Abstract

To evaluate the performance of a model based image reconstruction method in reducing metal artifacts in the megavoltage computed tomography (MVCT) images of a phantom representing bilateral hip prostheses and to compare with the filtered-backprojection (FBP) technique. An iterative maximum likelihood polychromatic algorithm for CT (IMPACT) is used with an additional model for the pair∕triplet production process and the energy dependent response of the detectors. The beam spectra for an in-house bench-top and TomoTherapy™ MVCTs are modeled for use in IMPACT. The empirical energy dependent response of detectors is calculated using a constrained optimization technique that predicts the measured attenuation of the beam by various thicknesses (0-24 cm) of solid water slabs. A cylindrical (19.1 cm diameter) plexiglass phantom containing various cylindrical inserts of relative electron densities 0.295-1.695 positioned between two steel rods (2.7 cm diameter) is scanned in the bench-top MVCT that utilizes the bremsstrahlung radiation from a 6 MeV electron beam passed through 4 cm solid water on the Varian Clinac 2300C and in the imaging beam of the TomoTherapy™ MVCT. The FBP technique in bench-top MVCT reconstructs images from raw signal normalized to air scan and corrected for beam hardening using a uniform plexiglass cylinder (20 cm diameter). The IMPACT starts with a FBP reconstructed seed image and reconstructs the final image in 150 iterations. In both MVCTs, FBP produces visible dark shading in the image connecting the steel rods. In the IMPACT reconstructed images this shading is nearly removed and the uniform background is restored. The average attenuation coefficients of the inserts and the background are very close to the corresponding values in the absence of the steel inserts. In the FBP images of the bench-top MVCT, the shading causes 4%-9.5% underestimation of electron density at the central inserts with an average of (6.3 ± 1.8)% for the range of electron densities studied. In the uniform plexiglass background, the shadow creates 0.8%-4.7% underestimation of electron density with an average of (2.9 ± 1.2)%. In the corresponding IMPACT images, the underestimation in the shaded plexiglass background is 0.3%-1.8% with an average of (0.9 ± 0.5)% and 1.4%-6.8% with an average of (2.8 ± 2.7)% in the central insert region. In the FBP images of the TomoTherapy™ MVCT, this shading creates 2.6%-6.7% underestimation of electron density with an average of (3.7 ± 1.4)% at the central inserts and 5.9%-7.2% underestimation in the background with an average of (6.4 ± 0.5)%. In the IMPACT images, the uniform background between the steel rods is restored with 0.3%-1.0% underestimation of electron density with an average of (0.7 ± 0.3)%. The corresponding underestimation at the central inserts of the IMPACT images is -0.4%-0.1% with an average of (-0.1 ± 0.2)%. The shading metal artifact has been nearly removed in MVCT images using the IMPACT algorithm with the accurate geometry of the system, proper modeling of energy dependent response of detectors, and all relevant photon interaction processes. This results less than 1% difference in electron density in the background plexiglass and less than 3% averaged over the range of electron densities investigated.

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