Bowtie Filter Research Articles

Study on the impact of bowtie filter on photon-counting CT imaging

Objective.The aim of this study was to investigate the impact of the bowtie filter on the image quality of the photon-counting detector (PCD) based CT imaging.Approach.Numerical simulations were conducted to investigate the impact of bowtie filters on image uniformity using two water phantoms, with tube potentials ranging from 60 to 140 kVp with a step of 5 kVp. Subsequently, benchtop PCD-CT imaging experiments were performed to verify the observations from the numerical simulations. Additionally, various correction methods were validated through these experiments.Main results.It was found that the use of a bowtie filter significantly alters the uniformity of PCD-CT images, depending on the size of the object and the x-ray spectrum. Two notable effects were observed: the capping effect and the flattening effect. Furthermore, it was demonstrated that the conventional beam hardening correction method could effectively mitigate such non-uniformity in PCD-CT images, provided that dedicated calibration parameters were used.Significance.It was demonstrated that the incorporation of a bowtie filter results in varied image artifacts in PCD-CT imaging under different conditions. Certain image correction methods can effectively mitigate and reduce these artifacts, thereby enhancing the overall quality of PCD-CT images.

Influence of X-ray spectrum and bowtie filter characterisation on the accuracy of Monte Carlo simulated organ doses: Validation in a whole-body CT scanning mode

PurposeFor patient-specific CT dosimetry, Monte Carlo dose simulations require an accurate description of the CT scanner. However, quantitative spectral information and information on the bowtie filter material and shape from the manufacturer is often not available. In this study, the influence of different X-ray spectra and bowtie filter characterisation methods on simulated CT organ doses is studied. MethodsUsing ImpactMC, organ doses of whole-body CTs were simulated in twenty adult whole-body voxel models, generated from PET/CT examinations previously conducted in these patients. Simulated CT organ doses based on the manufacturer X-ray spectra and bowtie filter data were compared with those obtained using alternative characterisation models, including spectrum generators and experimentally measured dose data. A total of four different X-ray spectra and one bowtie filter model were defined based on these data. ResultsFor all X-ray spectra and bowtie filter combinations, estimated CT organ doses are within 6% from those resulting from simulations with the CT characterisation models provided by the manufacturer. While varying the bowtie filter model results in CT organ dose differences smaller than 1%, dose differences up to 6% are observed when X-ray spectra are not based on the quantitative data from the manufacturer. ConclusionsEstimated organ doses slightly depend on the applied CT characterisation model. When manufacturer’s data are not available, half-value layer and dose measurements provide sufficient input to obtain equivalent X-ray spectra and bowtie filter profiles, respectively.

The influence of miscentering on radiation dose during computed tomography head examinations and the role of localiser orientation: A phantom study

IntroductionComputed Tomography (CT) chest, abdomen and pelvis research demonstrates a relationship between vertical phantom positioning and radiation dose. Moving the phantom closer or further from the x-ray source results in magnification or minimisation of the localiser. As automatic tube current modulation (ATCM) algorithms use localisers to estimate patient size and calculate required tube current, magnification or minimisation results in the incorrect provision of radiation dose. Radiation dose changes also depend on localiser orientation, changes with anteroposterior (AP) and posteroanterior (PA) localisers demonstrating an inverse relationship. However, within CT head literature often attributes radiation dose changes on impaired function of the bow-tie filter instead. The current study investigated the role of miscentering on ATCM function within CT head, paying particular attention to localiser orientation. MethodsHead scanning was performed with an anthropomorphic phantom at the isocentre, alongside ten vertically miscentered positions. This was performed three times, with an AP, PA and lateral localiser. CT dose index values at each miscentered level were compared across conditions. ResultsVertical miscentering altered radiation dose in both AP and PA conditions, radiation dose linearly increasing (up to 17.05%) when positioning the phantom closer to the x-ray source and decreasing when positioning away (up to −13.13%). Changes across AP and PA conditions demonstrated an inverse relationship. Radiation dose was unaffected in the lateral condition. ConclusionsMiscentering during CT head alters ATCM function due to magnification/minimisation of the localiser image, causing ATCM algorithms to misinterpret patient size and miscalculate required tube current. Implications for practiceRadiographers should be accurate when centering for CT head, avoiding any potential radiation dose changes. Further research into vertical miscentering and image quality during CT head is recommended.

A rotating beam-blocker method for cone beam CT scatter correction.

Cone beam CT (CBCT) is widely utilized in clinics. However, the scatter artifact degrades the CBCT image quality, hampering the expansion of CBCT applications. Recently, beam-blocker methods have been used for CBCT scatter correction and proved their high cost-effectiveness. A rotating beam-blocker (RBB) method for CBCT scatter correction was proposed to complete scatter correction and image reconstruction within a single scan in both full- and half-fan scan scenarios. The RBB consisted of two open regions and two blocked regions, and was designed as a centrosymmetric structure. The open and blocked projections could be alternatively obtained within one single rotation. The open projections were corrected with the scatter signal calculated from the blocked projections, and then used to reconstruct the 3D image via the Feldkamp-Davis-Kress algorithm. The performance of the RBB method was evaluated on head and pelvis phantoms in scenarios with and without a bowtie filter. The images obtained from nine repeated scans in each scenario were used to calculate the evaluation metrics including the CT number error, spatial nonuniformity (SNU) and contrast-to-noise ratio (CNR). For the head phantom, the CT number error was decreased to<5 after scatter correction from>200 HU before correction when scanned without a bowtie filter, and to<4 from>160 HU when scanned with a full bowtie filter. For the pelvis phantom, the CT number error was reduced to<12 after scatter correction from>250 HU before correction when scanned without a bowtie filter, and to<10 from>190 HU when scanned with a half bowtie filter. After scatter correction, the uniformity and contrast were both improved, resulting in an SNU of>79% decrease and CNR of>2 times increase, respectively. High-quality CBCT images could be obtained in a single scan after using the proposed RBB method for scatter correction, enabling more accurate image guidance for surgery and radiation therapy applications. With almost no time delay between the successive open and blocked projections, the RBB method could eliminate the motion-induced anatomical mismatches between the corresponding open and blocked projections and could find particular usefulness in thoracic and abdominal imaging.

Pixel-by-pixel correction of beam hardening artifacts by bowtie filter in fan-beam CT

Objective. Beam hardening (BH) artifacts in computed tomography (CT) images originate from the polychromatic nature of x-ray photons. In a CT system with a bowtie filter, residual BH artifacts remain when polynomial fits are used. These artifacts lead to worse visuals, reduced contrast, and inaccurate CT numbers. This work proposes a pixel-by-pixel correction (PPC) method to reduce the residual BH artifacts caused by a bowtie filter. Approach. The energy spectrum for each pixel at the detector after the photons pass through the bowtie filter was calculated. Then, the spectrum was filtered through a series of water slabs with different thicknesses. The polychromatic projection corresponding to the thickness of the water slab for each detector pixel could be obtained. Next, we carried out a water slab experiment with a mono energy E = 69 keV to get the monochromatic projection. The polychromatic and monochromatic projections were then fitted with a 2nd-order polynomial. The proposed method was evaluated on digital phantoms in a virtual CT system and phantoms in a real CT machine. Main results. In the case of a virtual CT system, the standard deviation of the line profile was reduced by 23.8%, 37.3%, and 14.3%, respectively, in the water phantom with different shapes. The difference of the linear attenuation coefficients (LAC) in the central and peripheral areas of an image was reduced from 0.010 to 0.003 cm−1 and 0.007 cm−1 to 0 in the biological tissue phantom and human phantom, respectively. The method was also validated using CT projection data obtained from Activion16 (Canon Medical Systems, Japan). The difference in the LAC in the central and peripheral areas can be reduced by a factor of two. Significance. The proposed PPC method can successfully remove the cupping artifacts in both virtual and authentic CT images. The scanned object’s shapes and materials do not affect the technique.

Usability of bowtie filter full-fan mode over half-fan mode in cone-beam computed tomography scanning - A prospective study

Usability of bowtie filter full-fan mode over half-fan mode in cone-beam computed tomography scanning - A prospective study

Noise Nonuniformity Dependency on Exposure Settings in Computed Tomography

In X-ray computed tomography (CT), noise distribution within images is nonuniform and thought to vary with imaging conditions. This study aimed to evaluate noise nonuniformity by altering specific imaging conditions, such as tube voltage, bow-tie filter (BTF), and phantom size. Using four tube voltages (80, 100, 120, and 135 kV), two BTF types (L and M), and circular water phantoms with diameters of 240, 320, and 400 mm, we employed filtered back projection (FBP) for reconstruction. Noise nonuniformity was assessed by defining six regions of interest (ROI) from the image center to the periphery, and the noise nonuniformity index (NNI) was calculated based on the standard deviation (SD) values within these ROIs. Results showed consistently larger noise SD values in the central region compared to the peripheral region under all imaging conditions, with the maximum NNI reaching 32.1%. Variations in NNI were observed, reaching up to 5.5 points for tube voltage, 7.8 points for BTF, and 8.2 points for phantom size. In conclusion, our quantitative assessment revealed moderate dependence of noise nonuniformity on imaging conditions in CT images.

Optically Stimulated Luminescence Nanodots experimental determination of bowtie filter shape in computed tomography

Optically Stimulated Luminescence Nanodots experimental determination of bowtie filter shape in computed tomography

Ultra-low-dose CT for attenuation correction: dose savings and effect on PET quantification for protocols with and without tin filter

BackgroundUltra-low-dose (ULD) computed tomography (CT) scans should be used when CT is performed only for attenuation correction (AC) of positron emission tomography (PET) data. A tin filter can be used in addition to the standard aluminium bowtie filter to reduce CT radiation dose to patients. The aim was to determine how low CT doses can be, when utilised for PET AC, with and without the tin filter, whilst providing adequate PET quantification.MethodsA water-filled NEMA image quality phantom was imaged in three configurations with 18F-FDG: (1) water only (0HU); (2) with cylindrical insert containing homogenous mix of sand, flour and water (SFW, approximately 475HU); (3) with cylindrical insert containing sand (approximately 1100HU). Each underwent one-bed-position (26.3 cm) PET-CT comprising 1 PET and 13 CT acquisitions. CT acquisitions with tube current modulation were performed at 120 kV/50 mAs-ref (reference standard), 100 kV/7 mAs-ref (standard ULDCT for PET AC protocol), Sn140kV (mAs range 7–50-ref) and Sn100kV (mAs range 12–400-ref). PET data were reconstructed with μ-maps provided by each CT dataset, and PET activity concentration measured in each reconstruction. Differences in CT dose length product (DLP) and PET quantification were determined relative to the reference standard.ResultsAt each tube voltage, changes in PET quantification were greater with increasing density and reducing mAs. Compared with the reference standard, differences in PET quantification for the standard ULDCT protocol for the three phantoms were ≤ 1.7%, with the water phantom providing a DLP of 7mGy.cm. With tin filter at Sn100kV, differences in PET quantification were negligible (≤ 1.2%) for all phantoms down to 50mAs-ref, proving a DLP of 2.8mGy.cm, at 60% dose reduction compared with standard ULDCT protocol. Below 50mAs-ref, differences in PET quantification were > 2% for at least one phantom (2.3% at 25mAs-ref in SFW; 6.4% at 12mAs-ref in sand). At Sn140kV/7mAs-ref, quantification differences were ≤ 0.6% in water, giving 3.8mGy.cm DLP, but increased to > 2% at bone-equivalent densities.ConclusionsCT protocols for PET AC can provide ultra-low doses with adequate PET quantification. The tin filter can allow 60–87% lower dose than the standard ULDCT protocol for PET AC, depending on tissue density and accepted change in PET quantification.

Improved compact representation method for Monte Carlo phase spaces

Phase space files used in particle Monte Carlo simulations can be large, and thereby awkward to distribute and slow to load into memory. To circumvent this, compact source models and phase space representations have been developed. In this study, the aim is to increase the versatility of a previously presented method, based on principal component analysis whitening, by evaluating several modifications to the method on simulated cone-beam computed tomography projection images. Scaling the phase space components before whitening was seen to give the largest improvement and allowed for accurate modelling of phase spaces with a shifted detector and/or a bowtie filter present, configurations where the original method struggled. The modified method reproduced results using the original phase space to within a few percent both in energy fluence on the detector and in simulated projection and scatter images of a patient pelvis, without obvious position-dependence of the errors. Hence, the modified method was deemed sufficiently accurate for most applications relying on cone-beam computed tomography simulations. The final aim is to use the more versatile method for a broader range of phase space-based applications such as linear accelerator beam simulations and room shielding calculations.

A new formula for converting dose-area product to effective dose in dental cone-beam computed tomography

PurposeThe purpose of this study was to determine a dedicated conversion formula between dose-area product (DAP) and effective dose (E) for dental CBCT, which incorporates X-ray beam energy as well as geometric factors. MethodsCBCT exposures of an adult phantom were simulated using PCXMC 2.0 (STUK, Finland). Fifty-seven fields of view (FOV) were included, ranging from Ø4x4cm to Ø21x19cm. Six tube voltages (70 kV to 120 kV), eight combinations of Al (2.5 to 10 mm) and Cu (0 to 0.5 mm) filtration, and four source-isocentre distances (35 to 65 cm) were used, resulting in 10 896 simulated scan protocols. In addition, 10 944 random combinations of scan parameters within the aforementioned ranges were simulated, resulting in 21 840 scan protocols that were used for fitting a formula using multiple linear regression with 8 independent variables. Finally, 2304 random scan protocols were simulated as validation data to evaluate the formula’s generalizability. ResultsE/DAP ranged between 0.031 µSv/mGy.cm2 and 0.294 µSv/mGy.cm2, with a mean of 0.150 µSv/mGy.cm2. Due to extensive clustering of the E/DAP, three formulas were determined according to FOV categories (Small: <100 cm2, Medium: 100–400 cm2, Large: >400 cm2). The resulting formulas showed mean absolute errors of 7.9%, 4.0% and 3.6%, respectively, for the validation data. ConclusionThe new formulas allow for a straightforward, yet accurate, estimation of the effective dose for dental CBCT based on DAP. Further fine-tuning of the model could be achieved by incorporating, for example, bowtie filtration and off-axis beam geometries.

Evaluation of a two-dimensional Moire-free antiscatter grid for cone-beam computed tomography.

Scatter radiation is a traditional problem in cone-beam computed tomography (CBCT). Accordingly, numerous methods have been researched for scatter reduction in terms of software- or hardware-based solutions. The concept of a two-dimensional antiscatter grid (2D-ASG) has been shown to provide a solution to the scatter reduction in CBCT. However, the use of an ASG makes it challenging to use in clinical CBCT systems because it causes Moire artifacts of theimage. We have developed a Moire-free 2D-ASG that was designed to solve the Moire artifact and the scatter radiation problems. We provide the experimental results pertaining to the image quality measurements from the evaluation of the 2D-ASG compared with those obtained from a one-dimensional antiscatter grid (1D-ASG) and no antiscatter grid (No-ASG) to demonstrate the quantitative extent of the improvements. The 2D-ASG, fabricated based on a sawing process with a graphite body, was prepared to evaluate image quality improvements. Projection images for Pro-CT MK II phantom were acquired using the CBCT testbed of sample rotation type and reconstructed by Feldkamp-Davis-Kress (FDK) algorithm without any filters. We measured the contrast-to-noise ratio (CNR) and uniformity index for the cupping artifacts of the 2D-ASG, 1D-ASG, and No-ASG cases. 2D-ASG considerably reduced the cupping artifacts owing to the scatter reduction compared with the 1D-ASG and No-ASG cases. The cupping artifacts were reduced by 85% in the 2D-ASG compared with No-ASG, while the cupping artifacts were reduced by 63% in 1D-ASG compared with No-ASG. The 2D-ASG also yielded a CNR improvement. The average CNR improvements for eight insert materials were 47% in the 2D-ASG compared with No-ASG, while the CNR was improved by 36% in the 1D-ASG compared withNo-ASG. We demonstrated that the Moire-free 2D-ASG improved the image quality by removing scatter radiation in CBCT compared with 1D-ASG and No-ASG. We believe that the Moire-free 2D-ASG can become one of the effective ways to solve the scatter radiation problem in CBCT images because it provides usability and has the potential to have synergistic effects on other methods, such as bow-tie filter and scattercorrection.

Construction of a computational MDCT model for simulations of the detector signals

ObjectiveTo develop a computational model of a multi-detector CT scanner (MDCT), which could be used to simulate the signal of each detector element in the MDCT by using the Monte Carlo method. MethodsThe CT scanner was modelled, including the X-ray source, the bowtie filter, the collimator, the couch and the detector panel. Under a general scanning condition, the signal in each detector element was simulated based on the model by using the MCNPX code. Both the energy spectra at different tube voltages and energy deposition in the detector panel at different collimations were simulated to test the robustness of the MDCT model built in this study. Furthermore, the simulated signals in each detector element were compared with their recorded signals. The accuracies were evaluated by the relative root mean square error (RRMSE) and the structural similarity (SSIM) for each detector element and the whole detector panel, respectively. ResultsThe simulated energy spectra before and after passing through the phantom and simulated energy deposition in the detector panel were rational. In the scan range from the apex of lung to pubic symphysis, the RRMSE of the 18 axial projections ranged from 0.02 to 0.17, with an average of 0.08. And the SSIMs were calculated to be 0.979 and 0.976 for projections with the largest peak signal and the smallest peak signal, respectively. ConclusionsThe computational model of the MDCT developed in this study is accurate and successful, it is helpful for further accurate simulations of the radiation dose and image quality of the MDCT.

A practical and robust method for beam blocker-based cone beam CT scatter correction

Objective. In the traditional beam-blocker based cone beam CT (CBCT) scatter correction, the scatter measured in the region shaded by lead strips was multiplied by a correction factor to directly represent the scatter in the unblocked region. The correction factor optimization is a tedious process and lacks an objective stop criterion. To skip the optimization process, an indirect scatter estimation method was developed and validated in phantom imaging. Approach. A beam-blocker made of lead strips was mounted between the x-ray source and object for scatter estimation. The primary signal between lead strips in the blocked region was first calculated by subtracting the measured scatter, and then used to calculate the scatter signal in the unblocked region corresponding to the same attenuation path. The calculated scatter signal was smoothed via local filtration and used to correct the measured projection in the unblocked region. Finally, the CBCT was reconstructed via Feldkamp–Davis–Kress algorithm. A Catphan and a head phantom were used to verify the performance of the proposed method in both full- and half-blocker scenarios, and with and without a bow-tie filter. Main Results. For scans without the bow-tie filter, the CT number error was reduced to 3.97 2.27 and 5.51 3.90 HU in the full- and half-blocker scenarios, respectively, for the Catphan, and to 4.01 2.18 and 7.97 ± 4.05 HU for the head phantom. When the bow-tie filter was applied, the CT number error was reduced to 2.29 1.42 and 6.72 0.77 HU in the full- and half-blocker scenarios, respectively, for the Catphan, and 2.35 1.25 and 4.96 ± 1.89 HU for the head phantom. Significance. The proposed method effectively avoids the influence of the inserted beam blocker itself on the scatter intensity estimation, and proves a more practical and robust way for the beam-blocker based scatter correction in CBCT scanning.

X-ray energy spectrum estimation based on a virtual computed tomography system

This paper presents a method for estimating the x-ray energy spectrum for computed tomography (CT) in the diagnostic energy range from the reconstructed CT image itself. To this end, a virtual CT system was developed, and datasets, including CT images for the Gammex phantom labeled by the corresponding energy spectra, were generated. Using these datasets, an artificial neural network (ANN) model was trained to reproduce the energy spectrum from the CT values in the Gammex inserts. In the actual application, an aluminum-based bow-tie filter was used in the virtual CT system, and an ANN model with a bow-tie filter was also developed. Both ANN models without/with a bow-tie filter can estimate the x-ray spectrum within the agreement, which is defined as one minus the absolute error, of more than 80% on average. The agreement increases as the tube voltage increases. The estimation was occasionally inaccurate when the amount of noise on the CT image was considerable. Image quality with a signal-to-noise ratio of more than 10 for the basis material of the Gammex phantom was required to predict the spectrum accurately. Based on the experimental data acquired from Activion16 (Canon Medical System, Japan), the ANN model with a bow-tie filter produced a reasonable energy spectrum by simultaneous optimization of the shape of the bow-tie filter. The present method requires a CT image for the Gammex phantom only, and no special setup, thus it is expected to be readily applied in clinical applications, such as beam hardening reduction, CT dose management, and material decomposition, all of which require exact information on the x-ray energy spectrum.

Usefulness of large beam-shaping filters at different tube voltages of newborn chest CT.

To investigate optimizing the use of different beam shaping filters (viz. small, medium and large) when using different tube voltages during the newborn chest computed tomography (CT) on a GE Lightspeed VCT scanner. We used pediatric anthropomorphic phantoms with a 64 detector-row CT scanner while scanning the chest. A real-time skin dosimeter (RD - 1000; Trek Corporation, Kanagawa, Japan) was positioned into the phantom center of the body, the surface of the body back, and the right and left mammary glands. We performed and compared six scan protocols using small, medium, and large beam shaping filters at 80 and 120 kVp protocols. There were no significant differences in the image noise for the chest scan among the different beam shaping filters. By using the large beam shaping filter at 80 kVp, it was possible to reduce the exposure dose by 5% in comparison with the small beam shaping filter, and by 10% in comparison with the medium beam shaping filter. By using the large beam shaping filter at 120 kVp, it was possible to reduce the exposure dose by 15% in comparison with the small beam shaping filter and by 20% in comparison with the medium beam shaping filter (p < 0.01). The large beam shaping filter had the most dose reduction effect during newborn chest CT on a GE Lightspeed VCT scanner. The additional copper filtration being present in the large bowtie filter of the GE Lightspeed CT scanner when using different tube voltages is more effective in reducing radiation exposure in children.

Dose uncertainty due to energy dependence in dual-energy computed tomography

PurposeTo evaluate the absolute dose uncertainty at 2 different energies and for the large and small bowtie filters in dual-energy computed tomography (DECT).Material and methodsMeasurements were performed using DECT at 80 kV and 140 kilovoltage peak (kVp), and single-energy computed tomography (CT) at 120 kV. The absolute dose was calculated from the mass-energy absorption obtained from the half-value layer (HVL) of aluminium.ResultsThe difference in the water-to-air ratio of the mean mass energy-absorption coefficients at 80 kV and 140 kV was 2.0% for the small bow-tie filter and 3.0% for the large bow-tie filter. At lower tube voltages, the difference in the absorbed dose with the large and small bow-tie filters was larger.ConclusionsThe absolute dose uncertainty due to energy dependence was 3.0%, which could be reduced with single-energy beams at 120 kV or by using the average effective energy measurement with dual-energy beams.

3D-printed large-area focused grid for scatter reduction in cone-beam CT.

Cone-beam computed tomography (CBCT) systems acquire volumetric data more efficiently than fan-beam or multislice CT, particularly when the anatomy of interest resides within the axial field-of-view of the detector and data can be acquired in one rotation. For such systems, scattered radiation remains a source of image quality degradation leading to increased noise, image artifacts, and CT number inaccuracies. Recent advances in metal additive manufacturing allow the production of highly focused antiscatter grids (2D-ASGs) that can be used to reduce scatter intensity, while preserving primary radiation transmission. We present the first implementation of a large-area, 2D-ASG for flat-panel CBCT, including grid-line artifact removal and related improvements in image quality. A 245 × 194 × 10 mm 2D-ASG was manufactured from chrome-cobalt alloy using laser powder-bed fusion (LPBF) (AM-400; Renishaw plc, New Mills Wotton-under-Edge, UK). The 2D-ASG had a square profile with a pitch of 9.09 lines/cm and 10:1 grid-ratio. The nominal 0.1mm grid septa were focused to a 732 mm x-ray source to optimize primary x-ray transmission and reduce grid-line shadowing at the detector. Powder-bed fusion ensured the structural stability of the ASG with no need for additional interseptal support. The 2D-ASG was coupled to a 0.139-mm element pitch flat-panel detector (DRX 3543, Carestream Health) and proper alignment was confirmed by consistent grid-line shadow thickness across the whole detector array. A 154-mm diameter CBCT image-quality-assurance phantom was imaged using a rotary stage and a ceiling-mounted, x-ray unit (Proteus XR/a, GE Medical Systems, 80kVp, 0.5mAs). Grid-line artifacts were removed using a combination of exposure-dependent gain correction and spatial-frequency, Fourier filtering. Projections were reconstructed using a Parker-weighted, FDK algorithm and voxels were spatially averaged to 357 × 357 × 595 µm to improve the signal-to-noise characteristics of the CBCT reconstruction. Finally, in order to compare image quality with and without scatter, the phantom was scanned again under the same CBCT conditions but with no 2D-ASG. No additional antiscatter (i.e., air-gap, bowtie filtration) strategies were used to evaluate the effects in image quality caused by the 2D-ASG alone. The large-area, 2D-ASG prototype was successfully designed and manufactured using LPBF. CBCT image-quality improvements using the 2D-ASG included: an overall 14.5% CNR increase across the volume; up to 48.8% CNR increase for low-contrast inserts inside the contrast plate of the QA phantom; and a 65% reduction of cupping artifact in axial profiles of water-filled cross sections of the phantom. Advanced image processing strategies to remove grid line artifacts did not affect the spatial resolution or geometric accuracy of the system. LPBF can be used to manufacture highly efficient, 2D-focused ASGs that can be easily coupled to clinical, flat-panel detectors. The implementation of ASGs in CBCT leads to reduced scatter-related artifacts, improved CT number accuracy, and enhanced CNR with no increased equivalent dose to the patient. Further improvements to image quality might be achieved with a combination of scatter-correction algorithms and iterative-reconstruction strategies. Finally, clinical applications where other scatter removal strategies are unfeasible might now achieve superior soft-tissue visualization and quantitative capabilities.

Photon count rates estimated from 1980 clinical CT scans.

All photon counting detectors have a characteristic count rate over which their performance degrades. Degradation in the clinical setting takes the form of increased noise, reduced material quantification accuracy, and image artifacts. Count rate is a function of patient attenuation, beam filtration, scanner geometry, and X-ray technique. To guide protocol and technology development in the photon counting space, knowledge of clinical count rates spanning the complete range of clinical indications and patient sizes is needed. In this paper, we use clinical data to characterize the range of computed tomography (CT) count rates. We retrospectively gathered 1980 patient exams spanning the entire body (head/neck/chest/abdomen/extremity) and sampled 36951 axial image slices. We assigned the tissue labels air/lung/fat/soft tissue/bone to each voxel for each slice using CT number thresholds. We then modeled four different bowtie filters, 70/80/100/120/140kV spectra, and a range of mA values. We forward-projected each slice to obtain detector-incident count rates, using the geometry of a GE Revolution Apex scanner. Our analysis divided the detector into thirds: the central one-third, one-third of the detector split into two equal regions adjacent to the central third, and the final one-third divided equally between the outer detector edges. We report the 99th percentile of counts to mimic the upper limits of count rates making passing through a patient as a function of patient water equivalent diameter. We also report the percentage of patient scans, by body region, over different count rate thresholds for all combinations of bowtie and beam energy. For routine exam types, we recorded count rates of approximately 3.5×108 counts/mm2 /s in the torso, extremities, and brain. For neck scans, we observed count rates near 6×108 counts/mm2 /s. Our simulations of 1000mA, appropriately mimicking the mA needs for fast pediatric, fast thoracic, and cardiac scanning, resulted in count rates of over 10×108 counts/mm2 /s for the torso, extremities, and brain. At 1000mA, for the neck region, we observed count rates close to 2×109 counts/mm2 /s. Importantly, we saw only a small change in maximum count rate needs over patient size, which we attribute to patient mis-positioning with respect to the bowtie filters. As expected, combinations of kV and bowtie filter with higher beam energies and wider/less attenuating bowtie fluence profiles lead to higher count rates relative to lower energies. The 99th-50th percentile count rate changed the most for the torso region, with a maximum variation of 3.9×108 to 1.2×107 counts/mm2 /s. The head/neck/extremity regions had less than a 50% change in count rate from the 99th to 50th percentiles. Our results are the first to use a large patient cohort spanning all body regions to characterize count rates in CT. Our results should be useful in helping researchers understand count rates as a function of body region and mA for various combinations of bowtie filter designs and beam energies. Our results indicate clinical rates >1×109 counts/mm2 /s, but they do not predict the image quality impact of using a detector with lower characteristic count rates.

Potential of Fluid Dynamic Bowtie Filter for Dose Reduction and Image Quality Improvement of Cone-Beam CT

Reducing radiation dose to patients without compromising imaging quality has been an important issue in the medical use of X-ray computed tomography (CT). In this study, based on the conceptual designs of different types of attenuation filters, the radiation doses to patients who undergo a typical head, thorax and abdomen scan using a cone-beam CT with different scanning protocols were simulated using the Monte Carlo method, and the isotropy of the noise power spectrum (NPS) of the reconstructed images was also calculated. Compared to the scanning protocol without attenuation and tube current modulation (TCM), the results showed that the fluid dynamic bowtie filter (FDB) combined with the TCM technique reduced the average organ dose by 70%, 34% and 60% for a typical head, thorax and abdomen scan, respectively, and the NPS isotropy of the reconstructed images was also significantly improved. Compared to most currently used static bowtie filters, the FDB has a higher potential to reduce the dose for patients undergoing CT scans. Further efforts are warranted to make the FDB technique clinically useful.