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A simple approach to measure computed tomography (CT) modulation transfer function (MTF) and noise-power spectrum (NPS) using the American College of Radiology (ACR) accreditation phantom.

ABSTRACT: To develop an easily-implemented technique with free publicly-available analysis software to measure the modulation transfer function (MTF) and noise-power spectrum (NPS) of a clinical computed tomography (CT) system from images acquired using a widely-available and standardized American College of Radiology (ACR) CT accreditation phantom.Images of the ACR phantom were acquired on a Siemens SOMATOM Definition Flash system using a standard adult head protocol: 120 kVp, 300 mAs, and reconstructed voxel size of 0.49 mm × 0.49 mm × 4.67 mm. The radial (axial) MTF was measured using an edge method where the boundary of the third module of the ACR phantom, originally designed to measure uniformity and noise, was used as a circular edge. The 3D NPS was measured using images from this same module and using a previously-described methodology that quantifies noise magnitude and 3D noise correlation.The axial MTF was radially symmetrical and had a value of 0.1 at 0.62 mm(-1). The 3D NPS shape was consistent with the filter-ramp function of filtered-backprojection reconstruction algorithms and previously reported values. The radial NPS peak value was ∼115 HU(2)mm(3) at ∼0.25 mm(-1) and dropped to 0 HU(2)mm(3) by 0.8 mm(-1).The authors have developed an easily-implementable technique to measure the axial MTF and 3D NPS of clinical CT systems using an ACR phantom. The widespread availability of the phantom along with the free software the authors have provided will enable many different institutions to immediately measure MTF and NPS values for comparison of protocols and systems.

SUBMITTER: Friedman SN

PROVIDER: S-EPMC3643984 | biostudies-other | 2013 May

REPOSITORIES: biostudies-other

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Project description:To investigate the correlation and stationarity of noise in volumetric computed tomography (CT) using the local discrete noise-power spectrum (NPS) and off-diagonal elements of the covariance matrix of the discrete Fourier transform of noise-only images (denoted Σ(DFT)). Experimental conditions were varied to affect noise correlation and stationarity, the effects were quantified in terms of the NPS and Σ(DFT), and practical considerations in CT performance characterization were identified.Cone-beam CT (CBCT) images were acquired using a benchtop system comprising an x-ray tube and flat-panel detector for a range of acquisition techniques (e.g., dose and x-ray scatter) and three phantom configurations hypothesized to impart distinct effects on the NPS and Σ(DFT): (A) air, (B) a 20-cm-diameter water cylinder with a bowtie filter, and (C) the cylinder without a bowtie filter. The NPS and off-diagonal elements of the Σ(DFT) were analyzed as a function of position within the reconstructions.The local NPS varied systematically throughout the axial plane in a manner consistent with changes in fluence transmitted to the detector and view sampling effects. Variability in fluence was manifest in the NPS magnitude-e.g., a factor of ~2 variation in NPS magnitude within the axial plane for case C (cylinder without bowtie), compared to nearly constant NPS magnitude for case B (bowtie filter matched to the cylinder). View sampling effects were most prominent in case A (air) where the variance increased at greater distance from the center of reconstruction and in case C (cylinder) where the NPS exhibited correlations in the radial direction. The effects of detector lag were observed as azimuthal correlation. The cylinder (without bowtie) had the strongest nonstationarity because of the larger variability in fluence transmitted to the detector. The diagonal elements of the Σ(DFT) were equivalent to the NPS estimated from the periodogram, and the average off-diagonal elements of the Σ(DFT) exhibited amplitude of ~1% of the NPS for the experimental conditions investigated. Furthermore, the off-diagonal elements demonstrated fairly long tails of nearly constant amplitude, with magnitude somewhat reduced for experimental conditions associated with greater stationarity (viz., lower Σ(DFT) tails for cases A and B in comparison to case C).Volumetric CT exhibits nonstationarity in the NPS as hypothesized in relation to fluence uniformity and view sampling. Measurement of the NPS should seek to minimize such changes in noise correlations and include careful reporting of experimental conditions (e.g., phantom design and use of a bowtie filter) and spatial dependence (e.g., analysis at fixed radius within a phantom). Off-diagonal elements of the Σ(DFT) similarly depend on experimental conditions and can be readily computed from the same data as the NPS. This work begins to check assumptions in NPS analysis examine the extent to which NPS is an appropriate descriptor of noise correlations, and investigate the magnitude of off-diagonal elements of the Σ(DFT). While the magnitude of such off-diagonal elements appears to be low, their cumulative effect on space-variant detectability remains to be investigated-e.g., using task-specific figures of merit.

Project description:BackgroundIt is known that not all chiropractors follow mainstream guidelines on the use of diagnostic ionising radiation. Various reasons have been discussed in the literature, including using radiography to screen for congenital anomalies, to perform postural analysis, to search for contraindications to spinal manipulation, and to document chiropractic subluxations, i.e., tiny anatomical displacements of vertebrae thought to affect nerves and health. The visualisation of subluxations was the reason chiropractic first adopted the x-ray in 1910. There has never been a study of the influence of this historical paradigm of radiography on the practices of chiropractic radiologists (DACBRs or Diplomates of the American Chiropractic College of Radiology).MethodsA survey was administered with a modified Dillman method using SurveyMonkey and supplemented by hard copies distributed at a professional conference. The target population was all active DACBRs. There were 34 items, which consisted of multiple choice and open-ended interrogatives on all three areas in which chiropractic radiologists work: education, clinical practice, and radiology practice.ResultsThe response rate was 38% (73 of 190 DACBRs). Respondents reported that the historical paradigm of radiography was found in all areas of practice, but not as a major aspect. The majority of respondents did not condone that historical paradigm, but many tolerated it, particularly from referring chiropractors. Radiographic subluxation analysis was reportedly perpetuated by private clinical practitioners as well as technique instructors and supervising clinicians in the teaching institutions.ConclusionsWithin the chiropractic profession, there is a continuing belief in radiographically visible subluxations as a cause of suboptimal health. This situation is sustained in part due to the reticence of other chiropractors to report these practices to licensing and registration boards. Investigation into other structures supporting a vitalistic belief system over science in chiropractic is recommended. In addition, it may be useful to explore remunerative systems that move beyond the inherently conflicted fee-for-service model.

Project description:Rationale and objectivesThis study aimed to compare the volume computed tomography dose index (CTDIvol), dose length product (DLP), and size-specific dose estimate (SSDE), with the China and updated 2017 American College of Radiology (ACR) diagnostic reference levels (DRLs) in chest CT examinations of adults based on the water-equivalent diameter (Dw).Materials and methodsAll chest CT examinations conducted without contrast administration from January 2020 to July 2020 were retrospectively included in this study. The Dw and SSDE of all examinations were calculated automatically by "teamplay". The CTDIvol and DLP were displayed on the DICOM-structured dose report in the console based on a 32cm phantom.The differences in patient CTDIvol, DLP, and SSDE values between groups were examined by the one-way ANOVA. The differences in patient CTDIvol, DLP, and SSDE values between the updated 2017 ACR and the China DRLs were examined with one sample t-tests.ResultsIn total 14666 chest examinations were conducted in our study. Patients were divided into four groups based on Dw:270 (1.84%) in 15-20 cm group, 10287 (70.14%) in the 21-25 cm group, 4097 (27.94%) in the 26-30 cm group, and 12 (0.08%) patients had sizes larger than 30 cm. CTDIvol, DLP, and SSDE increased as a function of Dw (p<0.05). CTDIvol was smaller than SSDE among groups (p<0.05). The mean CTDIvol and DLP values were lower than the 25th, 50th, and 75th percentile of the China DRLs (p <0.05). The CTDIvol, DLP, and SSDE were lower than the 50th and 75th percentiles of the updated 2017 ACR DRLs (p <0.05) among groups.ConclusionsSSDE takes into account the influence of the scanning parameters, patient size, and X-ray attenuation on the radiation dose, which can give a more realistic estimate of radiation exposure dose for patients undergoing CT examinations. Establishing hospital's own DRL according to CTDIvol and SSDE is very important even though the radiation dose is lower than the national DRLs.

Project description:PurposeTo determine radiation dose indexes for computed tomography (CT) performed with renal colic protocols in the United States, including frequency of reduced-dose technique usage and any institutional-level factors associated with high or low dose indexes.Materials and methodsThe Dose Imaging Registry (DIR) collects deidentified CT data, including examination type and dose indexes, for CT performed at participating institutions; thus, the DIR portion of the study was exempt from institutional review board approval and was HIPAA compliant. CT dose indexes were examined at the institutional level for CT performed with a renal colic protocol at institutions that contributed at least 10 studies to the registry as of January 2013. Additionally, patients undergoing CT for renal colic at a single institution (with institutional review board approval and informed consent from prospective subjects and waiver of consent from retrospective subjects) were studied to examine individual renal colic CT dose index patterns and explore relationships between patient habitus, demographics, and dose indexes. Descriptive statistics were used to analyze dose indexes, and linear regression and Spearman correlations were used to examine relationships between dose indexes and institutional factors.ResultsThere were 49 903 renal colic protocol CT examinations conducted at 93 institutions between May 2011 and January 2013. Mean age ± standard deviation was 49 years ± 18, and 53.9% of patients were female. Institutions contributed a median of 268 (interquartile range, 77-699) CT studies. Overall mean institutional dose-length product (DLP) was 746 mGy ⋅ cm (effective dose, 11.2 mSv), with a range of 307-1497 mGy ⋅ cm (effective dose, 4.6-22.5 mSv) for mean DLPs. Only 2% of studies were conducted with a DLP of 200 mGy ⋅ cm or lower (a "reduced dose") (effective dose, 3 mSv), and only 10% of institutions kept DLP at 400 mGy ⋅ cm (effective dose, 6 mSv) or less in at least 50% of patients.ConclusionReduced-dose renal protocol CT is used infrequently in the United States. Mean dose index is higher than reported previously, and institutional variation is substantial.

Project description:The differential phase contrast CT is emerging as a new technology to improve the contrast sensitivity of the conventional CT. Via system analysis, modeling, and computer simulation, the authors study the noise power spectrum (NPS)--an imaging performance indicator-of the differential phase contrast CT and compare it with that of the conventional CT.The differential phase contrast CT is implemented with x-ray tube and gratings. The x-ray propagation and data acquisition are modeled and simulated with Fourier analysis and Fresnel analysis. To avoid any interference caused by scatter and beam hardening, a monochromatic x-ray source (30 keV) is assumed, which irradiates the object to be imaged by 360 degrees so that no weighting scheme is needed. A 20-fold up-sampling is assumed to simulate x-ray beam's propagation through the gratings Gl and G2 with periods 8 and 4 microm, respectively, while the intergrating distance is 193.6 mm (1/16 of the Tabolt distance). The dimension of the detector cell for data acquisition ranges from 32 x 32 to 128 x 128 microm2, while the field of view in data acquisition is 40.96 x 40.96 mm2. A uniform water phantom with a diameter 37.68 mm is employed to study the NPS, with its complex refraction coefficient n = 1 - delta + ibeta = 1 - 2.5604 x 10(-7) + i1.2353 x 10(-10). The x-ray flux ranges from 10(6) to 10(8) photon/cm2.projection and observes the Poisson distribution, which is consistent with that of micro-CT in preclinical applications. The image matrix of reconstructed water phantom is 1280 x 1280, and a total of 180 regions at 128 x 128 matrix are used for NPS calculation via 2D Fourier Transform in which adequate zero padding is applied to avoid aliasing.The preliminary data show that the differential phase contrast CT manifests its NPS with a l/|k| trait, while the distribution of the conventional CTs NPS observes |k|. This accounts for the significant difference in their noise granularity and the differential phase contrast CTs substantial advantage in noise over the conventional CT, particularly, in the situations where the detector cell size for data acquisition is smaller than 100 microm.The differential phase contrast CT detects the projection of refractive coefficient's derivative and uses the Hilbert filter for image reconstruction, which leads to the radical difference in its NPS and the advantage in noise in comparison to that of the conventional CT.

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A simple approach to measure computed tomography (CT) modulation transfer function (MTF) and noise-power spectrum (NPS) using the American College of Radiology (ACR) accreditation phantom.

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