CT Image Quality Research Articles

Task-based image quality assessment of an intraoperative CBCT for spine surgery compared with conventional CT

Purpose:To analyze the image quality of a novel, state-of-the art platform for CBCT image-guided spine surgery, focusing particularly on the dose–effectiveness compared with conventional CT (the gold standard for postoperative assessment). Methods:The ClarifEye platform (Philips Healthcare) with integrated augmented-reality surgical navigation, has been compared with a GE Revolution CT (GE Healthcare). The 3D spatial resolution (TTF) and noise (NPS) were evaluated considering relevant feature contrasts (200–900 HU) and background noise for differently sized patients (200–300 mm water-equivalent diameter). These measures were used to determine the noise equivalent quanta (NEQ) and observer model detectability. Results:The CBCT system exhibited a linear response with 50% TTF at 5.7 cycles/cm (10% TTF at 9.2 cycles/cm), and the axial noise power peaking at about 3.6 cycles/cm (average frequency of 4.1 cycles/cm). The noise magnitude and texture differed markedly compared to iteratively reconstructed CT images (GE ASiR-V). The CBCT system had 26% lower detectability for a high-frequency task (related to edge detection) compared with CT images reconstructed using the Bone kernel combined with ASiR-V 50%. Likewise, it had 18% lower detectability for low- and mid-frequency tasks compared with CT images reconstructed using the Standard kernel. This difference translates to 50%–80% higher CBCT imaging doses required to match the CT image quality. Conclusions:The ClarifEye platform demonstrates intraoperative CBCT-imaging capabilities that under certain circumstances are comparable with conventional CT. However, due to limited dose–effectiveness, a trade-off between timeliness and radiation exposure must be considered if end-of-procedure CBCT is to replace postoperative CT.

CT image quality and dose optimization by combining tube voltage, dose reduction setting and ASIR-V (explorative study using VCT phantom)

Utilization of ASIR-V software to improve CT scan images with lower exposure factor settings has enormous potential to produce CT scan images with minimal dose and optimal image quality. Otherwise, the excessive use of iterative reconstruction may lead to poor image quality. The purpose of this study was to determine the differences in radiation dose and image quality in the combination of tube voltage, dose reduction and ASIR-V settings and giving recommendation out of it. This type of research is quasi-experimental with a pretest posttest design. VCT Quality Assurance phantom scanned with abdominal CT parameters with the combination of tube voltage variations and dose reduction settings then reconstructed using ASIR-V. Image quality data including noise, LCD and HCR obtained were analyzed by using the paired t-test statistical test. The lowest dose (2.01 mGy) resulted from the combination of tube voltage setting 80 kV, 60% dose reduction, and the dose reduction in the treatment group was in the range of 49% - 87%. The lowest noise was produced by a combination of tube voltage settings of 80 kV, 60% dose reduction, and 100% ASIR-V and noise reduction in the treatment group in the range of 15% -68%. There are significant differences in low contrast detectability of image obtained from 15 combination of tube voltage settings, and dose reduction setting after ASIR-V reconstruction on CT scans. Meanwhile, there are significant differences of extreme contrast spatial resolution in 13 combinations of the tube voltage and dose reduction setting after ASIR-V reconstruction showed. Decreasing the tube voltage and increasing the dose reduction value results in a lesser radiation dose accompanied by a decrease in image quality, while the application of ASIR-V is proven to improve the quality of CT scan images including noise and low contrast detectability, in the other hand the excessive use of ASIR-V may also decrease high contrast spatial resolution of the image. The combination of image quality that is closest to the image quality of the control group is a combination of tube voltage settings of 120 kV, 60% dose reduction and 60% ASIR-V which produces a radiation dose of 6.37 mGy.

Computed Tomography Effective Dose and Image Quality in Deep Learning Image Reconstruction in Intensive Care Patients Compared to Iterative Algorithms.

Deep learning image reconstruction (DLIR) algorithms employ convolutional neural networks (CNNs) for CT image reconstruction to produce CT images with a very low noise level, even at a low radiation dose. The aim of this study was to assess whether the DLIR algorithm reduces the CT effective dose (ED) and improves CT image quality in comparison with filtered back projection (FBP) and iterative reconstruction (IR) algorithms in intensive care unit (ICU) patients. We identified all consecutive patients referred to the ICU of a single hospital who underwent at least two consecutive chest and/or abdominal contrast-enhanced CT scans within a time period of 30 days using DLIR and subsequently the FBP or IR algorithm (Advanced Modeled Iterative Reconstruction [ADMIRE] model-based algorithm or Adaptive Iterative Dose Reduction 3D [AIDR 3D] hybrid algorithm) for CT image reconstruction. The radiation ED, noise level, and signal-to-noise ratio (SNR) were compared between the different CT scanners. The non-parametric Wilcoxon test was used for statistical comparison. Statistical significance was set at p < 0.05. A total of 83 patients (mean age, 59 ± 15 years [standard deviation]; 56 men) were included. DLIR vs. FBP reduced the ED (18.45 ± 13.16 mSv vs. 22.06 ± 9.55 mSv, p < 0.05), while DLIR vs. FBP and vs. ADMIRE and AIDR 3D IR algorithms reduced image noise (8.45 ± 3.24 vs. 14.85 ± 2.73 vs. 14.77 ± 32.77 and 11.17 ± 32.77, p < 0.05) and increased the SNR (11.53 ± 9.28 vs. 3.99 ± 1.23 vs. 5.84 ± 2.74 and 3.58 ± 2.74, p < 0.05). CT scanners employing DLIR improved the SNR compared to CT scanners using FBP or IR algorithms in ICU patients despite maintaining a reduced ED.

Reducing Metal Artifacts in X-ray Computed Tomography Based on Metal Effect Estimation and Multiple CT Volume Fusion

In recent years, X-ray Computed Tomography (CT) has been widely used for investigating industrial parts. Many industrial parts often include metals, which cause various CT artifacts such as beam hardening artifacts, and metal artifacts. These CT artifacts lower the quality of X-ray CT images, prevent precise measurements. In order to reduce metal artifacts, here we propose using multiple X-ray CT scanning. Our multiple X-ray CT scanning method includes local artifacts estimation, proposing adequate multiple scanning angles, multiple scanned data registration and multiple CT data fusion. Based on local artifacts estimation, optimal multiple scan angles for data fusion are selected. Data registration and fusion are also based on local artifacts estimation, excluding effects of artifacts during the process. In order to demonstrate our method, we measured industrial parts which includes metals and resins, proposed optimal multiple scanning angles and conducted volume fusion. As a result, the metal artifacts in the CT volume reduced significantly compared to single X-ray CT scanning. Experiments also showed that metal artifacts in different regions are reduced by additional scans, which suggest that our scan angle selection method successfully selected optimal multiple scan angles.

DistilIQA: Distilling Vision Transformers for no-reference perceptual CT image quality assessment

No-reference image quality assessment (IQA) is a critical step in medical image analysis, with the objective of predicting perceptual image quality without the need for a pristine reference image. The application of no-reference IQA to CT scans is valuable in providing an automated and objective approach to assessing scan quality, optimizing radiation dose, and improving overall healthcare efficiency. In this paper, we introduce DistilIQA, a novel distilled Vision Transformer network designed for no-reference CT image quality assessment. DistilIQA integrates convolutional operations and multi-head self-attention mechanisms by incorporating a powerful convolutional stem at the beginning of the traditional ViT network. Additionally, we present a two-step distillation methodology aimed at improving network performance and efficiency. In the initial step, a ”teacher ensemble network” is constructed by training five vision Transformer networks using a five-fold division schema. In the second step, a ”student network”, comprising of a single Vision Transformer, is trained using the original labeled dataset and the predictions generated by the teacher network as new labels. DistilIQA is evaluated in the task of quality score prediction from low-dose chest CT scans obtained from the LDCT and Projection data of the Cancer Imaging Archive, along with low-dose abdominal CT images from the LDCTIQAC2023 Grand Challenge. Our results demonstrate DistilIQA‘s remarkable performance in both benchmarks, surpassing the capabilities of various CNNs and Transformer architectures. Moreover, our comprehensive experimental analysis demonstrates the effectiveness of incorporating convolutional operations within the ViT architecture and highlights the advantages of our distillation methodology.

Neurovascular Imaging with Ultra-High-Resolution Photon-Counting CT: Preliminary Findings on Image-Quality Evaluation.

The first-generation photon-counting detector CT was recently introduced into clinical practice and represents a promising innovation in high-resolution CT imaging. The purpose of this study was to assess the image quality of ultra-high-resolution photon-counting detector CT compared with energy-integrating detector CT and to explore different reconstruction kernel sharpness levels for the evaluation of intracranial aneurysms. Ten patients with intracranial saccular aneurysms who had previously undergone conventional energy-integrating detector CT were prospectively enrolled. CT angiograms were acquired on a clinical dual-source photon-counting detector CT in ultra-high-resolution mode and reconstructed with 4 vascular kernels (Bv36, Bv40, Bv44, Bv48). Quantitative and qualitative image-quality parameters of the intracranial arteries were evaluated. For the quantitative analysis (image noise, SNR, contrast-to-noise ratio), ROIs were manually placed at standard anatomic intracranial and extracranial locations by 1 author. In addition, vessel border sharpness was evaluated quantitatively. For the qualitative analysis, 3 blinded neuroradiologists rated photon-counting detector CT and energy-integrating detector CT image quality for the evaluation of the intracranial vessels (ie, the aneurysms and 9 standard vascular branching locations) on a 5-point Likert-type scale. Additionally, readers independently selected their preferred kernel among the 4 kernels evaluated on photon-counting detector CT. In terms of quantitative image quality, Bv48, the sharpest kernel, yielded increased image noise and decreased SNR and contrast-to-noise ratio parameters compared with Bv36, the smoothest kernel. Compared with energy-integrating detector CT, the Bv48 kernel offered better quantitative image quality for the evaluation of small intracranial vessels (P < .001). Image-quality ratings of the Bv48 were superior to those of the energy-integrating detector CT and not significantly different from ratings of the B44 reconstruction kernel. When comparing side by side all 4 photon-counting detector reconstruction kernels, readers selected the B48 kernel as the best to visualize the aneurysms in 80% of cases. Ultra-high-resolution photon-counting detector CT provides improved image quality for neurovascular imaging. Although the less sharp kernels provided superior SNR and contrast-to-noise ratio, the sharpest kernels delivered the best subjective image quality on photon-counting detector CT for the evaluation of intracranial aneurysms.

WaveletDFDS-Net: A Dual Forward Denoising Stream Network for Low-Dose CT Noise Reduction

The challenge of denoising low-dose computed tomography (CT) has garnered significant research interest due to the detrimental impact of noise on CT image quality, impeding diagnostic accuracy and image-guided therapies. This paper introduces an innovative approach termed the Wavelet Domain Dual Forward Denoising Stream Network (WaveletDFDS-Net) to address this challenge. This method ingeniously combines convolutional neural networks and Transformers to leverage their complementary capabilities in feature extraction. Additionally, it employs a wavelet transform for efficient image downsampling, thereby preserving critical information while reducing computational requirements. Moreover, we have formulated a distinctive dual-domain compound loss function that significantly enhances the restoration of intricate details. The performance of WaveletDFDS-Net is assessed by comparative experiments conducted on public CT datasets, and results demonstrate its enhanced denoising effect with an SSIM of 0.9269, PSNR of 38.1343 and RMSE of 0.0130, superior to existing methods.

Sparse-View Spectral CT Reconstruction Based on Tensor Decomposition and Total Generalized Variation

Spectral computed tomography (CT)-reconstructed images often exhibit severe noise and artifacts, which compromise the practical application of spectral CT imaging technology. Methods that use tensor dictionary learning (TDL) have shown superior performance, but it is difficult to obtain a high-quality pre-trained global tensor dictionary in practice. In order to resolve this problem, this paper develops an algorithm called tensor decomposition with total generalized variation (TGV) for sparse-view spectral CT reconstruction. In the process of constructing tensor volumes, the proposed algorithm utilizes the non-local similarity feature of images to construct fourth-order tensor volumes and uses Canonical Polyadic (CP) tensor decomposition instead of pre-trained tensor dictionaries to further explore the inter-channel correlation of images. Simultaneously, introducing the TGV regularization term to characterize spatial sparsity features, the use of higher-order derivatives can better adapt to different image structures and noise levels. The proposed objective minimization model has been addressed using the split-Bregman algorithm. To assess the performance of the proposed algorithm, several numerical simulations and actual preclinical mice are studied. The final results demonstrate that the proposed algorithm has an enormous improvement in the quality of spectral CT images when compared to several existing competing algorithms.

Improving image quality of sparse-view lung tumor CT images with U-Net

BackgroundWe aimed to improve the image quality (IQ) of sparse-view computed tomography (CT) images using a U-Net for lung metastasis detection and determine the best tradeoff between number of views, IQ, and diagnostic confidence.MethodsCT images from 41 subjects aged 62.8 ± 10.6 years (mean ± standard deviation, 23 men), 34 with lung metastasis, 7 healthy, were retrospectively selected (2016–2018) and forward projected onto 2,048-view sinograms. Six corresponding sparse-view CT data subsets at varying levels of undersampling were reconstructed from sinograms using filtered backprojection with 16, 32, 64, 128, 256, and 512 views. A dual-frame U-Net was trained and evaluated for each subsampling level on 8,658 images from 22 diseased subjects. A representative image per scan was selected from 19 subjects (12 diseased, 7 healthy) for a single-blinded multireader study. These slices, for all levels of subsampling, with and without U-Net postprocessing, were presented to three readers. IQ and diagnostic confidence were ranked using predefined scales. Subjective nodule segmentation was evaluated using sensitivity and Dice similarity coefficient (DSC); clustered Wilcoxon signed-rank test was used.ResultsThe 64-projection sparse-view images resulted in 0.89 sensitivity and 0.81 DSC, while their counterparts, postprocessed with the U-Net, had improved metrics (0.94 sensitivity and 0.85 DSC) (p = 0.400). Fewer views led to insufficient IQ for diagnosis. For increased views, no substantial discrepancies were noted between sparse-view and postprocessed images.ConclusionsProjection views can be reduced from 2,048 to 64 while maintaining IQ and the confidence of the radiologists on a satisfactory level.Relevance statementOur reader study demonstrates the benefit of U-Net postprocessing for regular CT screenings of patients with lung metastasis to increase the IQ and diagnostic confidence while reducing the dose.Key points• Sparse-projection-view streak artifacts reduce the quality and usability of sparse-view CT images.• U-Net-based postprocessing removes sparse-view artifacts while maintaining diagnostically accurate IQ.• Postprocessed sparse-view CTs drastically increase radiologists’ confidence in diagnosing lung metastasis.Graphical

Contrastive learning with token projection for Omicron pneumonia identification from few-shot chest CT images.

Deep learning-based methods can promote and save critical time for the diagnosis of pneumonia from computed tomography (CT) images of the chest, where the methods usually rely on large amounts of labeled data to learn good visual representations. However, medical images are difficult to obtain and need to be labeled by professional radiologists. To address this issue, a novel contrastive learning model with token projection, namely CoTP, is proposed for improving the diagnostic quality of few-shot chest CT images. Specifically, (1) we utilize solely unlabeled data for fitting CoTP, along with a small number of labeled samples for fine-tuning, (2) we present a new Omicron dataset and modify the data augmentation strategy, i.e., random Poisson noise perturbation for the CT interpretation task, and (3) token projection is utilized to further improve the quality of the global visual representations. The ResNet50 pre-trained by CoTP attained accuracy (ACC) of 92.35%, sensitivity (SEN) of 92.96%, precision (PRE) of 91.54%, and the area under the receiver-operating characteristics curve (AUC) of 98.90% on the presented Omicron dataset. On the contrary, the ResNet50 without pre-training achieved ACC, SEN, PRE, and AUC of 77.61, 77.90, 76.69, and 85.66%, respectively. Extensive experiments reveal that a model pre-trained by CoTP greatly outperforms that without pre-training. The CoTP can improve the efficacy of diagnosis and reduce the heavy workload of radiologists for screening of Omicron pneumonia.

Photon-counting detector step-wedge calibration enabling water and iodine material decomposition

Photon-counting detector computed tomography (PCD-CT) has demonstrated improvements in conventional image quality compared to energy integrating detector (EID) CT. PCD-CT has the advantage of being able to operate in conventional and spectral mode simultaneously by sorting photons according to selected energy thresholds. However, to reconstruct spectral images PCD-CT requires extensive calibration and specifically fine-tuning a spectral response. This response is then used to perform material decomposition (MD). We propose a step-wedge phantom made of water and iodine to calibrate a prototype PCD-CT system. Four methods were tested and compared based on calibration accuracy and CT image quality. The exhaustive PCD response was not well calibrated, but a reduced model was defined that was able to perform accurate water/iodine MD and to reduce the ring artifact intensity. The impact of the number of energy bins (from two to seven) was also studied. The number of bins did not affect the spectral accuracy. However, compared to the two energy bin configuration, the seven bin configuration decreased the noise by 10% and 15% in the water and iodine maps, respectively. The model was tested on ex-vivo tissue samples injected with iodine to demonstrate the results of the water/iodine MD on biological materials.

Image fast reconstruction for sparse view computed tomography with reduced sampling integration time

Industrial computed tomography (CT) can detect the internal structure of objects nondestructively. Its scanning and image reconstruction are time-consuming, which limits its application in the fast detection field. In this work, we reduce the sampling integration time in sparse view CT to achieve ultra-fast scanning in only 5 s. However, this ultra-fast scanning method produces more noise and streak artifacts in the reconstructed CT images. The existing reconstruction methods cannot effectively reconstruct high quality CT images under this ultra-fast scanning. To solve this issue, a faster and higher quality CT image reconstruction method is proposed in this paper. We construct a novel objective function using multi-directional TV and adaptive non-local means (ANLM), and design a solution algorithm to solve the objective function. The multi-directional TV-norm takes into account the differences in horizontal, vertical, and 45° directional gradients to obtain more image detail information, while the ANLM-norm focuses on noise suppression. Simulation and practical experiments show that the proposed method can reconstruct higher quality CT images under faster CT scanning strategy, and the peak signal to noise ratio (PSNR) is 1.3 dB higher than the optimal baseline algorithm. On the other hand, our method converges faster and achieves a shorter CT image reconstruction time, which is 47 s shorter than the current popular iterative reconstruction methods. This reconstruction method provides a reliable scheme for faster CT scanning and image reconstruction.

Computed tomography system performance for different iterative reconstruction algorithms

The number of the Computed Tomography (CT) examinations has increased greatly over the past decade; This has made CT doses the largest source of the individual effective dose from medical exposures worldwide. Evaluation of image quality in CT is an important issue to ensure diagnostic accuracy, while keeping the radiation dose especially to the pediatric patient as low as reasonably possible. The purpose of this study was to assess the physical and psychophysical image quality in pediatric CT for different iterative reconstruction (IR) algorithms. The image quality was measured on each CT system using pediatric QRM abdomen and thorax phantoms for clinical thorax and abdomen examination scanning parameters and using the Catphan 600 phantom for head examination scanning parameters. The performance of each CT systems was evaluated individually using conventional filtered back-projection (FBP) and IR algorithm employed in that system. Noise, contrast-to-noise ratio (CNR), inverse image quality figure (IQFinv), modulation transfer function (MTF) and noise power spectrum (NPS) were assessed for FBP and wide range of iteration level of different IR algorithms. Figure of Merit (FOM) parameter was calculated to characterize the dose efficiency of each CT system. The CTDIvol values were changed from 20.6 to 45.7, 0.9 to 7.4 and 2.4–9.6 mGy for pediatric head, thorax and abdomen scanning protocols between CT systems, respectively. With increasing iteration level, image noise decreased while CNR and IQFinv increased. NPS peak was decreased with increasing iteration level for both two (2D) and three dimensional (3D) NPS and the ratio of the 3D NPS to 2D NPS varied from 4.5 to 8.3 for pediatric head, from 4.6 to 8.7 for pediatric thorax and from 4.0 to 14.0 for pediatric abdomen scanning protocols. For all IR algorithms employed with CT systems used in this study, the FOM values were increased with increasing iteration level.

Evaluation of low-dose computed tomography reconstruction using spatial-radon domain total generalized variation regularization

The x-ray radiation dose in computed tomography (CT) examination has been a major concern for patients. Lowing the tube current and exposure time in data acquisition is a straightforward and cost-effective strategy to reduce the x-ray radiation dose. However, this will inevitably increase the noise fluctuations in measured projection data, and the corresponding CT image quality will be severely degraded if noise suppression is not performed during image reconstruction. To reconstruct high-quality low-dose CT image, we present a spatial-radon domain total generalized variation (SRDTGV) regularization for statistical iterative reconstruction based on penalized weighted least-squares (PWLS) principle, which is called PWLS-SRDTGV for simplicity. The presented PWLS-SRDTGV model can simultaneously reconstruct high-quality CT image in space domain and its corresponding projection in radon domain. An efficient split Bregman algorithm was applied to minimize the cost function of the proposed reconstruction model. Qualitative and quantitative studies were performed to evaluate the effectiveness of the PWLS-SRDTGV image reconstruction algorithm using a digital 3D XCAT phantom and an anthropomorphic torso phantom. The experimental results demonstrate that PWLS-SRDTGV algorithm achieves notable gains in noise reduction, streak artifact suppression, and edge preservation compared with competing reconstruction approaches.

Influence of helical pitch and gantry rotation time on image quality and file size in ultrahigh-resolution photon-counting detector CT

The goal of this experimental study was to quantify the influence of helical pitch and gantry rotation time on image quality and file size in ultrahigh-resolution photon-counting CT (UHR-PCCT). Cervical and lumbar spine, pelvis, and upper legs of two fresh-frozen cadaveric specimens were subjected to nine dose-matched UHR-PCCT scan protocols employing a collimation of 120 × 0.2 mm with varying pitch (0.3/1.0/1.2) and rotation time (0.25/0.5/1.0 s). Image quality was analyzed independently by five radiologists and further substantiated by placing normed regions of interest to record mean signal attenuation and noise. Effective mAs, CT dose index (CTDIvol), size-specific dose estimate (SSDE), scan duration, and raw data file size were compared. Regardless of anatomical region, no significant difference was ascertained for CTDIvol (p ≥ 0.204) and SSDE (p ≥ 0.240) among protocols. While exam duration differed substantially (all p ≤ 0.016), the lowest scan time was recorded for high-pitch protocols (4.3 ± 1.0 s) and the highest for low-pitch protocols (43.6 ± 15.4 s). The combination of high helical pitch and short gantry rotation times produced the lowest perceived image quality (intraclass correlation coefficient 0.866; 95% confidence interval 0.807–0.910; p < 0.001) and highest noise. Raw data size increased with acquisition time (15.4 ± 5.0 to 235.0 ± 83.5 GByte; p ≤ 0.013). Rotation time and pitch factor have considerable influence on image quality in UHR-PCCT and must therefore be chosen deliberately for different musculoskeletal imaging tasks. In examinations with long acquisition times, raw data size increases considerably, consequently limiting clinical applicability for larger scan volumes.

Wasserstein-GAN-based noise reduction for preserving anatomical structures in low-dose CT

The purpose of low-dose computed tomography (LDCT) is to reduce patient's radiation dose. However, LDCT imaging often suffers from low image quality due to computed tomography (CT) noise patterns. While conventional methods such as iterative reconstruction and image processing have been studied to address this issue, their clinical application remains limited due to the degradation of critical anatomical structures. Recently, deep-learning-based noise reduction approaches have shown promising results in improving the image quality of LDCT. Particularly, generative adversarial network (GAN)-based noise reduction methods have produced outstanding results, approaching the quality of normal-dose CT (NDCT) images. In this study, we propose a hybrid framework based on Wasserstein-GAN with the non-subsampled contourlet transform for enhanced noise reduction in LDCT. The aim is to meticulously address CT noise patterns and generate CT images similar to NDCT. We implemented the proposed algorithm and conducted an experiment using clinical abdominal CT datasets to demonstrate its feasibility. According to our results, the proposed method effectively reduced noise components in LDCT images while preserving the anatomical structures of NDCT. This was confirmed through both qualitative and quantitative evaluations. The implications of our findings for clinical practice are significant, as the proposed method can improve the accuracy of LDCT and reduce radiation dose to patients, ultimately enhancing patient safety.

An automated technique for global noise level measurement in CT image with a conjunction of image gradient.

Automated assessment of noise level in clinical computed tomography (CT) images is a crucial technique for evaluating and ensuring the quality of these images. There are various factors that can impact CT image noise, such as statistical noise, electronic noise, structure noise, texture noise, artifact noise, etc. In this study, a method was developed to measure the global noise index (GNI) in clinical CT scans due to the fluctuation of x-ray quanta. Initially, a noise map is generated by sliding a 10 × 10 pixel for calculating Hounsfield unit (HU) standard deviation and the noise map is further combined with the gradient magnitude map. By employing Boolean operation, pixels with high gradients are excluded from the noise histogram generated with the noise map. By comparing the shape of the noise histogram from this method with Christianson's tissue-type global noise measurement algorithm, it was observed that the noise histogram computed in anthropomorphic phantoms had a similar shape with a close GNI value. In patient CT images, excluding the HU deviation due the structure change demonstrated to have consistent GNI values across the entire CT scan range with high heterogeneous tissue compared to the GNI values using Christianson's tissue-type method. The proposed GNI was evaluated in phantom scans and was found to be capable of comparing scan protocols between different scanners. The variation of GNI when using different reconstruction kernels in clinical CT images demonstrated a similar relationship between noise level and kernel sharpness as observed in uniform phantom: sharper kernel resulted in noisier images. This indicated that GNI was a suitable index for estimating the noise level in clinical CT images with either a smooth or grainy appearance. The study's results suggested that the algorithm can be effectively utilized to screen the noise level for a better CT image quality control.

Projection domain decomposition denoising algorithm based on low rank and similarity-based regularization.

Projection Domain Decomposition (PDD) is a dual energy reconstruction method which implements the decomposition process before image reconstruction. The advantage of PDD is that it can alleviate beam hardening artifacts and metal artifacts effectively as energy spectra estimation is considered in PDD. However, noise amplification occurs during the decomposition process, which significantly impacts the accuracy of effective atomic number and electron density. Therefore, effective noise reduction techniques are required in PDD. This study aims to develop a new algorithm capable of minimizing noise while simultaneously preserving edges and fine details. In this study, a denoising algorithm based on low rank and similarity-based regularization (LRSBR) is presented. This algorithm incorporates the low-rank characteristic of tensors into similarity-based regularization (SBR) framework. This method effectively addresses the issue of instability in edge pixels within the SBR algorithm and enhances the structural consistency of dual-energy images. A series of simulation and practical experiments were conducted on a dual-layer dual-energy CT system. Experiments demonstrate that the proposed method outperforms exiting noise removal methods in Peak Signal-to-noise Ratio (PSNR), Root Mean Square Error (RMSE), and Structural Similarity (SSIM). Meanwhile, there has been a notable enhancement in the visual quality of CT images. The proposed algorithm has a significantly improved noise reduction compared to other competing approach in dual-energy CT. Meanwhile, the LRSBR method exhibits outstanding performance in preserving edges and fine structures, making it practical for PDD applications.

Initial experience with astate-of-the-art mobile head CT scanner for use in neurointensive care units.

Mobile head computed tomography (CT) scanners can reduce transport-related complications in neurointensive care unit (NICU) patients and decrease the burden on NICU staff; however, the initial investment cost and reduced image quality of early mobile scanners have prevented their widespread clinical use. Here, we report our initial experience with anovel 32-row mobile CT scanner for use in NICUs. Over a2-year period, 107 patients received amobile head CT scan. The technical characteristics of the scanner and the organizational procedures are described in detail. Patient characteristics were retrospectively collected and image quality was subjectively evaluated on aLikert scale ranging from 0 to 5 and compared with astationary CT scanner. Mobile head CT was used for follow-up of intracranial hemorrhage in 51%, routine postoperative imaging in 28%, evaluation of neurological deterioration in 14%, bedside monitoring after external ventricular drain placement in 4%, and follow-up of ischemic stroke in 3% of cases. Diagnostic imaging quality was achieved in all cases, eliminating the need for stationary CT scanning. The overall image quality of mobile CT (median 4points) was inferior to that of conventional stationary CT (median 5points, p < 0.01), but was rated with 4 or 5points in the majority of cases. State-of-the-art mobile CT was found to be easy to use and maneuver and has the potential to expedite the diagnosis of NICU patients and reduce staff workload. Image quality was adequate for common NICU issues.

Comparison of Image Quality and Radiation Dose in Pediatric Temporal Bone CT Using Photon-Counting Detector CT and Energy-Integrating Detector CT.

Currently, there is a lack of research directly comparing photon-counting detector CT (PCD-CT) and energy-integrating detector CT (EID-CT) in pediatric temporal bone CT imaging. The purpose of this study was to compare the image quality and radiation dose of temporal bone CT scans in pediatric patients acquired with PCD-CT and EID-CT. The retrospective study included a total of 110 pediatric temporal bone CT scans (PCD-CT, n = 52; EID-CT, n = 58). Two independent readers evaluated the spatial resolution of 4 anatomic structures (tympanic membrane, incudostapedial joint, stapedial crura, and cochlear modiolus) and overall image quality by using a 4-point scale. Interreader agreement was assessed. Dose-length product for each CT was compared, and subgroup analyses were performed based on age (younger than 3 years, 3-5 years, 6-11 years, and 12 years and above). PCD-CT demonstrated statistically significantly higher scores than EID-CT for all items (tympanic membrane, 2.9 versus 2.4; incudostapedial joint, 3.6 versus 2.6; stapedial crura, 3.2 versus 2.4; cochlear modiolus, 3.4 versus 2.8; overall image quality, 3.6 versus 2.8; P < .05). Interreader agreement ranged from good to excellent (interclass correlation coefficients, 0.6-0.81). PCD-CT exhibited a 43% dose reduction compared with EID-CT, with a particularly substantial reduction of over 70% in the subgroups of children younger than 6 years. PCD temporal bone CT achieves significantly superior imaging quality at a lower radiation dose compared with EID-CT.