Dose Reduction in Molecular Breast Imaging With a New Image-Processing Algorithm.

OBJECTIVE. The purpose of this study was to determine whether application of a proprietary image-processing algorithm would allow a reduction in the necessary administered activity for molecular breast imaging (MBI) examinations. MATERIALS AND METHODS. Images from standard-dose MBI examinations (300 MBq 99mTc-sestamibi) of 50 subjects were analyzed. The images were acquired in dynamic mode and showed at least one breast lesion. Half-dose MBI examinations were simulated by summing one-half of the dynamic frames and were processed with the algorithm under study in both a default and a preferred filter mode. Two breast radiologists independently completed a set of two-alternative forced-choice tasks to compare lesion conspicuity on standard-dose images, half-dose images, and the algorithm-processed half-dose images in both modes. RESULTS. Relative to the standard-dose images, the half-dose images were preferred in 4, the default-filtered half-dose images in 50, and preferred-filtered half-dose images in 76 of 100 readings. Compared with standard-dose images, in terms of lesion conspicuity, the half-dose images were rated better in 2, equivalent in 6, and poorer in 92 of 100 readings. The default-filtered half-dose images were rated better, equivalent, or poorer in 13, 73, and 14 of 100 readings. The preferred-filtered half-dose images were rated as better, equivalent, or poorer in 55, 34, and 11 of 100 readings. CONCLUSION. Compared with that on standard-dose images, lesion conspicuity on images obtained with the algorithm and acquired at one-half the standard dose was equivalent or better without compromise of image quality. The algorithm can also be used to decrease imaging time with a resulting increase in patient comfort and throughput.

Improving apparent diffusion coefficient accuracy on a compact 3T MRI scanner using gradient nonlinearity correction.

BACKGROUND: Gradient nonlinearity (GNL) leads to biased apparent diffusion coefficients (ADCs) in diffusion-weighted imaging. A gradient nonlinearity correction (GNLC) method has been developed for whole body systems, but is yet to be tested for the new compact 3T (C3T) scanner, which exhibits more complex GNL due to its asymmetrical design. PURPOSE: To assess the improvement of ADC quantification with GNLC for the C3T scanner. STUDY TYPE: Phantom measurements and retrospective analysis of patient data. PHANTOM/SUBJECTS: A diffusion quality control phantom with vials containing 0-30% polyvinylpyrrolidone in water was used. For in vivo data, 12 patient exams were analyzed (median age, 33). FIELD STRENGTH/SEQUENCE: Imaging was performed on the C3T and two commercial 3T scanners. A clinical DWI (repetition time [TR] = 10,000 msec, echo time [TE] = minimum, b = 1000 s/mm2 ) sequence was used for phantom imaging and 10 patient cases and a clinical DTI (TR = 6000-10,000 msec, TE = minimum, b = 1000 s/mm2 ) sequence was used for two patient cases. ASSESSMENT: The 0% vial was measured along three orthogonal axes, and at two different temperatures. The ADC for each concentration was compared between the C3T and two whole-body scanners. Cerebrospinal fluid and white matter ADCs were quantified for each patient and compared to values in literature. STATISTICAL TESTS: Paired t-test and two-way analysis of variance (ANOVA). RESULTS: For all PVP concentrations, the corrected ADC was within 2.5% of the reference ADC. On average, the ADC of cerebrospinal fluid and white matter post-GNLC were within 1% and 6%, respectively, of values reported in the literature and were significantly different from the uncorrected data (P < 0.05). DATA CONCLUSION: This study demonstrated that GNL effects were more severe for the C3T due to the asymmetric gradient design, but our implementation of a GNLC compensated for these effects, resulting in ADC values that are in good agreement with values from the literature. LEVEL OF EVIDENCE: 4 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2018;48:1498-1507.

Multi-energy CT imaging for large patients using dual-source photon-counting detector CT.

Multi-energy CT imaging of large patients with conventional dual-energy (DE)-CT using an energy-integrating-detector (EID) is challenging due to photon starvation-induced image artifacts, especially in lower tube potential (80-100 kV) images. Here, we performed phantom experiments to investigate the performance of DECT for morbidly obese patients, using an iodine and water material decomposition task as an example, on an emulated dual-source (DS)-photon-counting-detector (PCD)-CT, and compared its performance with a clinical DS-EID-CT. An abdominal CT phantom with iodine inserts of different concentrations was wrapped with tissue-equivalent gel layers to emulate a large patient (50 cm lateral size). The phantom was scanned on a research whole-body single-source (SS)-PCD-CT (140 kV tube potential), a DS-PCD-CT (100/Sn140 kV; Sn140 indicates 140 kV with Sn filter), and a clinical DS-EID-CT (100/Sn140 kV) with the same radiation dose. Phantom scans were repeated five times on each system. The DS-PCD-CT acquisition was emulated by scanning twice on the SS-PCD-CT using different tube potentials. The multi-energy CT images acquired on each system were then reconstructed, and iodine- and water-specific images were generated using material decomposition. The root-mean-square-error (RMSE) between true and measured iodine concentrations were calculated for each system and compared. The images acquired on the DS-EID-CT showed severe artifacts, including ringing, reduced uniformity, and photon starvation artifacts, especially for low-energy images. These were largely reduced in DS-PCD-CT images. The CT number difference that was measured using regions-of-interest across field-of-view were reduced from 20.3 ± 0.9 (DS-EID-CT) to 2.5 ± 0.4 HU on DS-PCD-CT, showing improved image uniformity using DS-PCD-CT. Iodine RMSE was reduced from 3.42 ± 0.03 mg ml-1 (SS-PCD-CT) and 2.90 ± 0.03 mg ml-1 (DS-EID-CT) to 2.39 ± 0.05 mg ml-1 using DS-PCD-CT. DS-PCD-CT out-performed a clinical DS-EID-CT for iodine and water-based material decomposition on phantom emulating obese patients by reducing image artifacts and improving iodine quantification (RMSE reduced by 20%). With DS-PCD-CT, multi-energy CT can be performed on large patients that cannot be accommodated with current DECT.

Integration of high velocity test object motion into a channelized Hotelling observer for the assessment of x-ray angiography systems.

Assessment of x-ray angiography system performance is typically performed using stationary test objects with simple geometries such as a disk on a uniform background. However, these methods do not represent realistic imaging conditions in interventional cardiology as anatomy and devices are inherently non-stationary due to cardiac motion. In this work, a novel implementation of the channelized Hotelling observer (CHO) was used to assess the influence of motion blur on object detectability. A standard CHO model assumes imaging system stationarity whereby the detectability index [Formula: see text] of a test object is independent of location. However, real angiography systems are inherently non-stationary. While vendor correction gain factors and offset maps are used to compensate for visual non-uniformities, these corrections do not restore stationarity to the images. Methods to accommodate non-stationarity and allow assessment of the influence of motion blur on test object detectability will be presented. The effect of motion blur was quantified with the relative detectability index ([Formula: see text]), where the [Formula: see text] for an object when moving with constant linear velocity was compared to a low velocity 'pseudo-stationary' condition to account for system non-stationarity. The pseudo-stationary condition was used to isolate the influences of spatial non-stationarity and motion blur. Three different test object shapes (disks, spheres and capsules) with linear velocity in the range 0-30 cm · s-1 were tested. For 1 mm diameter objects and linear velocity 30 cm · s-1, [Formula: see text] was degraded by 37%, 33% and 42% for the disk, sphere and capsule respectively, relative to the pseudo-stationary condition. Considering all test objects with diameter greater than 2 mm and linear velocity 30 cm · s-1, [Formula: see text] was degraded by less than 10% due to motion. In summary, this work describes a new approach to assess performance of x-ray angiography systems using the CHO model and moving test objects.

Technical Note: Assessment of scatter originating from the x-ray tube collimator assembly of modern angiography systems.

PURPOSE: While scatter from the patient is assumed to be the primary source of occupational radiation dose associated with fluoroscopically guided interventional procedures, the potential contribution of scatter from the x-ray collimator assembly is unknown. The purpose of this work was to survey clinical x-ray angiography systems to assess the potential contribution of collimator assembly scatter on occupational radiation dose. METHODS: Experimental methods were designed to measure the relative contributions of scatter originating from within the collimator assembly of the x-ray tube to total scatter, which included scatter from a patient-simulating phantom. Measurements were acquired as a function of lateral distance from the x-ray beam center using a posterior anterior (PA) projection and at a fixed location for variable right anterior oblique to left anterior oblique projections in the range -90º to 90º. For one system, the collimator assembly was partially disassembled to assess the scatter contribution of individual components. For two systems, 0.5 mm Pb was added to the inner surface of the collimator assembly cover and tested for efficacy to block collimator assembly scatter. RESULTS: Considering all x-ray systems and only the PA projection, collimator assembly scatter contributed 20-50% to total scatter. For x-ray projection angles of -90º to 90º, the relative contribution of collimator assembly to total scatter was dependent on projection angle and ranged from 5% to 56%. X-ray systems with kerma-area product meters demonstrated higher collimator assembly scatter than those without. Considering all projection angles, the addition of 0.5 mm Pb to the inside of the collimator assembly cover reduced collimator assembly scatter from 28% to 16% of total scatter for both systems. CONCLUSION: Findings from this work suggest that contemporary radiation safety practices and guidelines should be revised to account for scatter originating from the collimator assembly of angiographic x-ray tubes.

Dual-source photon counting detector CT with a tin filter: a phantom study on iodine quantification performance.

Photon counting detectors (PCD) can provide spectral information to enable iodine quantification through multi-energy imaging but performance is limited by current PCD technology. The purpose of this work is to evaluate iodine quantification in a phantom study using dual-source PCD-CT (DS-PCD-CT), and compare to single-source (SS)-PCD-CT and traditional DS energy integrating detector (EID)-based dual-energy CT. A multi-energy CT phantom with iodine inserts (0 to 15 mg ml-1 concentration) was imaged on a research SS-PCD-CT scanner (CTDIvol = 18 mGy). A DS-PCD-CT was emulated by acquiring two sequential scans (CTDIvol = 9 mGy each) using tube potentials: 140 kVp/80 kVp, 140 kVp/100 kVp and 140 kVp/120 kVp. For each kVp, 1 or 2 energy bins were reconstructed to achieve either dual-energy or quadruple energy CT. In addition to these energy combinations, a Sn filter was used for the high tube potential (140 kVp) of each kVp pair. For comparison, the same phantom was also scanned on a commercially available DS-EID-CT with matched radiation dose (CTDIvol = 18 mGy). Material decomposition was performed in image space using a standard least-squares based approach to generate iodine and water-specific images. The root-mean-square-error (RMSE) measured over each insert from the iodine image was used to determine iodine accuracy. The iodine RMSE from SS-PCD (140 kVp with 2 energy bins) was 2.72 mg ml-1. The use of a DS configuration with 1 energy bin per kVp (140 kVp/80 kVp) resulted in a RMSE of 2.29 mg ml-1. Two energy bins per kVp further reduced iodine RMSE to 1.83 mg ml-1. The addition of a Sn filter to the latter quadruple energy mode reduced RMSE to 1.48 mg ml-1. RMSE for DS-PCD-CT (2 energy bins per kVp) decreased by 1.3% (Sn140 kVp/80 kVp) and 15% (Sn140 kVp/100 kVp) as compared to DS-EID-CT. DS-PCD-CT with a Sn filter improved iodine quantification as compared to both SS-PCD-CT and DS-EID-CT.