Task-based validation and application of a scanner-specific CT simulator using an anthropomorphic phantom.

BACKGROUND: Quantitative analysis of computed tomography (CT) images traditionally utilizes real patient data that can pose challenges with replicability, efficiency, and radiation exposure. Instead, virtual imaging trials (VITs) can overcome these hurdles through computer simulations of models of patients and imaging systems. DukeSim is a scanner-specific CT imaging simulator that has previously been validated with simple cylindrical phantoms, but not with anthropomorphic conditions and clinically relevant measurements. PURPOSE: To validate a scanner-specific CT simulator (DukeSim) for the assessment of lung imaging biomarkers under clinically relevant conditions across multiple scanners using an anthropomorphic chest phantom, and to demonstrate the utility of virtual trials by studying the effects or radiation dose and reconstruction kernels on the lung imaging quantifications. METHODS: An anthropomorphic chest phantom with customized tube inserts was imaged with two commercial scanners (Siemens Force and Siemens Flash) at 28 dose and reconstruction conditions. A computational version of the chest phantom was used with a scanner-specific CT simulator (DukeSim) to simulate virtual images corresponding to the settings of the real acquisitions. Lung imaging biomarkers were computed from both real and simulated CT images and quantitatively compared across all imaging conditions. The VIT framework was further utilized to investigate the effects of radiation dose (20-300 mAs) and reconstruction settings (Qr32f, Qr40f, and Qr69f reconstruction kernels using ADMIRE strength 3) on the accuracy of lung imaging biomarkers, compared against the ground-truth values modeled in the computational chest phantom. RESULTS: The simulated CT images matched closely the real images for both scanners and all imaging conditions qualitatively and quantitatively, with the average biomarker percent error of 3.51% (range 0.002%-18.91%). The VIT study showed that sharper reconstruction kernels had lower accuracy with errors in mean lung HU of 84-94 HU, lung volume of 797-3785 cm3 , and lung mass of -800 to 1751 g. Lower tube currents had the lower accuracy with errors in mean lung HU of 6-84 HU, lung volume of 66-3785 cm3 , and lung mass of 170-1751 g. Other imaging biomarkers were consistent under the studied reconstruction settings and tube currents. CONCLUSION: We comprehensively evaluated the realism of DukeSim in an anthropomorphic setup across a diverse range of imaging conditions. This study paves the way toward utilizing VITs more reliably for conducting medical imaging experiments that are not practical using actual patient images.

Scanner-specific validation of a CT simulator using a COPD-emulated anthropomorphic phantom.

Traditional methods of quantitative analysis of CT images typically involve working with patient data, which is often expensive and limited in terms of ground truth. To counter these restrictions, quantitative assessments can instead be made through Virtual Imaging Trials (VITs) which simulate the CT imaging process. This study sought to validate DukeSim (a scanner-specific CT simulator) utilizing clinically relevant biomarkers for a customized anthropomorphic chest phantom. The physical phantom was imaged utilizing two commercial CT scanners (Siemens Somatom Force and Definition Flash) with varying imaging parameters. A computational version of the phantom was simulated utilizing DukeSim for each corresponding real acquisition. Biomarkers were computed and compared between the real and virtually acquired CT images to assess the validity of DukeSim. The simulated images closely matched the real images both qualitatively and quantitatively, with the average biomarker percent difference of 3.84% (range 0.19% to 18.27%). Results showed that DukeSim is reasonably well validated across various patient imaging conditions and scanners, which indicates the utility of DukeSim for further VIT studies where real patient data may not be feasible.

Inter- and intra-scan variability for lung imaging quantifications via CT.

CT imaging provides physicians valuable insights when diagnosing disease in a clinical setting. In order to provide an accurate diagnosis, is it important to have a high accuracy with controlled variability across CT scans from different scanners and imaging parameters. The purpose of this study was to analyze variability of lung imaging biomarkers across various scanners and parameters using a customized version of a commercially available anthropomorphic chest Phantom (Kyoto Kagaku) with several experimental sample inserts. The phantom was across 10 different CT scanners with a total of 209 imaging conditions. An algorithm was developed to compute different imaging biomarkers. Variability across images from the same scanner and from different scanners was analyzed by computing coefficients of variation (CV) and standard deviations of HU values. LAA -950 and LAA -856 biomarkers had the highest levels of variability, while the majority of other biomarkers had variability less than 10 HU or 10% CV in both inter and intra-scan measurements. There was no clear trend present between the biomarker measurements and CTDIvol. The results of this study demonstrates the existing variability in CT quantifications for lung imaging, which prompt further studies on how to reduce such variation.

Isotonic ion replacement can lower the threshold for selective infrared neural inhibition.

Significance: Infrared (IR) inhibition can selectively block peripheral sensory nerve fibers, a potential treatment for autonomic-dysfunction-related diseases (e.g., neuropathic pain and interstitial cystitis). Lowering the IR inhibition threshold can increase its translational potentials. Aim: Infrared induces inhibition by enhancing potassium channel activation. We hypothesized that the IR dose threshold could be reduced by combining it with isotonic ion replacement. Approach: We tested the IR inhibition threshold on the pleural-abdominal connective of Aplysia californica. Using a customized chamber system, the IR inhibition was applied either in normal saline or in isotonic ion-replaced saline, which could be high glucose saline, high choline saline, or high glucose/high choline saline. Each modified saline was at a subthreshold concentration for inhibiting neural conduction. Results: We showed that isotonically replacing ions in saline with glucose and/or choline can reduce the IR threshold and temperature threshold of neural inhibition. Furthermore, the size selectivity of IR inhibition was preserved when combined with high glucose/high choline saline. Conclusions: The present work of IR inhibition combined with isotonic ion replacement will guide further development of a more effective size-selective IR inhibition modality for future research and translational applications.