Enhancement of weakly tagged fecal materials in dual-energy CT colonography using spectral-driven iterative reconstruction technique

Abstract

Dual-energy computed tomography is used increasingly in CT colonography (CTC). The combination of computer-aided detection (CAD) and dual-energy CTC has a high clinical value because it can automatically detect clinically significant colonic lesions in CTC images with higher accuracy than does single-energy CTC. While CAD has demonstrated its ability to detect small polyps, its performance is highly dependent on the quality of the input images. The presence of artifacts such as beam hardening and image noise in ultra-low-dose CTC may severely degrade detection performance for small polyps. A further limitation to the effectiveness of CAD are the weakly tagged fecal materials in the colon that may cause false-positive detections. In this work, we developed a dual-energy method for enhancing the appearance of weakly tagged fecal materials in CTC images. The proposed method consists of two stages: 1) the detection of weakly tagged fecal materials by use of sinogram-based image decomposition and 2) the enhancement of the detected tagged fecal materials in the images using an iterative reconstruction method. In the first stage, the ultra-low-dose dual-energy projection data obtained from a CT scanner are decomposed into two basis materials – soft tissue and fecal-tagged material (iodine). Virtual monochromatic projection data are calculated from the material decomposition at a pre-determined energy. The iodine-decomposed sinogram and the virtual monochromatic projection data are then used as input to an iterative reconstruction method. In the second stage, virtual monochromatic images are reconstructed iteratively while the intensity of weakly tagged iodine in the images is enhanced. The performance of the proposed method was assessed qualitatively and quantitatively. Preliminary results show that our method effectively enhances the visual appearance of weakly tagged fecal materials in the reconstructed CT images while reducing noise and improving the overall quality of the reconstructed images.