Abstract

Misregistration due to cardiac motion causes artifacts in two‐exposure dual‐energy subtraction images, in both the soft‐tissue‐only image and the bone‐only image. Two previous investigations have attempted to avoid misregistration artifacts by using cardiac gating of the first and second exposures. The severity of misregistration was affected by the heart rate, the time interval between the low‐ and high‐energy exposures, the total duration of the two exposures, and the phase of the cardiac cycle at the start of the exposure sequence. We sought to determine whether a commercial phantom with a simulated beating heart can be use to investigate the factors affecting misregistration in dual‐energy chest radiography. We made dual‐energy images of the phantom in postero–anterior orientation using the indirect digital radiography system (GE XQ/i). We acquired digital images at heart rates between 40 beats per minute and 120 beats per minute and transferred them to a computer, where the area of the artifact on the silhouette of the heart was measured from both soft‐tissue‐only and bone‐only images. For comparison, we measured misregistration in clinical dual‐energy subtraction images by the same method. Generally speaking, without synchronization of the exposure sequence with the cardiac cycle, the area of the misregistration artifact increased with heart rate for both the phantom and clinical images. However, the phantom exaggerated the magnitude of misregistration relative to clinical images. Although this phantom was designed for horizontal operation and computed tomography imaging, it can be use in an upright configuration to simulate heart motion for investigation of dual‐energy misregistration artifacts and control.PACS numbers: 87.59.bf, 87.57.cf, 87.57N

Highlights

  • Dual-energy subtraction (DES) X-ray imaging offers a promising adjuvant to conventional chest radiography for accurate, early detection of lung disease

  • We estimated the size of the patient that the phantom represents on the basis of the work of Shah et al[8] Using the mAs delivered at 125 kilovoltage potential (kVp) with the LucAl phantom (2.8 mAs) and the mAs delivered for the cardiac motion phantom (1.6 mAs), and assuming a half-value layer for the thorax of 9.6 cm, the thickness of the thorax corresponding to the cardiac motion phantom is only about 15 cm

  • The cardiac motion phantom is sufficiently realistic for the study of misregistration in DES imaging using clinical X-ray systems

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Summary

Introduction

Dual-energy subtraction (DES) X-ray imaging offers a promising adjuvant to conventional chest radiography for accurate, early detection of lung disease. DES images reduce the influence of anatomical noise and offer the potential for analysis of nodule calcification. 236 Hsieh et al.: Cardiac motion phantom for DES chest imaging (a) (b). Any object that exhibits periodic motion could be used to study temporal misregistration in DES. DES examinations can be performed only by using automatic exposure control (AEC). The clock phantom required additional polymethyl methacrylate to deliver clinically realistic beam current (mAs) when using AEC

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