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Design of a digital beam attenuation system for computed tomography: part I. System design and simulation framework.

ABSTRACT: The purpose of this work is to introduce a new device that allows for patient-specific imaging-dose modulation in conventional and cone-beam CT. The device is called a digital beam attenuator (DBA). The DBA modulates an x-ray beam by varying the attenuation of a set of attenuating wedge filters across the fan angle. The ability to modulate the imaging dose across the fan beam represents another stride in the direction of personalized medicine. With the DBA, imaging dose can be tailored for a given patient anatomy, or even tailored to provide signal-to-noise ratio enhancement within a region of interest. This modulation enables decreases in: dose, scatter, detector dynamic range requirements, and noise nonuniformities. In addition to introducing the DBA, the simulation framework used to study the DBA under different configurations is presented. Finally, a detailed study on the choice of the material used to build the DBA is presented.To change the attenuator thickness, the authors propose to use an overlapping wedge design. In this design, for each wedge pair, one wedge is held stationary and another wedge is moved over the stationary wedge. The composite thickness of the two wedges changes as a function of the amount of overlap between the wedges. To validate the DBA concept and study design changes, a simulation environment was constructed. The environment allows for changes to system geometry, different source spectra, DBA wedge design modifications, and supports both voxelized and analytic phantom models. A study of all the elements from atomic number 1 to 92 were evaluated for use as DBA filter material. The amount of dynamic range and tube loading for each element were calculated for various DBA designs. Tube loading was calculated by comparing the attenuation of the DBA at its minimum attenuation position to a filtered non-DBA acquisition.The design and parametrization of DBA implemented FFMCT has been introduced. A simulation framework was presented with which DBA-FFMCT, bowtie filter CT acquisitions, and unmodulated CT acquisitions can be simulated. The study on wedge filter design concluded that the ideal filter material should have an atomic number in the range of 21-34. Iron was chosen for an experimental relative-tube-loading measurement and showed that DBA-FFMCT scans could be acquired with negligible increases in tube power demands.The basic idea of DBA implemented fluence field modulated CT, a simulation framework to verify the concept, and a filter selection study have been presented. The use of a DBA represents another step toward the ultimate in patient specific CT dose delivery as patient dose can be delivered uniquely as a function of view and fan angle using this device.

SUBMITTER: Szczykutowicz TP

PROVIDER: S-EPMC3562347 | biostudies-other | 2013 Feb

REPOSITORIES: biostudies-other

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Project description:The purpose of this work is to present a performance study of the digital beam attenuator (DBA) for implementing fluence field modulated CT (FFMCT) using a simulation framework developed to model the incorporation of the DBA into an existing CT system. Additionally, initial results will be presented using a prototype DBA and the realization of the prototype will be described. To our knowledge, this study represents the first experimental use of a device capable of modulating x-ray fluence as a function of fan angle using a CT geometry.To realize FFMCT, the authors propose to use a wedge design in which one wedge is held stationary and another wedge is moved over the stationary wedge. Due to the wedge shape, the composite thickness of the two wedges changes as a function of the amount of overlap between the wedges. This design allows for the wedges to modulate the photon fluence incident onto a patient. Using a simulation environment, the effect of changing the number of wedges has on dose, scatter, detector dynamic range, and noise uniformity is explored. Experimental results are presented using a prototype DBA having ten Fe wedges and a c-arm CT system geometry. The experimental DBA results are compared to non-DBA scans using scatter and detector dynamic range as metrics. Both flat field and bowtie filtered CT acquisitions were simulated for comparison with the DBA.Numerical results suggest that substantial gains in noise uniformity and scatter-to-primary ratio (SPR) can be obtained using only seven wedges. After seven wedges, the decrease in noise ununiformity and SPR falls off at a lower rate. Simulations comparing CT acquisitions between flat field, bowtie enabled, and DBA CT acquisitions suggest DBA-FFMCT can reduce dose relative to flat field CT by ≈3 times. A bowtie filter under the same imaging conditions was shown to only allow a dose reduction of 1.65 times. Experimentally, a 10 wedge DBA prototype result showed a SPR reduction of ≈4 times relative to flat field CT. The dynamic range for the DBA prototype was 3.7 compared to 84.2 for the flat field scan.Based on the results presented in this paper and the companion paper [T. Szczykutowicz and C. Mistretta, "Design of a digital beam attenuation system for computed tomography. Part I. System design and simulation framework," Med. Phys. 40, 021905 (2013)], FFMCT implemented via the DBA device seems feasible and should result in both a dose reduction and an improvement in image quality as judged by noise uniformity and scatter reduction. In addition, the dynamic range reduction achievable using the DBA may allow photon counting imaging to become a clinical reality. This study may allow for yet another step to be taken in the field of patient specific dose modulation.

Project description:Domestic rabbits are increasing in popularity as household pets; therefore, veterinarians need to be familiar with the most common diseases afflicting rabbits including dental disease. Current diagnostic approaches include gross oral examination, endoscopic oral examination, skull radiography, and computed tomography (CT). Cone beam computed tomography (CBCT), a new oral and maxillofacial imaging modality that has the capability to produce high-resolution images, has not yet been described for use in evaluating dental disease in rabbits. A total of 15 client-owned rabbits had CBCT, oral examination, dental charting, and dental treatment performed under general anesthesia. Images were evaluated using transverse and custom multiplanar (MPR), 3D, and panoramic reconstructed images. The CBCT findings were grouped into abnormalities that could be detected on conscious oral examination vs. abnormalities that could not be detected by conscious oral examination. Potential associations between the two categories were examined by pairwise Fisher's exact test with statistical significance determined by P?<?0.05. The most common findings identified on CBCT images were periodontal ligament space widening (14/15), premolar and molar malocclusion (13/15), apical elongation (13/15), coronal elongation (12/15), inflammatory tooth resorption (12/15), periapical lucency (11/15), moth-eaten pattern of osteolysis of the alveolar bone (9/15), ventral mandibular border contour changes (9/15), and missing teeth (8/15). Of the CBCT abnormalities likely to be observed on oral examination, coronal elongation (detectable on oral examination) was significantly associated with apical elongation (P?=?0.029). There were no other significant associations between CBCT findings that are also clinically detectable and CBCT findings that are not be detectable on oral examination. This suggests that pathology often exists that is not apparent upon oral examination. This study establishes the common CBCT findings associated with dental disease in rabbits and demonstrates the feasibility of this technology to diagnose and plan treatment in dental disorders in this species.

Project description:The vertebral endplate forms a structural boundary between intervertebral disc and the trabecular bone of the vertebral body. As a mechanical interface between the stiff bone and resilient disc, the endplate is the weakest portion of the vertebral-disc complex and is predisposed to mechanical failure. However, the literature concerning the bone mineral density (BMD) distribution within the spinal endplate is comparatively sparse. The objective of this study is to investigate the three-dimensional (3D) distribution of computed tomography (CT) attenuation across the lumbosacral endplate measured in Hounsfield Units (HU). A total of 308 endplates from 28 cadaveric fresh-frozen lumbosacral spines were used in this study. Each spine was CT-scanned and the resulting DICOM data was used to obtain HU values of the bone endplate. Each individual endplate surface was subdivided into five clinically-relevant topographic zones. Attenuation was analyzed by spinal levels, sites (superior or inferior endplate) and endplate region. The highest HU values were found at the S1 endplate. Comparisons between the superior and inferior endplates showed the HU values in inferior endplates were significantly higher than those in the superior endplates within the same vertebra and the HU values in endplates cranial to the disc were significantly higher than those in the endplates caudal to the disc within the same disc. Attenuation in the peripheral region was significantly higher than in the central region by 32.5%. Regional comparison within the peripheral region showed the HU values in the posterior region were significantly higher than those in the anterior region and the HU values in the left region were significantly higher than those in the right region. This study provided detailed data on the regional HU distribution across the lumbosacral endplate, which can be useful to understand causes of some endplate lesions, such as fracture, and also to design interbody instrumentation.

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Design of a digital beam attenuation system for computed tomography: part I. System design and simulation framework.

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