberMed Inc., Seoul, Korea). Guide holes were made at the point of insertion on the surgical stent using newly designed guide jig. CBCT scans was taken for the second time to verify the accuracy of the newly designed surgical stent. Teflon-PFA showed radiologically excellent image characteristics for the surgical stent. High accuracy and reproducibility of implantation were confirmed with the surgical stent. The newly designed surgical stent can lead to the accurate implantation and achieve the clinically predictable result.

Assessment of coronary artery stent patency by electron-beam CT

Energy Technology Data Exchange (ETDEWEB)

Knollmann, Friedrich D.; Felix, Roland [Department of Radiology, Charite, Campus Virchow-Klinikum, Humboldt-University, Augustenburger Platz 1, 13353, Berlin (Germany); Moeller, Joerg; Gebert, Axel; Bethge, Christian [Department of Cardiology, Juedisches Krankenhaus, Berlin (Germany)

2004-08-01

Following coronary angioplasty and stent implantation, restenosis remains common and its outcome difficult to predict. We set out to determine the diagnostic accuracy of electron-beam computed tomography (EBCT) for the non-invasive detection of stent obstruction. In a prospective, blinded investigation, we included 152 coronary artery segments in 117 patients treated with a stent implant. All segments were evaluated by a dynamic EBCT study that depicted contrast bolus passage distal to the stent and a CT angiographic study of the entire coronary arteries. It was found that delayed contrast enhancement in the distal segment correlated with angiographic stent obstruction (Spearman's rank correlation, P=0.008), while all other indicators of stent occlusion did not correlate with angiographic diagnosis. However, direct comparison of patients with obstruction of less vs. more than 75% of luminal diameter did not yield any statistically significant differences of distal enhancement delay, and for the detection of >90% occlusion, the sensitivity was 72% at a specificity of 60%. Although delayed contrast enhancement distal to the stent upon EBCT did correlate with angiographical obstruction, the correlation did not suffice to appear clinically satisfactory. (orig.)

Image Registration of Cone-Beam Computer Tomography and Preprocedural Computer Tomography Aids in Localization of Adrenal Veins and Decreasing Radiation Dose in Adrenal Vein Sampling

Energy Technology Data Exchange (ETDEWEB)

Busser, Wendy M. H., E-mail: wendy.busser@radboudumc.nl; Arntz, Mark J.; Jenniskens, Sjoerd F. M. [Radboud University Medical Center, Department of Radiology, Section of Interventional Radiology (Netherlands); Deinum, Jaap [Radboud University Medical Center, Department of General Internal Medicine (Netherlands); Hoogeveen, Yvonne L.; Lange, Frank de; Schultze Kool, Leo J. [Radboud University Medical Center, Department of Radiology, Section of Interventional Radiology (Netherlands)

2015-08-15

PurposeWe assessed whether image registration of cone-beam computed tomography (CT) (CBCT) and contrast-enhanced CT (CE-CT) images indicating the locations of the adrenal veins can aid in increasing the success rate of first-attempts adrenal vein sampling (AVS) and therefore decreasing patient radiation dose.Materials and Methods CBCT scans were acquired in the interventional suite (Philips Allura Xper FD20) and rigidly registered to the vertebra in previously acquired CE-CT. Adrenal vein locations were marked on the CT image and superimposed with live fluoroscopy and digital-subtraction angiography (DSA) to guide the AVS. Seventeen first attempts at AVS were performed with image registration and retrospectively compared with 15 first attempts without image registration performed earlier by the same 2 interventional radiologists. First-attempt AVS was considered successful when both adrenal vein samples showed representative cortisol levels. Sampling time, dose-area product (DAP), number of DSA runs, fluoroscopy time, and skin dose were recorded.ResultsWithout image registration, the first attempt at sampling was successful in 8 of 15 procedures indicating a success rate of 53.3 %. This increased to 76.5 % (13 of 17) by adding CBCT and CE-CT image registration to AVS procedures (p = 0.266). DAP values (p = 0.001) and DSA runs (p = 0.026) decreased significantly by adding image registration guidance. Sampling and fluoroscopy times and skin dose showed no significant changes.ConclusionGuidance based on registration of CBCT and previously acquired diagnostic CE-CT can aid in enhancing localization of the adrenal veins thereby increasing the success rate of first-attempt AVS with a significant decrease in the number of used DSA runs and, consequently, radiation dose required.

Radiation dose reduction in CT-guided sacroiliac joint injections to levels of pulsed fluoroscopy: a comparative study with technical considerations

Directory of Open Access Journals (Sweden)

Artner J

2012-08-01

Full Text Available Juraj Artner, Balkan Cakir, Heiko Reichel, Friederike LattigDepartment of Orthopaedic Surgery, University of Ulm, RKU, GermanyBackground: The sacroiliac (SI joint is frequently the primary source of low back pain. Over the past decades, a number of different SI injection techniques have been used in its diagnosis and therapy. Despite the concerns regarding exposure to radiation, image-guided injection techniques are the preferred method to achieve safe and precise intra-articular needle placement. The following study presents a comparison of radiation doses, calculated for fluoroscopy and CT-guided SI joint injections in standard and low-dose protocol and presents the technical possibility of CT-guidance with maximum radiation dose reduction to levels of fluoroscopic-guidance for a precise intra-articular injection technique.Objective: To evaluate the possibility of dose reduction in CT-guided sacroiliac joint injections to pulsed-fluoroscopy-guidance levels and to compare the doses of pulsed-fluoroscopy-, CT-guidance, and low-dose CT-guidance for intra-articular SI joint injections.Study design: Comparative study with technical considerations.Methods: A total of 30 CT-guided intra-articular SI joint injections were performed in January 2012 in a developed low-dose mode and the radiation doses were calculated. They were compared to 30 pulsed-fluoroscopy-guided SI joint injections, which were performed in the month before, and to five injections, performed in standard CT-guided biopsy mode for spinal interventions. The statistical significance was calculated with the SPSS software using the Mann–Whitney U-Test. Technical details and anatomical considerations were provided.Results: A significant dose reduction of average 94.01% was achieved using the low-dose protocol for CT-guided SI joint injections. The radiation dose could be approximated to pulsed-fluoroscopy-guidance levels.Conclusion: Radiation dose of CT-guided SI joint injections can be

Investigation of the accuracy of MV radiation isocentre calculations in the Elekta cone-beam CT software XVI

DEFF Research Database (Denmark)

Lynggaard Riis, Hans; Moltke, Lars N; Zimmermann, S. J.

2016-01-01

Accurate determination of the megavoltage (MV) radiation isocentre of a linear accelerator (linac) is an important task in radiotherapy. The localization of the MV radiation isocentre is crucial for correct calibration of the in-room lasers and the cone-beam CT scanner used for patient positioning...... orientation or the phantom asymmetry in the longitudinal direction do not appear to cause the discrepancy. The main cause of the differences could not be clearly identified. However, it is our opinion that the commercial software delivered by the linac manufacturer should be improved to reach better stability...

Investigation of the accuracy of MV radiation isocentre calculations in the Elekta cone-beam CT software XVI

DEFF Research Database (Denmark)

Zimmermann, S. J.; Rowshanfarzad, P.; Ebert, M. A.

2015-01-01

) and the radiation field centre (RFC) is calculated. A software package was developed for accurate calculation of the linac isocentre position. This requires precise determination of the position of the ball bearing and the RFC. Results: Data were acquired for 6 MV, 18 MV and flattening filter free (FFF) 6 MV FFF...... radiation isocentre prior to routine use of the cone-beam CT system. The isocentre determination method used in the XVI software is not available to users. The aim of this work is to perform an independent evaluation of the Elekta XVI 4.5 software for isocentre verification with focus on the robustness...... iView GT software. Two images were acquired at each cardinal gantry angle (-180o, -90o , 0o, 90o) at two opposing collimator angles. The images were exported to the conebeam CT software XVI 4.5 where the difference between the ball bearing position in the XYZ-room coordinates (IEC61217...

Characterization of the nanoDot OSLD dosimeter in CT

Energy Technology Data Exchange (ETDEWEB)

Scarboro, Sarah B. [The University of Texas MD Anderson Cancer Center, Houston, Texas 77030 (United States); Graduate School of Biomedical Sciences, The University of Texas Health Science Center Houston, Houston, Texas 77030 (United States); The Methodist Hospital, Houston, Texas 77030 (United States); Cody, Dianna; Followill, David; Court, Laurence; Stingo, Francesco C.; Kry, Stephen F., E-mail: SFKry@mdanderson.org [The University of Texas MD Anderson Cancer Center, Houston, Texas 77030 and Graduate School of Biomedical Sciences, The University of Texas Health Science Center Houston, Houston, Texas 77030 (United States); Alvarez, Paola [The University of Texas MD Anderson Cancer Center, Houston, Texas 77030 (United States); Zhang, Di [Biomedical Physics Graduate Program, David Geffen School of Medicine at UCLA, Los Angeles, California 90095 and Toshiba American Medical Systems, Tustin, California 92780 (United States); McNitt-Gray, Michael [The Department of Radiological Sciences, David Geffen School of Medicine at UCLA, Los Angeles, California 90095 (United States)

2015-04-15

Purpose: The extensive use of computed tomography (CT) in diagnostic procedures is accompanied by a growing need for more accurate and patient-specific dosimetry techniques. Optically stimulated luminescent dosimeters (OSLDs) offer a potential solution for patient-specific CT point-based surface dosimetry by measuring air kerma. The purpose of this work was to characterize the OSLD nanoDot for CT dosimetry, quantifying necessary correction factors, and evaluating the uncertainty of these factors. Methods: A characterization of the Landauer OSL nanoDot (Landauer, Inc., Greenwood, IL) was conducted using both measurements and theoretical approaches in a CT environment. The effects of signal depletion, signal fading, dose linearity, and angular dependence were characterized through direct measurement for CT energies (80–140 kV) and delivered doses ranging from ∼5 to >1000 mGy. Energy dependence as a function of scan parameters was evaluated using two independent approaches: direct measurement and a theoretical approach based on Burlin cavity theory and Monte Carlo simulated spectra. This beam-quality dependence was evaluated for a range of CT scanning parameters. Results: Correction factors for the dosimeter response in terms of signal fading, dose linearity, and angular dependence were found to be small for most measurement conditions (<3%). The relative uncertainty was determined for each factor and reported at the two-sigma level. Differences in irradiation geometry (rotational versus static) resulted in a difference in dosimeter signal of 3% on average. Beam quality varied with scan parameters and necessitated the largest correction factor, ranging from 0.80 to 1.15 relative to a calibration performed in air using a 120 kV beam. Good agreement was found between the theoretical and measurement approaches. Conclusions: Correction factors for the measurement of air kerma were generally small for CT dosimetry, although angular effects, and particularly effects due

Characterization of the nanoDot OSLD dosimeter in CT

International Nuclear Information System (INIS)

Scarboro, Sarah B.; Cody, Dianna; Followill, David; Court, Laurence; Stingo, Francesco C.; Kry, Stephen F.; Alvarez, Paola; Zhang, Di; McNitt-Gray, Michael

2015-01-01

Purpose: The extensive use of computed tomography (CT) in diagnostic procedures is accompanied by a growing need for more accurate and patient-specific dosimetry techniques. Optically stimulated luminescent dosimeters (OSLDs) offer a potential solution for patient-specific CT point-based surface dosimetry by measuring air kerma. The purpose of this work was to characterize the OSLD nanoDot for CT dosimetry, quantifying necessary correction factors, and evaluating the uncertainty of these factors. Methods: A characterization of the Landauer OSL nanoDot (Landauer, Inc., Greenwood, IL) was conducted using both measurements and theoretical approaches in a CT environment. The effects of signal depletion, signal fading, dose linearity, and angular dependence were characterized through direct measurement for CT energies (80–140 kV) and delivered doses ranging from ∼5 to >1000 mGy. Energy dependence as a function of scan parameters was evaluated using two independent approaches: direct measurement and a theoretical approach based on Burlin cavity theory and Monte Carlo simulated spectra. This beam-quality dependence was evaluated for a range of CT scanning parameters. Results: Correction factors for the dosimeter response in terms of signal fading, dose linearity, and angular dependence were found to be small for most measurement conditions (<3%). The relative uncertainty was determined for each factor and reported at the two-sigma level. Differences in irradiation geometry (rotational versus static) resulted in a difference in dosimeter signal of 3% on average. Beam quality varied with scan parameters and necessitated the largest correction factor, ranging from 0.80 to 1.15 relative to a calibration performed in air using a 120 kV beam. Good agreement was found between the theoretical and measurement approaches. Conclusions: Correction factors for the measurement of air kerma were generally small for CT dosimetry, although angular effects, and particularly effects due

Accuracy of radiotherapy dose calculations based on cone-beam CT: comparison of deformable registration and image correction based methods

Science.gov (United States)

Marchant, T. E.; Joshi, K. D.; Moore, C. J.

2018-03-01

Radiotherapy dose calculations based on cone-beam CT (CBCT) images can be inaccurate due to unreliable Hounsfield units (HU) in the CBCT. Deformable image registration of planning CT images to CBCT, and direct correction of CBCT image values are two methods proposed to allow heterogeneity corrected dose calculations based on CBCT. In this paper we compare the accuracy and robustness of these two approaches. CBCT images for 44 patients were used including pelvis, lung and head & neck sites. CBCT HU were corrected using a ‘shading correction’ algorithm and via deformable registration of planning CT to CBCT using either Elastix or Niftyreg. Radiotherapy dose distributions were re-calculated with heterogeneity correction based on the corrected CBCT and several relevant dose metrics for target and OAR volumes were calculated. Accuracy of CBCT based dose metrics was determined using an ‘override ratio’ method where the ratio of the dose metric to that calculated on a bulk-density assigned version of the same image is assumed to be constant for each patient, allowing comparison to the patient’s planning CT as a gold standard. Similar performance is achieved by shading corrected CBCT and both deformable registration algorithms, with mean and standard deviation of dose metric error less than 1% for all sites studied. For lung images, use of deformed CT leads to slightly larger standard deviation of dose metric error than shading corrected CBCT with more dose metric errors greater than 2% observed (7% versus 1%).

Physics and basic technology of CT

International Nuclear Information System (INIS)

Mahesh, Mahadevappa

2017-01-01

Computed Tomography is one of the prime imaging modalities in any hospital around the globe. From its inception in 1973, CT technology have advanced leaps and bounds in medical diagnosis. Advances in X-ray tubes, detection technologies and image reconstruction methods led to the development of multiple-row detector CT (MDCT) technologies in early 2000, that has been the impetus for new fields such as Cardiovascular CT, Hybrid CT (PET-CT and SPECT-CT), CT Perfusion, Cone Beam CT, etc. It is now possible to image the entire organ (such as heart) in less than 0.3 seconds providing isotropic resolution images with high temporal resolution. With all X-ray imaging modalities, including CT, the concern is the radiation dose. Since CT procedures are one of the major imaging procedures performed in any hospital, it is important to optimize CT protocols in order to provide quality images at optimal radiation dose

Interesting detector shapes for 3rd generation CT

Energy Technology Data Exchange (ETDEWEB)

Kachelriess, Marc [Erlangen-Nuernberg Univ., Erlangen (Germany). Inst. of Medical Physics (IMP)

2011-07-01

Third generation CT scanners typically comprise detectors which are flat or whose shape is the segment of a cylinder or a sphere that is focussed onto the focal spot of the X-ray source. There appear to be two design criteria that favor this choice of detector shape. One is the possibility of performing fan-beam and cone-beam filtered backprojection in the native geometry (without rebinning) and the other criterium is to enable the use of focussed anti scatter grids. It is less known, however, that other detector shapes may also have these properties. While these designs have been evaluated for 2D CT from a rather theoretical standpoint more than one decade ago we revisit and generalize these considerations, extend them to 3D circular, sequential and spiral cone-beam CT and propose an optimal design in terms of detector costs. (orig.)

Respiratory correlated cone beam CT

International Nuclear Information System (INIS)

Sonke, Jan-Jakob; Zijp, Lambert; Remeijer, Peter; Herk, Marcel van

2005-01-01

A cone beam computed tomography (CBCT) scanner integrated with a linear accelerator is a powerful tool for image guided radiotherapy. Respiratory motion, however, induces artifacts in CBCT, while the respiratory correlated procedures, developed to reduce motion artifacts in axial and helical CT are not suitable for such CBCT scanners. We have developed an alternative respiratory correlated procedure for CBCT and evaluated its performance. This respiratory correlated CBCT procedure consists of retrospective sorting in projection space, yielding subsets of projections that each corresponds to a certain breathing phase. Subsequently, these subsets are reconstructed into a four-dimensional (4D) CBCT dataset. The breathing signal, required for respiratory correlation, was directly extracted from the 2D projection data, removing the need for an additional respiratory monitor system. Due to the reduced number of projections per phase, the contrast-to-noise ratio in a 4D scan reduced by a factor 2.6-3.7 compared to a 3D scan based on all projections. Projection data of a spherical phantom moving with a 3 and 5 s period with and without simulated breathing irregularities were acquired and reconstructed into 3D and 4D CBCT datasets. The positional deviations of the phantoms center of gravity between 4D CBCT and fluoroscopy were small: 0.13±0.09 mm for the regular motion and 0.39±0.24 mm for the irregular motion. Motion artifacts, clearly present in the 3D CBCT datasets, were substantially reduced in the 4D datasets, even in the presence of breathing irregularities, such that the shape of the moving structures could be identified more accurately. Moreover, the 4D CBCT dataset provided information on the 3D trajectory of the moving structures, absent in the 3D data. Considerable breathing irregularities, however, substantially reduces the image quality. Data presented for three different lung cancer patients were in line with the results obtained from the phantom study. In

TH-C-BRD-05: Reducing Proton Beam Range Uncertainty with Patient-Specific CT HU to RSP Calibrations Based On Single-Detector Proton Radiography

Energy Technology Data Exchange (ETDEWEB)

Doolan, P [University College London, London (United Kingdom); Massachusetts General Hospital, Boston, MA (United States); Sharp, G; Testa, M; Lu, H-M [Massachusetts General Hospital, Boston, MA (United States); Bentefour, E [Ion Beam Applications (IBA), Louvain la Neuve (Belgium); Royle, G [University College London, London (United Kingdom)

2014-06-15

Purpose: Beam range uncertainty in proton treatment comes primarily from converting the patient's X-ray CT (xCT) dataset to relative stopping power (RSP). Current practices use a single curve for this conversion, produced by a stoichiometric calibration based on tissue composition data for average, healthy, adult humans, but not for the individual in question. Proton radiographs produce water-equivalent path length (WEPL) maps, dependent on the RSP of tissues within the specific patient. This work investigates the use of such WEPL maps to optimize patient-specific calibration curves for reducing beam range uncertainty. Methods: The optimization procedure works on the principle of minimizing the difference between the known WEPL map, obtained from a proton radiograph, and a digitally-reconstructed WEPL map (DRWM) through an RSP dataset, by altering the calibration curve that is used to convert the xCT into an RSP dataset. DRWMs were produced with Plastimatch, an in-house developed software, and an optimization procedure was implemented in Matlab. Tests were made on a range of systems including simulated datasets with computed WEPL maps and phantoms (anthropomorphic and real biological tissue) with WEPL maps measured by single detector proton radiography. Results: For the simulated datasets, the optimizer showed excellent results. It was able to either completely eradicate or significantly reduce the root-mean-square-error (RMSE) in the WEPL for the homogeneous phantoms (to zero for individual materials or from 1.5% to 0.2% for the simultaneous optimization of multiple materials). For the heterogeneous phantom the RMSE was reduced from 1.9% to 0.3%. Conclusion: An optimization procedure has been designed to produce patient-specific calibration curves. Test results on a range of systems with different complexities and sizes have been promising for accurate beam range control in patients. This project was funded equally by the Engineering and Physical Sciences

A motion-compensated cone-beam CT using electrical impedance tomography imaging

International Nuclear Information System (INIS)

Pengpan, T; Smith, N D; Qiu, W; Yao, A; Mitchell, C N; Soleimani, M

2011-01-01

Cone-beam CT (CBCT) is an imaging technique used in conjunction with radiation therapy. For example CBCT is used to verify the position of lung cancer tumours just prior to radiation treatment. The accuracy of the radiation treatment of thoracic and upper abdominal structures is heavily affected by respiratory movement. Such movement typically blurs the CBCT reconstruction and ideally should be removed. Hence motion-compensated CBCT has recently been researched for correcting image artefacts due to breathing motion. This paper presents a new dual-modality approach where CBCT is aided by using electrical impedance tomography (EIT) for motion compensation. EIT can generate images of contrasts in electrical properties. The main advantage of using EIT is its high temporal resolution. In this paper motion information is extracted from EIT images and incorporated directly in the CBCT reconstruction. In this study synthetic moving data are generated using simulated and experimental phantoms. The paper demonstrates that image blur, created as a result of motion, can be reduced through motion compensation with EIT

CT-guided pericardiocenteses: Clinical profile, practice patterns and clinical outcome

Energy Technology Data Exchange (ETDEWEB)

Eichler, Katrin, E-mail: k.eichler@em.uni-frankfurt.d [Department of Diagnostic and Interventional Radiology, University of Frankfurt, Frankfurt (Germany); Zangos, Stephan; Thalhammer, Axel; Jacobi, Volkmar [Department of Diagnostic and Interventional Radiology, University of Frankfurt, Frankfurt (Germany); Walcher, Felix; Marzi, Ingo [Department of Trauma, Hand and Reconstructive Surgery, University of Frankfurt, Frankfurt (Germany); Moritz, Anton [Department of Thoracic and Cardiovascular Surgery, University of Frankfurt, Frankfurt (Germany); Vogl, Thomas J.; Mack, Martin G. [Department of Diagnostic and Interventional Radiology, University of Frankfurt, Frankfurt (Germany)

2010-07-15

Objective: To assess the effectiveness and clinical outcome and technique of CT-guided pericardiocenteses in the treatment of pericardial effusions in adults and children. Methods: 20 drainages were performed in Seldinger-technique under CT-guidance on 20 patients suffering from pericardial effusions and haematomas. In 85%, the etiology of effusion was postoperative. The mean age of the patients was 59 years (minimum 9 years, maximum 86 years).There were 12 male and eight female patients. The inclusion criterion was an echocardiographically relevant proved pericardial effusion. Results: All catheters could be placed successfully (20/20) in the pericardial effusion and allowed for draining of the effusion in all cases under CT-guidance. The overall 30-day mortality rate was 0%. CT-guided pericardiocentesis was successful for withdrawing pericardial fluid and/or relieving tamponade in 100% of all procedures. No major complication was occurred. A total of one minor complication (5%) occurred that required no specific interventions, except for monitoring and appropriate follow-up. We observed one pneumothorax as a minor complication. Conclusions: Pericardial effusions of various causes can be safely, effectively, and quickly managed with CT-guided pericardiocenteses in adults and children. The ventrolateral entry side for the puncture should be preferred to reach the whole effusion and avoid complications, like a pneumothorax.

CT-guided pericardiocenteses: Clinical profile, practice patterns and clinical outcome

International Nuclear Information System (INIS)

Eichler, Katrin; Zangos, Stephan; Thalhammer, Axel; Jacobi, Volkmar; Walcher, Felix; Marzi, Ingo; Moritz, Anton; Vogl, Thomas J.; Mack, Martin G.

2010-01-01

Objective: To assess the effectiveness and clinical outcome and technique of CT-guided pericardiocenteses in the treatment of pericardial effusions in adults and children. Methods: 20 drainages were performed in Seldinger-technique under CT-guidance on 20 patients suffering from pericardial effusions and haematomas. In 85%, the etiology of effusion was postoperative. The mean age of the patients was 59 years (minimum 9 years, maximum 86 years).There were 12 male and eight female patients. The inclusion criterion was an echocardiographically relevant proved pericardial effusion. Results: All catheters could be placed successfully (20/20) in the pericardial effusion and allowed for draining of the effusion in all cases under CT-guidance. The overall 30-day mortality rate was 0%. CT-guided pericardiocentesis was successful for withdrawing pericardial fluid and/or relieving tamponade in 100% of all procedures. No major complication was occurred. A total of one minor complication (5%) occurred that required no specific interventions, except for monitoring and appropriate follow-up. We observed one pneumothorax as a minor complication. Conclusions: Pericardial effusions of various causes can be safely, effectively, and quickly managed with CT-guided pericardiocenteses in adults and children. The ventrolateral entry side for the puncture should be preferred to reach the whole effusion and avoid complications, like a pneumothorax.

Soft-tissue imaging with C-arm cone-beam CT using statistical reconstruction

International Nuclear Information System (INIS)

Wang, Adam S; Stayman, J Webster; Otake, Yoshito; Siewerdsen, Jeffrey H; Kleinszig, Gerhard; Vogt, Sebastian; Gallia, Gary L; Khanna, A Jay

2014-01-01

The potential for statistical image reconstruction methods such as penalized-likelihood (PL) to improve C-arm cone-beam CT (CBCT) soft-tissue visualization for intraoperative imaging over conventional filtered backprojection (FBP) is assessed in this work by making a fair comparison in relation to soft-tissue performance. A prototype mobile C-arm was used to scan anthropomorphic head and abdomen phantoms as well as a cadaveric torso at doses substantially lower than typical values in diagnostic CT, and the effects of dose reduction via tube current reduction and sparse sampling were also compared. Matched spatial resolution between PL and FBP was determined by the edge spread function of low-contrast (∼40–80 HU) spheres in the phantoms, which were representative of soft-tissue imaging tasks. PL using the non-quadratic Huber penalty was found to substantially reduce noise relative to FBP, especially at lower spatial resolution where PL provides a contrast-to-noise ratio increase up to 1.4–2.2× over FBP at 50% dose reduction across all objects. Comparison of sampling strategies indicates that soft-tissue imaging benefits from fully sampled acquisitions at dose above ∼1.7 mGy and benefits from 50% sparsity at dose below ∼1.0 mGy. Therefore, an appropriate sampling strategy along with the improved low-contrast visualization offered by statistical reconstruction demonstrates the potential for extending intraoperative C-arm CBCT to applications in soft-tissue interventions in neurosurgery as well as thoracic and abdominal surgeries by overcoming conventional tradeoffs in noise, spatial resolution, and dose. (paper)

Construction of a voxel model from CT images with density derived from CT numbers

International Nuclear Information System (INIS)

Cheng Mengyun; Zeng Qin; Cao Ruifen; Li Gui; Zheng Huaqing; Huang Shanqing; Song Gang; Wu Yican

2010-01-01

The voxel models representing human anatomy have been developed to calculate dose distribution in human body, while the density is the most important physical property of voxel model. Traditionally, when creating the Monte Carlo input files, the average tissue parameters recommended in ICRP report were used to assign each voxel in the existing voxel models. However, as each tissue consists of many voxels in which voxels are different in their densities, the method of assigning average tissue parameters doesn't take account of the voxel's discrepancy, and can't represent human anatomy faithfully. To represent human anatomy more faithfully, a method was implemented to assign each voxel, the density of which was derived from CT number. In order to compare with the traditional method, we have constructed two models from a same cadaver specimen date set. A CT-based pelvic voxel model called Pelvis-CT model, was constructed, the densities of which were derived from the CT numbers. A color photograph-based pelvic voxel model called Pelvis-Photo model, was also constructed, the densities of which were taken from ICRP Publication. The CT images and color photographs were obtained from the same female cadaver specimen. The Pelvis-CT and Pelvis-Photo models were ported into Monte Carlo code MCNP to calculate the conversion coefficients from kerma free-in-air to absorbed dose for external monoenergetic photon beams with energies of 0.1, 1 and 10 MeV under anterior-posterior (AP) geometries. The results were compared with those of given in ICRP74. Differences of up to 50% were observed between conversion coefficients of Pelvis-CT and Pelvis-Photo models, moreover the discrepancies decreased for the photon beams with higher energies. The overall trend of conversion coefficients of the Pelvis-CT model were agreed well with that of ICRP74 data. (author)

Construction of a voxel model from CT images with density derived from CT numbers

International Nuclear Information System (INIS)

Cheng Mengyun; Zeng Qin; Cao Ruifen; Li Gui; Zheng Huaqing; Huang Shanqing; Song Gang; Wu Yican

2011-01-01

The voxel models representing human anatomy have been developed to calculate dose distribution in human body, while the density and elemental composition are the most important physical properties of voxel model. Usually, when creating the Monte Carlo input files, the average tissue densities recommended in ICRP Publication were used to assign each voxel in the existing voxel models. As each tissue consists of many voxels with different densities, the conventional method of average tissue densities failed to take account of the voxel's discrepancy, and therefore could not represent human anatomy faithfully. To represent human anatomy more faithfully, a method was implemented to assign each voxel, the densities of which were derived from CT number. In order to compare with the traditional method, we constructed two models from the cadaver specimen dataset. A CT-based pelvic voxel model called Pelvis-CT model was constructed, the densities of which were derived from the CT numbers. A color photograph-based pelvic voxel model called Pelvis-Photo model was also constructed, the densities of which were taken from ICRP Publication. The CT images and the color photographs were obtained from the same female cadaver specimen. The Pelvis-CT and Pelvis-Photo models were both ported into Monte Carlo code MCNP to calculate the conversion coefficients from kerma free-in-air to absorbed dose for external monoenergetic photon beams with energies of 0.1, 1 and 10 MeV under anterior-posterior (AP) geometry. The results were compared with those of given in ICRP Publication 74. Differences of up to 50% were observed between conversion coefficients of Pelvis-CT and Pelvis- Photo models, moreover the discrepancies decreased for the photon beams with higher energies. The overall trend of conversion coefficients of the Pelvis-CT model agreed well with that of ICRP Publication 74 data. (author)

Perceived Impact of Guidance and Counseling Services on the Development of Entrepreneurial Skills for Sustainable Livelihood among Students

Science.gov (United States)

Chinedum, Ubah Anthony; Onwuasoanya, Paul; Eze, Justina

2012-01-01

This paper focused on finding out the opinions of three categories of educators viz.: EA (education administrators), GC (guidance counselors), and CT (classroom teachers) on the impact of guidance and counselling services in entrepreneurship development among secondary school students. Three research questions were drawn to ascertain the opinions…

Evaluation of stability of stereotactic space defined by cone-beam CT for the Leksell Gamma Knife Icon.

Science.gov (United States)

AlDahlawi, Ismail; Prasad, Dheerendra; Podgorsak, Matthew B

2017-05-01

The Gamma Knife Icon comes with an integrated cone-beam CT (CBCT) for image-guided stereotactic treatment deliveries. The CBCT can be used for defining the Leksell stereotactic space using imaging without the need for the traditional invasive frame system, and this allows also for frameless thermoplastic mask stereotactic treatments (single or fractionated) with the Gamma Knife unit. In this study, we used an in-house built marker tool to evaluate the stability of the CBCT-based stereotactic space and its agreement with the standard frame-based stereotactic space. We imaged the tool with a CT indicator box using our CT-simulator at the beginning, middle, and end of the study period (6 weeks) for determining the frame-based stereotactic space. The tool was also scanned with the Icon's CBCT on a daily basis throughout the study period, and the CBCT images were used for determining the CBCT-based stereotactic space. The coordinates of each marker were determined in each CT and CBCT scan using the Leksell GammaPlan treatment planning software. The magnitudes of vector difference between the means of each marker in frame-based and CBCT-based stereotactic space ranged from 0.21 to 0.33 mm, indicating good agreement of CBCT-based and frame-based stereotactic space definition. Scanning 4-month later showed good prolonged stability of the CBCT-based stereotactic space definition. © 2017 The Authors. Journal of Applied Clinical Medical Physics published by Wiley Periodicals, Inc. on behalf of American Association of Physicists in Medicine.

Accuracy and reliability of different cone beam computed tomography (CBCT) devices for structural analysis of alveolar bone in comparison with multislice CT and micro-CT.

Science.gov (United States)

Van Dessel, Jeroen; Nicolielo, Laura Ferreira Pinheiro; Huang, Yan; Coudyzer, Walter; Salmon, Benjamin; Lambrichts, Ivo; Jacobs, Reinhilde

The aim of this study was to assess whether cone beam computed tomography (CBCT) may be used for clinically reliable alveolar bone quality assessment in comparison to its clinical alternatives, multislice computed tomography and the gold standard (micro-CT). Six dentate mandibular bone samples were scanned with seven CBCT devices (ProMax 3D Max, NewTom GiANO, Cranex 3D, 3D Accuitomo 170, Carestream 9300, Scanora 3D, I-CAT Next generation), one micro-CT scanner (SkyScan 1174) and one MSCT machine (Somatom Definition Flash) using two protocols (standard and high-resolution). MSCT and CBCT images were automatically spatially aligned on the micro-CT scan of the corresponding sample. A volume of interest was manually delineated on the micro-CT image and overlaid on the other scanning devices. Alveolar bone structures were automatically extracted using the adaptive thresholding algorithm. Based on the resulting binary images, an automatic 3D morphometric quantification was performed in a CT-Analyser (Bruker, Kontich, Belgium). The reliability and measurement errors were calculated for each modality compared to the gold standard micro-CT. Both MSCT and CBCT were associated with a clinically and statistically (P max, bone surface density -0.47 mm-1 min to 0.16 mm-1 max and trabecular thickness 0.15 mm min to 0.31 mm max) were significantly (P max and fractal dimension 0.08 min to 0.17 max) in all scanners compared to micro-CT. However, the structural pattern of the alveolar bone remained similar compared to that of the micro-CT for the ProMax 3D Max, NewTom GiANO, Cranex 3D, 3D Accuitomo 170 and Carestream 9300. On the other hand, the Scanora 3D, i-CAT Next Generation, standard and high-resolution MSCT displayed an overrated bone quantity and aberrant structural pattern compared to other scanning devices. The calculation of morphometric indices had an overall high reliability (intraclass correlation coefficient [ICC] 0.62 min to 0.99 max), except

Osteoid osteoma: percutaneous treatment with CT guidance

International Nuclear Information System (INIS)

Velan, Osvaldo; Ayzaguer, Alejandro H.; Endara Bustos, Olinda; Lambertini, Roberto G.

2004-01-01

Purpose: The osteoid osteoma (OO) is a benign bone tumor characterized by causing severe and constant pain at night, and for that reason it requires a surgical excision. Although for years the treatment of choice has been surgery, the development of CT-guided percutaneous procedures, such as percutaneous resection with trephine (PR), and more recently the radiofrequency ablation (RF), it is possible to remove the core of the lesion and therefore relieve the symptoms in a considerably less invasive way. Material and methods: Between January 1990 and February 2004, 65 lesions in 60 patients with a presumptive diagnosis of osteoid osteoma were treated. 49 PRs and 16 RFs were performed. Of the 49 PRs, 5 required curettage and one required an ethanol injection. The procedures were guided by CT imaging under general or spinal anesthesia with 24 hr hospitalization. Tumor samples were taken for anatomical pathology analysis (AP). The absence of symptoms and late complications was verified 30 days after the procedure. Results: All lesions were accessed successfully. In 5 of them it was necessary to broaden the resection due to a possible insufficient margin. In 38 of the 65 lesions (58,5%) AP confirmed the OO diagnosis; in 6/65 (9.2%) of them AP found other specific lesions, such as enostoma (n=2), bone cyst (n=1), inclusion cyst (n=1), chondroma (n=1), and chronic osteitis (n=1), and in the rest of the cases the findings were unspecified. All patients (60/60) showed no pain within 24-48 hours of the procedure, and 5/60 (8,3%) received further treatment due to recurring symptoms. Conclusion: The percutaneous procedure has shown to be an effective technique for the treatment of OO. Compared to surgical excision, the percutaneous technique is less invasive, it requires less anesthesia and hospitalization time, and it allows an earlier return to active life. The PR is less expensive than the RF, but it requires a wider bone incision. However, both techniques are equally

Introduction of guidance dose levels inpaediatrics CT

International Nuclear Information System (INIS)

Verdun, F.R.; Valley, J.F.; Bernasconi, M.; Schnyder, P.; Gudinchet, F.

2001-01-01

The purpose of this work is to present a methodology in order to define reference levels for chest or abdominal CT examinations performed on children. For children aged from 0 to 6 the CTDI w measured in the head test object (i.e. diameter 16 cm) should be used as a dose indicator. For children older than 12 years old the CTDI w measured in the body test object (i.e. 32 cm) should be used as a dose indicator. For children aged between 6 to 12 we propose to use an intermediate CTDI w in order to avoid an over or underestimation of the dose delivered in the slices. Finally a set of dose length products (DLP) measured in our centre for standard abdominal acquisitions will be given. (author)

Imatron CT C100 presentation. Limits-advantages

International Nuclear Information System (INIS)

Molle, M.; Molle, S.; Hernigou, A.

1994-01-01

Principles of Electron Beam CT are described and compared to conventional CT. Fast acquisitions and a short exposure time are the major qualities of the machine. Despite of a lower spatial resolution than in mechanical CT it allows exploration of moving organs and especially morphological and dynamic heart studies. The new possibilities of the Continuous Volume Scanning seems to present a promising future outlook. (authors). 5 refs., 4 figs., 1 tab

An experimental approach to improve the Monte Carlo modelling of offline PET/CT-imaging of positron emitters induced by scanned proton beams

International Nuclear Information System (INIS)

Bauer, J; Unholtz, D; Kurz, C; Parodi, K

2013-01-01

We report on the experimental campaign carried out at the Heidelberg Ion-Beam Therapy Center (HIT) to optimize the Monte Carlo (MC) modelling of proton-induced positron-emitter production. The presented experimental strategy constitutes a pragmatic inverse approach to overcome the known uncertainties in the modelling of positron-emitter production due to the lack of reliable cross-section data for the relevant therapeutic energy range. This work is motivated by the clinical implementation of offline PET/CT-based treatment verification at our facility. Here, the irradiation induced tissue activation in the patient is monitored shortly after the treatment delivery by means of a commercial PET/CT scanner and compared to a MC simulated activity expectation, derived under the assumption of a correct treatment delivery. At HIT, the MC particle transport and interaction code FLUKA is used for the simulation of the expected positron-emitter yield. For this particular application, the code is coupled to externally provided cross-section data of several proton-induced reactions. Studying experimentally the positron-emitting radionuclide yield in homogeneous phantoms provides access to the fundamental production channels. Therefore, five different materials have been irradiated by monoenergetic proton pencil beams at various energies and the induced β + activity subsequently acquired with a commercial full-ring PET/CT scanner. With the analysis of dynamically reconstructed PET images, we are able to determine separately the spatial distribution of different radionuclide concentrations at the starting time of the PET scan. The laterally integrated radionuclide yields in depth are used to tune the input cross-section data such that the impact of both the physical production and the imaging process on the various positron-emitter yields is reproduced. The resulting cross-section data sets allow to model the absolute level of measured β + activity induced in the investigated

An experimental approach to improve the Monte Carlo modelling of offline PET/CT-imaging of positron emitters induced by scanned proton beams

Science.gov (United States)

Bauer, J.; Unholtz, D.; Kurz, C.; Parodi, K.

2013-08-01

We report on the experimental campaign carried out at the Heidelberg Ion-Beam Therapy Center (HIT) to optimize the Monte Carlo (MC) modelling of proton-induced positron-emitter production. The presented experimental strategy constitutes a pragmatic inverse approach to overcome the known uncertainties in the modelling of positron-emitter production due to the lack of reliable cross-section data for the relevant therapeutic energy range. This work is motivated by the clinical implementation of offline PET/CT-based treatment verification at our facility. Here, the irradiation induced tissue activation in the patient is monitored shortly after the treatment delivery by means of a commercial PET/CT scanner and compared to a MC simulated activity expectation, derived under the assumption of a correct treatment delivery. At HIT, the MC particle transport and interaction code FLUKA is used for the simulation of the expected positron-emitter yield. For this particular application, the code is coupled to externally provided cross-section data of several proton-induced reactions. Studying experimentally the positron-emitting radionuclide yield in homogeneous phantoms provides access to the fundamental production channels. Therefore, five different materials have been irradiated by monoenergetic proton pencil beams at various energies and the induced β+ activity subsequently acquired with a commercial full-ring PET/CT scanner. With the analysis of dynamically reconstructed PET images, we are able to determine separately the spatial distribution of different radionuclide concentrations at the starting time of the PET scan. The laterally integrated radionuclide yields in depth are used to tune the input cross-section data such that the impact of both the physical production and the imaging process on the various positron-emitter yields is reproduced. The resulting cross-section data sets allow to model the absolute level of measured β+ activity induced in the investigated

CT and MRI of hip arthroplasty

International Nuclear Information System (INIS)

Cahir, J.G.; Toms, A.P.; Marshall, T.J.; Wimhurst, J.; Nolan, J.

2007-01-01

Plain films are the initial imaging method of choice for evaluation of hip arthroplasty. Recent advances in technology and imaging techniques have largely overcome the problems of beam hardening in computed tomography (CT) and magnetic susceptibility artefact in magnetic resonance imaging (MRI). CT and MRI have now become useful imaging techniques in the assessment of hip arthroplasty

Measuring interfraction and intrafraction lung function changes during radiation therapy using four-dimensional cone beam CT ventilation imaging

Energy Technology Data Exchange (ETDEWEB)

Kipritidis, John, E-mail: john.kipritidis@sydney.edu.au; Keall, Paul J. [Radiation Physics Laboratory, Sydney Medical School, University of Sydney, Sydney NSW 2006 (Australia); Hugo, Geoffrey; Weiss, Elisabeth; Williamson, Jeffrey [Department of Radiation Oncology, Virginia Commonwealth University, Richmond, Virginia 23298 (United States)

2015-03-15

Purpose: Adaptive ventilation guided radiation therapy could minimize the irradiation of healthy lung based on repeat lung ventilation imaging (VI) during treatment. However the efficacy of adaptive ventilation guidance requires that interfraction (e.g., week-to-week), ventilation changes are not washed out by intrafraction (e.g., pre- and postfraction) changes, for example, due to patient breathing variability. The authors hypothesize that patients undergoing lung cancer radiation therapy exhibit larger interfraction ventilation changes compared to intrafraction function changes. To test this, the authors perform the first comparison of interfraction and intrafraction lung VI pairs using four-dimensional cone beam CT ventilation imaging (4D-CBCT VI), a novel technique for functional lung imaging. Methods: The authors analyzed a total of 215 4D-CBCT scans acquired for 19 locally advanced non-small cell lung cancer (LA-NSCLC) patients over 4–6 weeks of radiation therapy. This set of 215 scans was sorted into 56 interfraction pairs (including first day scans and each of treatment weeks 2, 4, and 6) and 78 intrafraction pairs (including pre/postfraction scans on the same-day), with some scans appearing in both sets. VIs were obtained from the Jacobian determinant of the transform between the 4D-CBCT end-exhale and end-inhale images after deformable image registration. All VIs were deformably registered to their corresponding planning CT and normalized to account for differences in breathing effort, thus facilitating image comparison in terms of (i) voxelwise Spearman correlations, (ii) mean image differences, and (iii) gamma pass rates for all interfraction and intrafraction VI pairs. For the side of the lung ipsilateral to the tumor, we applied two-sided t-tests to determine whether interfraction VI pairs were more different than intrafraction VI pairs. Results: The (mean ± standard deviation) Spearman correlation for interfraction VI pairs was r{sup -}{sub Inter

Measuring interfraction and intrafraction lung function changes during radiation therapy using four-dimensional cone beam CT ventilation imaging

International Nuclear Information System (INIS)

Kipritidis, John; Keall, Paul J.; Hugo, Geoffrey; Weiss, Elisabeth; Williamson, Jeffrey

2015-01-01

Purpose: Adaptive ventilation guided radiation therapy could minimize the irradiation of healthy lung based on repeat lung ventilation imaging (VI) during treatment. However the efficacy of adaptive ventilation guidance requires that interfraction (e.g., week-to-week), ventilation changes are not washed out by intrafraction (e.g., pre- and postfraction) changes, for example, due to patient breathing variability. The authors hypothesize that patients undergoing lung cancer radiation therapy exhibit larger interfraction ventilation changes compared to intrafraction function changes. To test this, the authors perform the first comparison of interfraction and intrafraction lung VI pairs using four-dimensional cone beam CT ventilation imaging (4D-CBCT VI), a novel technique for functional lung imaging. Methods: The authors analyzed a total of 215 4D-CBCT scans acquired for 19 locally advanced non-small cell lung cancer (LA-NSCLC) patients over 4–6 weeks of radiation therapy. This set of 215 scans was sorted into 56 interfraction pairs (including first day scans and each of treatment weeks 2, 4, and 6) and 78 intrafraction pairs (including pre/postfraction scans on the same-day), with some scans appearing in both sets. VIs were obtained from the Jacobian determinant of the transform between the 4D-CBCT end-exhale and end-inhale images after deformable image registration. All VIs were deformably registered to their corresponding planning CT and normalized to account for differences in breathing effort, thus facilitating image comparison in terms of (i) voxelwise Spearman correlations, (ii) mean image differences, and (iii) gamma pass rates for all interfraction and intrafraction VI pairs. For the side of the lung ipsilateral to the tumor, we applied two-sided t-tests to determine whether interfraction VI pairs were more different than intrafraction VI pairs. Results: The (mean ± standard deviation) Spearman correlation for interfraction VI pairs was r - Inter =0.52±0

TU-EF-207-05: Dedicated Cone-beam Breast CT

International Nuclear Information System (INIS)

Vedantham, S.

2015-01-01

mode due to lower photon fluence per projection. This may require fast-frame acquisition and symmetric or asymmetric pixel binning in some systems. Recent studies investigated the performance of increased conversion layer thickness for contrast-enhanced imaging of the breast in dual-energy acquisition mode. In other direct conversion detectors operating in the avalanche mode, sensitivities close to the single photon response are also explored for mammography and breast tomosynthesis. The potential advantages and challenges of this approach are described. Dedicated breast CT brings x-ray imaging of the breast to true tomographic 3D imaging. It can eliminate the tissue superposition problem and does not require physical compression of the breast. Using cone beam geometry and a flat-panel detector, several hundred projections are acquired and reconstructed to near isotropic voxels. Multiplanar reconstruction facilitates viewing the breast volume in any desired orientation. Ongoing clinical studies, the current state-of-the art, and research to advance the technology are described. Learning Objectives: To understand the ongoing developments in x-ray imaging of the breast To understand the approaches and applications of spectral mammography To understand the potential advantages of distributed x-ray source arrays for digital breast tomosynthesis To understand the ongoing developments in detector technology for digital mammography and breast tomosynthesis To understand the current state-of-the-art for dedicated cone-beam breast CT and research to advance the technology. Research collaboration with Koning Corporation

TU-EF-207-05: Dedicated Cone-beam Breast CT

Energy Technology Data Exchange (ETDEWEB)

Vedantham, S. [Univ. of Massachusetts Medical School (United States)

2015-06-15

mode due to lower photon fluence per projection. This may require fast-frame acquisition and symmetric or asymmetric pixel binning in some systems. Recent studies investigated the performance of increased conversion layer thickness for contrast-enhanced imaging of the breast in dual-energy acquisition mode. In other direct conversion detectors operating in the avalanche mode, sensitivities close to the single photon response are also explored for mammography and breast tomosynthesis. The potential advantages and challenges of this approach are described. Dedicated breast CT brings x-ray imaging of the breast to true tomographic 3D imaging. It can eliminate the tissue superposition problem and does not require physical compression of the breast. Using cone beam geometry and a flat-panel detector, several hundred projections are acquired and reconstructed to near isotropic voxels. Multiplanar reconstruction facilitates viewing the breast volume in any desired orientation. Ongoing clinical studies, the current state-of-the art, and research to advance the technology are described. Learning Objectives: To understand the ongoing developments in x-ray imaging of the breast To understand the approaches and applications of spectral mammography To understand the potential advantages of distributed x-ray source arrays for digital breast tomosynthesis To understand the ongoing developments in detector technology for digital mammography and breast tomosynthesis To understand the current state-of-the-art for dedicated cone-beam breast CT and research to advance the technology. Research collaboration with Koning Corporation.

CT fluoroscopy-assisted puncture of thoracic and abdominal masses: a randomized trial.

Science.gov (United States)

Kirchner, Johannes; Kickuth, Ralph; Laufer, Ulf; Schilling, Esther Maria; Adams, Stephan; Liermann, Dieter

2002-03-01

We investigated the benefit of real-time guidance of interventional punctures by means of computed tomography fluoroscopy (CTF) compared with the conventional sequential acquisition guidance. In a prospective randomized trial, 75 patients underwent either CTF-guided (group A, n = 50) or sequential CT-guided (group B, n = 25) punctures of thoracic (n = 29) or abdominal (n = 46) masses. CTF was performed on the CT machine (Somatom Plus 4 Power, Siemens Corp., Forchheim, Germany) equipped with the C.A.R.E. Vision application (tube voltage 120 kV, tube current 50 mA, rotational time 0.75 s, slice thickness 10 mm, 8 frames/s). The average procedure time showed a statistically significant difference between the two study groups (group A: 564 s, group B 795 s, P = 0.0032). The mean total mAs was 7089 mAs for the CTF and 4856 mAs for the sequential image-guided intervention, respectively. The sensitivity was 71% specificity 100% positive predictive value 100% and negative predictive value 60% for the CTF-guided puncture, and 68, 100, 100 and 50% for sequential CT, respectively. CTF guidance realizes a time-saving but increases the radiation exposure dosage.

Computed Tomography (CT) -- Sinuses

Medline Plus

Full Text Available ... up in shades of gray, and air appears black. With CT scanning, numerous x-ray beams and ... Safety page for more information about radiation dose. Women should always inform their physician and x-ray ...

Abdominal and Pelvic CT

Medline Plus

Full Text Available ... up in shades of gray, and air appears black. With CT scanning, numerous x-ray beams and ... Safety page for more information about radiation dose. Women should always inform their physician and x-ray ...

Computed Tomography (CT) -- Head

Medline Plus

Full Text Available ... up in shades of gray, and air appears black. With CT scanning, numerous x-ray beams and ... Safety page for more information about radiation dose. Women should always inform their physician and x-ray ...

Abdominal and Pelvic CT

Medline Plus

Full Text Available ... the examination table will move during the scan, so that the x-ray beam follows a spiral ... and additional view capabilities. Modern CT scanners are so fast that they can scan through large sections ...

Computed Tomography (CT) -- Sinuses

Medline Plus

Full Text Available ... the examination table will move during the scan, so that the x-ray beam follows a spiral ... and additional view capabilities. Modern CT scanners are so fast that they can scan through large sections ...

Computed Tomography (CT) -- Head

Medline Plus

Full Text Available ... the examination table will move during the scan, so that the x-ray beam follows a spiral ... and additional view capabilities. Modern CT scanners are so fast that they can scan through large sections ...

Regression and statistical shape model based substitute CT generation for MRI alone external beam radiation therapy from standard clinical MRI sequences

Science.gov (United States)

Ghose, Soumya; Greer, Peter B.; Sun, Jidi; Pichler, Peter; Rivest-Henault, David; Mitra, Jhimli; Richardson, Haylea; Wratten, Chris; Martin, Jarad; Arm, Jameen; Best, Leah; Dowling, Jason A.

2017-11-01

In MR only radiation therapy planning, generation of the tissue specific HU map directly from the MRI would eliminate the need of CT image acquisition and may improve radiation therapy planning. The aim of this work is to generate and validate substitute CT (sCT) scans generated from standard T2 weighted MR pelvic scans in prostate radiation therapy dose planning. A Siemens Skyra 3T MRI scanner with laser bridge, flat couch and pelvic coil mounts was used to scan 39 patients scheduled for external beam radiation therapy for localized prostate cancer. For sCT generation a whole pelvis MRI (1.6 mm 3D isotropic T2w SPACE sequence) was acquired. Patients received a routine planning CT scan. Co-registered whole pelvis CT and T2w MRI pairs were used as training images. Advanced tissue specific non-linear regression models to predict HU for the fat, muscle, bladder and air were created from co-registered CT-MRI image pairs. On a test case T2w MRI, the bones and bladder were automatically segmented using a novel statistical shape and appearance model, while other soft tissues were separated using an Expectation-Maximization based clustering model. The CT bone in the training database that was most ‘similar’ to the segmented bone was then transformed with deformable registration to create the sCT component of the test case T2w MRI bone tissue. Predictions for the bone, air and soft tissue from the separate regression models were successively combined to generate a whole pelvis sCT. The change in monitor units between the sCT-based plans relative to the gold standard CT plan for the same IMRT dose plan was found to be 0.3%+/-0.9% (mean  ±  standard deviation) for 39 patients. The 3D Gamma pass rate was 99.8+/-0.00 (2 mm/2%). The novel hybrid model is computationally efficient, generating an sCT in 20 min from standard T2w images for prostate cancer radiation therapy dose planning and DRR generation.

Beam standardization and dosimetric methodology in computed tomography

International Nuclear Information System (INIS)

Maia, Ana Figueiredo

2005-01-01

Special ionization chambers, named pencil ionization chambers, are used in dosimetric procedures in computed tomography beams (CT). In this work, an extensive study about pencil ionization chambers was performed, as a contribution to the accuracy of the dosimetric procedures in CT beams. The international scientific community has recently been discussing the need of the establishment of a specific calibration procedure for CT ionization chambers, once these chambers present special characteristics that differentiate them from other ionization chambers used in diagnostic radiology beams. In this work, an adequate calibration procedure for pencil ionization chambers was established at the Calibration Laboratory, of the Institute de Pesquisas Energeticas e Nucleares, in accordance with the most recent international recommendations. Two calibration methodologies were tested and analyzed by comparative studies. Moreover, a new extended length parallel plate ionization chamber, with a transversal section very similar to pencil ionization chambers, was developed. The operational characteristics of this chamber were determined and the results obtained showed that its behaviour is adequate as a reference system in CT standard beams. Two other studies were performed during this work, both using CT ionization chambers. The first study was about the performance of a pencil ionization chamber in standard radiation beams of several types and energies, and the results showed that this chamber presents satisfactory behaviour in other radiation qualities as of diagnostic radiology, mammography and radiotherapy. In the second study, a tandem system for verification of hal'-value layer variations in CT equipment, using a pencil ionization chamber, was developed. Because of the X rays tube rotation, the determination of half-value layers in computed tomography equipment is not an easy task, and it is usually not performed within quality control programs. (author)

A prototype table-top inverse-geometry volumetric CT system

International Nuclear Information System (INIS)

Schmidt, Taly Gilat; Star-Lack, Josh; Bennett, N. Robert; Mazin, Samuel R.; Solomon, Edward G.; Fahrig, Rebecca; Pelc, Norbert J.

2006-01-01

A table-top volumetric CT system has been implemented that is able to image a 5-cm-thick volume in one circular scan with no cone-beam artifacts. The prototype inverse-geometry CT (IGCT) scanner consists of a large-area, scanned x-ray source and a detector array that is smaller in the transverse direction. The IGCT geometry provides sufficient volumetric sampling because the source and detector have the same axial, or slice direction, extent. This paper describes the implementation of the table-top IGCT scanner, which is based on the NexRay Scanning-Beam Digital X-ray system (NexRay, Inc., Los Gatos, CA) and an investigation of the system performance. The alignment and flat-field calibration procedures are described, along with a summary of the reconstruction algorithm. The resolution and noise performance of the prototype IGCT system are studied through experiments and further supported by analytical predictions and simulations. To study the presence of cone-beam artifacts, a ''Defrise'' phantom was scanned on both the prototype IGCT scanner and a micro CT system with a ±5 deg.cone angle for a 4.5-cm volume thickness. Images of inner ear specimens are presented and compared to those from clinical CT systems. Results showed that the prototype IGCT system has a 0.25-mm isotropic resolution and that noise comparable to that from a clinical scanner with equivalent spatial resolution is achievable. The measured MTF and noise values agreed reasonably well with theoretical predictions and computer simulations. The IGCT system was able to faithfully reconstruct the laminated pattern of the Defrise phantom while the micro CT system suffered severe cone-beam artifacts for the same object. The inner ear acquisition verified that the IGCT system can image a complex anatomical object, and the resulting images exhibited more high-resolution details than the clinical CT acquisition. Overall, the successful implementation of the prototype system supports the IGCT concept for

The measurement of proton stopping power using proton-cone-beam computed tomography

International Nuclear Information System (INIS)

Zygmanski, P.; Rabin, M.S.Z.; Gall, K.P.; Rosenthal, S.J.

2000-01-01

A cone-beam computed tomography (CT) system utilizing a proton beam has been developed and tested. The cone beam is produced by scattering a 160 MeV proton beam with a modifier that results in a signal in the detector system, which decreases monotonically with depth in the medium. The detector system consists of a Gd 2 O 2 S:Tb intensifying screen viewed by a cooled CCD camera. The Feldkamp-Davis-Kress cone-beam reconstruction algorithm is applied to the projection data to obtain the CT voxel data representing proton stopping power. The system described is capable of reconstructing data over a 16x16x16cm 3 volume into 512x512x512 voxels. A spatial and contrast resolution phantom was scanned to determine the performance of the system. Spatial resolution is significantly degraded by multiple Coulomb scattering effects. Comparison of the reconstructed proton CT values with x-ray CT derived proton stopping powers shows that there may be some advantage to obtaining stopping powers directly with proton CT. The system described suggests a possible practical method of obtaining this measurement in vivo. (author)

CT-guided percutaneous treatment of osteoid osteoma

International Nuclear Information System (INIS)

Mazoyer, J.F.; Kohler, R.; Bossard, D.

1990-01-01

The authors of this paper report seven cases of percutaneous destruction of osteoid osteoma. All patients complained of typical pain lasting for several months. In each case, finding of plain radiography, bone scintigraphy, and CT were strongly suggestive of an osteoid osteoma. All the lesions were located on the lower limb (five femoral and two tibial). Under general anesthesia, the nidus was drilled through a trocar inserted percutaneously with CT guidance. Patients were discharged 1-3 days after the procedure with no residual pain, and they are still asymptomatic 18-33 months later, with normal scintigraphic and CT studies. Histologic confirmation was allowed by technical improvement of the method in the last four cases

Analysis of laser-induced heating in optical neuronal guidance

DEFF Research Database (Denmark)

Ebbesen, Christian L.; Bruus, Henrik

2012-01-01

Recently, it has been shown that it is possible to control the growth direction of neuronal growth cones by stimulation with weak laser light; an effect dubbed optical neuronal guidance. The effect exists for a broad range of laser wavelengths, spot sizes, spot intensities, optical intensity...... profiles and beam modulations, but it is unknown which biophysical mechanisms govern it. Based on thermodynamic modeling and simulation using published experimental parameters as input, we argue that the guidance is linked to heating. Until now, temperature effects due to laser-induced heating...

X-ray absorption microtomography (microCT) and small beam diffraction mapping of sea urchin teeth.

Science.gov (United States)

Stock, S R; Barss, J; Dahl, T; Veis, A; Almer, J D

2002-07-01

Two noninvasive X-ray techniques, laboratory X-ray absorption microtomography (microCT) and X-ray diffraction mapping, were used to study teeth of the sea urchin Lytechinus variegatus. MicroCT revealed low attenuation regions at near the tooth's stone part and along the carinar process-central prism boundary; this latter observation appears to be novel. The expected variation of Mg fraction x in the mineral phase (calcite, Ca(1-x)Mg(x)CO(3)) cannot account for all of the linear attenuation coefficient decrease in the two zones: this suggested that soft tissue is localized there. Transmission diffraction mapping (synchrotron X-radiation, 80.8 keV, 0.1 x 0.1mm(2) beam area, 0.1mm translation grid, image plate area detector) simultaneously probed variations in 3-D and showed that the crystal elements of the "T"-shaped tooth were very highly aligned. Diffraction patterns from the keel (adaxial web) and from the abaxial flange (containing primary plates and the stone part) differed markedly. The flange contained two populations of identically oriented crystal elements with lattice parameters corresponding to x=0.13 and x=0.32. The keel produced one set of diffraction spots corresponding to the lower x. The compositions were more or less equivalent to those determined by others for camarodont teeth, and the high Mg phase is expected to be disks of secondary mineral epitaxially related to the underlying primary mineral element. Lattice parameter gradients were not noted in the keel or flange. Taken together, the microCT and diffraction results indicated that there was a band of relatively high protein content, of up to approximately 0.25 volume fraction, in the central part of the flange and paralleling its adaxial and abaxial faces. X-ray microCT and microdiffraction data used in conjunction with protein distribution data will be crucial for understanding the properties of various biocomposites and their mechanical functions.

Cone beam CT imaging with limited angle of projections and prior knowledge for volumetric verification of non-coplanar beam radiation therapy: a proof of concept study

Science.gov (United States)

Meng, Bowen; Xing, Lei; Han, Bin; Koong, Albert; Chang, Daniel; Cheng, Jason; Li, Ruijiang

2013-11-01

Non-coplanar beams are important for treatment of both cranial and noncranial tumors. Treatment verification of such beams with couch rotation/kicks, however, is challenging, particularly for the application of cone beam CT (CBCT). In this situation, only limited and unconventional imaging angles are feasible to avoid collision between the gantry, couch, patient, and on-board imaging system. The purpose of this work is to develop a CBCT verification strategy for patients undergoing non-coplanar radiation therapy. We propose an image reconstruction scheme that integrates a prior image constrained compressed sensing (PICCS) technique with image registration. Planning CT or CBCT acquired at the neutral position is rotated and translated according to the nominal couch rotation/translation to serve as the initial prior image. Here, the nominal couch movement is chosen to have a rotational error of 5° and translational error of 8 mm from the ground truth in one or more axes or directions. The proposed reconstruction scheme alternates between two major steps. First, an image is reconstructed using the PICCS technique implemented with total-variation minimization and simultaneous algebraic reconstruction. Second, the rotational/translational setup errors are corrected and the prior image is updated by applying rigid image registration between the reconstructed image and the previous prior image. The PICCS algorithm and rigid image registration are alternated iteratively until the registration results fall below a predetermined threshold. The proposed reconstruction algorithm is evaluated with an anthropomorphic digital phantom and physical head phantom. The proposed algorithm provides useful volumetric images for patient setup using projections with an angular range as small as 60°. It reduced the translational setup errors from 8 mm to generally <1 mm and the rotational setup errors from 5° to <1°. Compared with the PICCS algorithm alone, the integration of rigid

CT evaluation of complications of cryoablation treatment in lung cancer

International Nuclear Information System (INIS)

Zhu Caiqiao; Chen Yao; Zhang Zhitian; Su Jinzhan; Huang Zhen; Bao Kaikai

2011-01-01

Objective: To assess the complications of percutaneous targeted Argon-Helium cryoablation treatment in patients with lung cancer on CT. Methods: Ten patients with unresectable lung cancer were treated by cryotherapy under CT guidance with Argon-Helium cryoablation system. Dynamic contrast-enhanced CT was performed to assess changes before and after treatment, complications and treatment response. Results: Ice ball coverage immediately after surgery was satisfactory in all patients. There were a few complications including worsening hoarseness (1), small pneumothorax (1), and small amount of bleeding at the site of probe puncture (1). Conclusion: Percutaneous targeted Argon-Helium cryoablation guided by CT is an effective treatment for lung cancer without severe complications. (authors)

Cardiac and pulmonary dose reduction for tangentially irradiated breast cancer, utilizing deep inspiration breath-hold with audio-visual guidance, without compromising target coverage

International Nuclear Information System (INIS)

Vikstroem, Johan; Hjelstuen, Mari H.B.; Mjaaland, Ingvil; Dybvik, Kjell Ivar

2011-01-01

Background and purpose. Cardiac disease and pulmonary complications are documented risk factors in tangential breast irradiation. Respiratory gating radiotherapy provides a possibility to substantially reduce cardiopulmonary doses. This CT planning study quantifies the reduction of radiation doses to the heart and lung, using deep inspiration breath-hold (DIBH). Patients and methods. Seventeen patients with early breast cancer, referred for adjuvant radiotherapy, were included. For each patient two CT scans were acquired; the first during free breathing (FB) and the second during DIBH. The scans were monitored by the Varian RPM respiratory gating system. Audio coaching and visual feedback (audio-visual guidance) were used. The treatment planning of the two CT studies was performed with conformal tangential fields, focusing on good coverage (V95>98%) of the planning target volume (PTV). Dose-volume histograms were calculated and compared. Doses to the heart, left anterior descending (LAD) coronary artery, ipsilateral lung and the contralateral breast were assessed. Results. Compared to FB, the DIBH-plans obtained lower cardiac and pulmonary doses, with equal coverage of PTV. The average mean heart dose was reduced from 3.7 to 1.7 Gy and the number of patients with >5% heart volume receiving 25 Gy or more was reduced from four to one of the 17 patients. With DIBH the heart was completely out of the beam portals for ten patients, with FB this could not be achieved for any of the 17 patients. The average mean dose to the LAD coronary artery was reduced from 18.1 to 6.4 Gy. The average ipsilateral lung volume receiving more than 20 Gy was reduced from 12.2 to 10.0%. Conclusion. Respiratory gating with DIBH, utilizing audio-visual guidance, reduces cardiac and pulmonary doses for tangentially treated left sided breast cancer patients without compromising the target coverage

Cardiac and pulmonary dose reduction for tangentially irradiated breast cancer, utilizing deep inspiration breath-hold with audio-visual guidance, without compromising target coverage

Energy Technology Data Exchange (ETDEWEB)

Vikstroem, Johan; Hjelstuen, Mari H.B.; Mjaaland, Ingvil; Dybvik, Kjell Ivar (Dept. of Radiotherapy, Stavanger Univ. Hospital, Stavanger (Norway)), e-mail: vijo@sus.no

2011-01-15

Background and purpose. Cardiac disease and pulmonary complications are documented risk factors in tangential breast irradiation. Respiratory gating radiotherapy provides a possibility to substantially reduce cardiopulmonary doses. This CT planning study quantifies the reduction of radiation doses to the heart and lung, using deep inspiration breath-hold (DIBH). Patients and methods. Seventeen patients with early breast cancer, referred for adjuvant radiotherapy, were included. For each patient two CT scans were acquired; the first during free breathing (FB) and the second during DIBH. The scans were monitored by the Varian RPM respiratory gating system. Audio coaching and visual feedback (audio-visual guidance) were used. The treatment planning of the two CT studies was performed with conformal tangential fields, focusing on good coverage (V95>98%) of the planning target volume (PTV). Dose-volume histograms were calculated and compared. Doses to the heart, left anterior descending (LAD) coronary artery, ipsilateral lung and the contralateral breast were assessed. Results. Compared to FB, the DIBH-plans obtained lower cardiac and pulmonary doses, with equal coverage of PTV. The average mean heart dose was reduced from 3.7 to 1.7 Gy and the number of patients with >5% heart volume receiving 25 Gy or more was reduced from four to one of the 17 patients. With DIBH the heart was completely out of the beam portals for ten patients, with FB this could not be achieved for any of the 17 patients. The average mean dose to the LAD coronary artery was reduced from 18.1 to 6.4 Gy. The average ipsilateral lung volume receiving more than 20 Gy was reduced from 12.2 to 10.0%. Conclusion. Respiratory gating with DIBH, utilizing audio-visual guidance, reduces cardiac and pulmonary doses for tangentially treated left sided breast cancer patients without compromising the target coverage

A comprehensive study on decreasing the kilovoltage cone-beam CT dose by reducing the projection number.

Science.gov (United States)

Lu, Bo; Lu, Haibin; Palta, Jatinder

2010-05-12

The objective of this study was to evaluate the effect of kilovoltage cone-beam computed tomography (CBCT) on registration accuracy and image qualities with a reduced number of planar projections used in volumetric imaging reconstruction. The ultimate goal is to evaluate the possibility of reducing the patient dose while maintaining registration accuracy under different projection-number schemes for various clinical sites. An Elekta Synergy Linear accelerator with an onboard CBCT system was used in this study. The quality of the Elekta XVI cone-beam three-dimensional volumetric images reconstructed with a decreasing number of projections was quantitatively evaluated by a Catphan phantom. Subsequently, we tested the registration accuracy of imaging data sets on three rigid anthropomorphic phantoms and three real patient sites under the reduced projection-number (as low as 1/6th) reconstruction of CBCT data with different rectilinear shifts and rota-tions. CBCT scan results of the Catphan phantom indicated the CBCT images got noisier when the number of projections was reduced, but their spatial resolution and uniformity were hardly affected. The maximum registration errors under the small amount transformation of the reference CT images were found to be within 0.7 mm translation and 0.3 masculine rotation. However, when the projection number was lower than one-fourth of the full set with a large amount of transformation of reference CT images, the registration could easily be trapped into local minima solutions for a nonrigid anatomy. We concluded, by using projection-number reduction strategy under conscientious care, imaging-guided localization procedure could achieve a lower patient dose without losing the registration accuracy for various clinical sites and situations. A faster scanning time is the main advantage compared to the mA decrease-based, dose-reduction method.

Radiographic evaluation of dentigerous cyst with cone beam CT

International Nuclear Information System (INIS)

Park, Yong Chan; Lee, Wan; Lee, Byung Do

2010-01-01

The purpose of this study was to accurately analyze the radiographic characteristics of dentigerous cyst (DC) with multiplanar images of cone beam computed tomography (CBCT). Thirty eight radiographically and histopathologically proven cases of DCs were analyzed with panoramic radiograph and CBCT, retrospectively. The radiographic CT pattern, symmetry of radiolucency around the unerupted tooth crown, ratio of long length to short length, degree of cortical bone alternation, effects on adjacent tooth, and cyst size were analyzed. Relative frequencies of these radiographic features were evaluated. In order to compare the CBCT features of DC with those of odontogenic keratocyst (OKC), 9 cases of OKCs were analyzed with the same method radiographically. DCs consisted of thirty unilocular cases (79.0%), seven lobulated cases (18.4%) and one multilocular case (2.6%). Eight were asymmetric (21.0%) and thirty were symmetric (79.0%). Maxillary DC showed rounder shape than mandibular DC (L/S ratio; maxilla 1.32, mandible 1.67). Alternations of lingual cortical bone (14 cases, 48.2%) were more frequent than those of buccal side (7 cases, 24.1%). CBCT images of DC showed definite root resorption and bucco-lingual tooth displacement. These findings were hardly observed on panoramic radiographs of DCs. Comparison of CBCT features of DC with those of OKC showed several different features. CBCT images of DC showed various characteristic radiographic features. Therefore, CBCT can be helpful for the diagnosis of DC radiographically.

Radiographic evaluation of dentigerous cyst with cone beam CT

Energy Technology Data Exchange (ETDEWEB)

Park, Yong Chan; Lee, Wan; Lee, Byung Do [School of Dentisity, Wonkwang University, Iksan (Korea, Republic of)

2010-09-15

The purpose of this study was to accurately analyze the radiographic characteristics of dentigerous cyst (DC) with multiplanar images of cone beam computed tomography (CBCT). Thirty eight radiographically and histopathologically proven cases of DCs were analyzed with panoramic radiograph and CBCT, retrospectively. The radiographic CT pattern, symmetry of radiolucency around the unerupted tooth crown, ratio of long length to short length, degree of cortical bone alternation, effects on adjacent tooth, and cyst size were analyzed. Relative frequencies of these radiographic features were evaluated. In order to compare the CBCT features of DC with those of odontogenic keratocyst (OKC), 9 cases of OKCs were analyzed with the same method radiographically. DCs consisted of thirty unilocular cases (79.0%), seven lobulated cases (18.4%) and one multilocular case (2.6%). Eight were asymmetric (21.0%) and thirty were symmetric (79.0%). Maxillary DC showed rounder shape than mandibular DC (L/S ratio; maxilla 1.32, mandible 1.67). Alternations of lingual cortical bone (14 cases, 48.2%) were more frequent than those of buccal side (7 cases, 24.1%). CBCT images of DC showed definite root resorption and bucco-lingual tooth displacement. These findings were hardly observed on panoramic radiographs of DCs. Comparison of CBCT features of DC with those of OKC showed several different features. CBCT images of DC showed various characteristic radiographic features. Therefore, CBCT can be helpful for the diagnosis of DC radiographically.

Prostate image-guided radiotherapy by megavolt cone-beam CT

International Nuclear Information System (INIS)

Zucca, Sergio; Carau, Barbara; Solla, Ignazio; Garibaldi, Elisabetta; Farace, Paolo; Lay, Giancarlo; Meleddu, Gianfranco; Gabriele, Pietro

2011-01-01

To test megavolt cone-beam CT (MV-CBCT) in order to evaluate setup errors in prostate radiotherapy. The setup of 9 patients was verified weekly by electronic portal imaging (EPI) and MV-CBCT, both performed in the same treatment session. EPI were compared with digitally reconstructed radiographies (DRRs). MV-CBCTs were matched to simulation CTs by manual registration based on bone markers (BMR), by manual registration based on soft tissues (STR) - rectum, bladder, and seminal vesicles - and by automatic registration (AR) performed by a mutual information algorithm. Shifts were evaluated along the three main axes: anteroposterior (AP), craniocaudal (CC), and laterolateral (LL). Finally, in 4 additional patients showing intraprostatic calcifications, the calcification mismatch error was used to evaluate the three MV-CBCT matching methods. A total of 50 pairs of orthogonal EPIs and 50 MV-CBCTs were analyzed. Assuming an overall tolerance of 2 mm, no significant differences were observed comparing EPI vs BMR in any axis. A significant difference (p < 0.001) was observed along the AP axis comparing EPI vs AR and EPI vs STR. On the calcification data set (22 measures), the calcification mismatch along the AP direction was significantly lower (p < 0.05) after STR than after BMR or AR. Bone markers were not an effective surrogate of the target position and significant differences were observed comparing EPI or BMR vs STR, supporting the assessment of soft tissue position by MVCBs to verify and correct patient setup in prostate radiotherapy. (orig.)

Prostate image-guided radiotherapy by megavolt cone-beam CT

Energy Technology Data Exchange (ETDEWEB)

Zucca, Sergio; Carau, Barbara; Solla, Ignazio; Garibaldi, Elisabetta; Farace, Paolo; Lay, Giancarlo; Meleddu, Gianfranco; Gabriele, Pietro [Regional Oncological Hospital, Cagliari (Italy). Dept. of Radiooncology

2011-08-15

To test megavolt cone-beam CT (MV-CBCT) in order to evaluate setup errors in prostate radiotherapy. The setup of 9 patients was verified weekly by electronic portal imaging (EPI) and MV-CBCT, both performed in the same treatment session. EPI were compared with digitally reconstructed radiographies (DRRs). MV-CBCTs were matched to simulation CTs by manual registration based on bone markers (BMR), by manual registration based on soft tissues (STR) - rectum, bladder, and seminal vesicles - and by automatic registration (AR) performed by a mutual information algorithm. Shifts were evaluated along the three main axes: anteroposterior (AP), craniocaudal (CC), and laterolateral (LL). Finally, in 4 additional patients showing intraprostatic calcifications, the calcification mismatch error was used to evaluate the three MV-CBCT matching methods. A total of 50 pairs of orthogonal EPIs and 50 MV-CBCTs were analyzed. Assuming an overall tolerance of 2 mm, no significant differences were observed comparing EPI vs BMR in any axis. A significant difference (p < 0.001) was observed along the AP axis comparing EPI vs AR and EPI vs STR. On the calcification data set (22 measures), the calcification mismatch along the AP direction was significantly lower (p < 0.05) after STR than after BMR or AR. Bone markers were not an effective surrogate of the target position and significant differences were observed comparing EPI or BMR vs STR, supporting the assessment of soft tissue position by MVCBs to verify and correct patient setup in prostate radiotherapy. (orig.)

Cine-CT: A new technique in X-ray computed tomography

International Nuclear Information System (INIS)

Jaschke, W.; Georgi, M.; Lipton, M.J.; Gould, R.G.

1988-01-01

The 'Cine-CT' belongs to a new generation of CT devices permitting not only diagnostics on a morphological basis but also function studies. By means of Cine-CT's electron beam technique, image frequencies of up to 17 images per second and exposure times of 50 msec are possible. (orig.) [de

Compensation techniques in NIRS proton beam radiotherapy

International Nuclear Information System (INIS)

Akanuma, A.; Majima, H.; Furukawa, S.

1982-01-01

Proton beam has the dose distribution advantage in radiation therapy, although it has little advantage in biological effects. One of the best advantages is its sharp fall off of dose after the peak. With proton beam, therefore, the dose can be given just to cover a target volume and potentially no dose is delivered thereafter in the beam direction. To utilize this advantage, bolus techniques in conjunction with CT scanning are employed in NIRS proton beam radiation therapy planning. A patient receives CT scanning first so that the target volume can be clearly marked and the radiation direction and fixation method can be determined. At the same time bolus dimensions are calculated. The bolus frames are made with dental paraffin sheets according to the dimensions. The paraffin frame is replaced with dental resin. Alginate (a dental impression material with favorable physical density and skin surface contact) is now employed for the bolus material. With fixation device and bolus on, which are constructed individually, the patient receives CT scanning again prior to a proton beam treatment in order to prove the devices are suitable. Alginate has to be poured into the frame right before each treatments. Further investigations are required to find better bolus materials and easier construction methods

Compensation techniques in NIRS proton beam radiotherapy

Energy Technology Data Exchange (ETDEWEB)

Akanuma, A. (Univ. of Tokyo, Japan); Majima, H.; Furukawa, S.

1982-09-01

Proton beam has the dose distribution advantage in radiation therapy, although it has little advantage in biological effects. One of the best advantages is its sharp fall off of dose after the peak. With proton beam, therefore, the dose can be given just to cover a target volume and potentially no dose is delivered thereafter in the beam direction. To utilize this advantage, bolus techniques in conjunction with CT scanning are employed in NIRS proton beam radiation therapy planning. A patient receives CT scanning first so that the target volume can be clearly marked and the radiation direction and fixation method can be determined. At the same time bolus dimensions are calculated. The bolus frames are made with dental paraffin sheets according to the dimensions. The paraffin frame is replaced with dental resin. Alginate (a dental impression material with favorable physical density and skin surface contact) is now employed for the bolus material. With fixation device and bolus on, which are constructed individually, the patient receives CT scanning again prior to a proton beam treatment in order to prove the devices are suitable. Alginate has to be poured into the frame right before each treatments. Further investigations are required to find better bolus materials and easier construction methods.

Three-dimensional monochromatic x-ray CT

Science.gov (United States)

Saito, Tsuneo; Kudo, Hiroyuki; Takeda, Tohoru; Itai, Yuji; Tokumori, Kenji; Toyofuku, Fukai; Hyodo, Kazuyuki; Ando, Masami; Nishimura, Ktsuyuki; Uyama, Chikao

1995-08-01

In this paper, we describe a 3D computed tomography (3D CT) using monochromatic x-rays generated by synchrotron radiation, which performs a direct reconstruction of 3D volume image of an object from its cone-beam projections. For the develpment of 3D CT, scanning orbit of x-ray source to obtain complete 3D information about an object and corresponding 3D image reconstruction algorithm are considered. Computer simulation studies demonstrate the validities of proposed scanning method and reconstruction algorithm. A prototype experimental system of 3D CT was constructed. Basic phantom examinations and specific material CT image by energy subtraction obtained in this experimental system are shown.

WE-DE-207B-11: Implementation of Size-Specific 3D Beam Modulation Filters On a Dedicated Breast CT Platform Using Breast Immobilization

Energy Technology Data Exchange (ETDEWEB)

Hernandez, A [Department of Radiology, Biomedical Engineering Graduate Group, University of California Davis, Sacramento, CA (United States); Boone, J [Departments of Radiology and Biomedical Engineering, University of California Davis, Sacramento, CA (United States)

2016-06-15

Purpose: To implement a 3D beam modulation filter (3D-BMF) in dedicated breast CT (bCT) and develop a method for conforming the patient’s breast to a pre-defined shape, optimizing the effects of the filter. This work expands on previous work reporting the methodology for designing a 3D-BMF that can spare unnecessary dose and improve signal equalization at the detector by preferentially filtering the beam in the thinner anterior and peripheral breast regions. Methods: Effective diameter profiles were measured for 219 segmented bCT images, grouped into volume quintiles, and averaged within each group to represent the range of breast sizes found clinically. These profiles were then used to generate five size-specific computational phantoms and fabricate five size-specific UHMW phantoms. Each computational phantom was utilized for designing a size-specific 3D-BMF using previously reported methods. Glandular dose values and projection images were simulated in MCNP6 with and without the 3DBMF using the system specifications of our prototype bCT scanner “Doheny”. Lastly, thermoplastic was molded around each of the five phantom sizes and used to produce a series of breast immobilizers for use in conforming the patient’s breast during bCT acquisition. Results: After incorporating the 3D-BMF, MC simulations estimated an 80% average reduction in the detector dynamic range requirements across all phantom sizes. The glandular dose was reduced on average 57% after normalizing by the number of quanta reaching the detector under the thickest region of the breast. Conclusion: A series of bCT-derived breast phantoms were used to design size-specific 3D-BMFs and breast immobilizers that can be used on the bCT platform to conform the patient’s breast and therefore optimally exploit the benefits of the 3D-BMF. Current efforts are focused on fabricating several prototype 3D-BMFs and performing phantom scans on Doheny for MC simulation validation and image quality analysis

WE-DE-207B-11: Implementation of Size-Specific 3D Beam Modulation Filters On a Dedicated Breast CT Platform Using Breast Immobilization

International Nuclear Information System (INIS)

Hernandez, A; Boone, J

2016-01-01

Purpose: To implement a 3D beam modulation filter (3D-BMF) in dedicated breast CT (bCT) and develop a method for conforming the patient’s breast to a pre-defined shape, optimizing the effects of the filter. This work expands on previous work reporting the methodology for designing a 3D-BMF that can spare unnecessary dose and improve signal equalization at the detector by preferentially filtering the beam in the thinner anterior and peripheral breast regions. Methods: Effective diameter profiles were measured for 219 segmented bCT images, grouped into volume quintiles, and averaged within each group to represent the range of breast sizes found clinically. These profiles were then used to generate five size-specific computational phantoms and fabricate five size-specific UHMW phantoms. Each computational phantom was utilized for designing a size-specific 3D-BMF using previously reported methods. Glandular dose values and projection images were simulated in MCNP6 with and without the 3DBMF using the system specifications of our prototype bCT scanner “Doheny”. Lastly, thermoplastic was molded around each of the five phantom sizes and used to produce a series of breast immobilizers for use in conforming the patient’s breast during bCT acquisition. Results: After incorporating the 3D-BMF, MC simulations estimated an 80% average reduction in the detector dynamic range requirements across all phantom sizes. The glandular dose was reduced on average 57% after normalizing by the number of quanta reaching the detector under the thickest region of the breast. Conclusion: A series of bCT-derived breast phantoms were used to design size-specific 3D-BMFs and breast immobilizers that can be used on the bCT platform to conform the patient’s breast and therefore optimally exploit the benefits of the 3D-BMF. Current efforts are focused on fabricating several prototype 3D-BMFs and performing phantom scans on Doheny for MC simulation validation and image quality analysis

Correction of CT artifacts and its influence on Monte Carlo dose calculations

International Nuclear Information System (INIS)

Bazalova, Magdalena; Beaulieu, Luc; Palefsky, Steven; Verhaegen, Frank

2007-01-01

Computed tomography (CT) images of patients having metallic implants or dental fillings exhibit severe streaking artifacts. These artifacts may disallow tumor and organ delineation and compromise dose calculation outcomes in radiotherapy. We used a sinogram interpolation metal streaking artifact correction algorithm on several phantoms of exact-known compositions and on a prostate patient with two hip prostheses. We compared original CT images and artifact-corrected images of both. To evaluate the effect of the artifact correction on dose calculations, we performed Monte Carlo dose calculation in the EGSnrc/DOSXYZnrc code. For the phantoms, we performed calculations in the exact geometry, in the original CT geometry and in the artifact-corrected geometry for photon and electron beams. The maximum errors in 6 MV photon beam dose calculation were found to exceed 25% in original CT images when the standard DOSXYZnrc/CTCREATE calibration is used but less than 2% in artifact-corrected images when an extended calibration is used. The extended calibration includes an extra calibration point for a metal. The patient dose volume histograms of a hypothetical target irradiated by five 18 MV photon beams in a hypothetical treatment differ significantly in the original CT geometry and in the artifact-corrected geometry. This was found to be mostly due to miss-assignment of tissue voxels to air due to metal artifacts. We also developed a simple Monte Carlo model for a CT scanner and we simulated the contribution of scatter and beam hardening to metal streaking artifacts. We found that whereas beam hardening has a minor effect on metal artifacts, scatter is an important cause of these artifacts

Exact cone beam CT with a spiral scan

International Nuclear Information System (INIS)