A systematic assessment of photon-counting CT for bone mineral density and microarchitecture quantifications.

Photon-counting CT (PCCT) is an emerging imaging technology with potential improvements in quantification and rendition of micro-structures due to its smaller detector sizes. The aim of this study was to assess the performance of a new PCCT scanner (NAEOTOM Alpha, Siemens) in quantifying clinically relevant bone imaging biomarkers for characterization of common bone diseases. We evaluated the ability of PCCT in quantifying microarchitecture in bones compared to conventional energy-integrating CT.

Development and Application of a Virtual Imaging Trial framework for Airway Quantifications via CT.

(COPD) is one of the top three causes of death worldwide, characterized by emphysema and bronchitis. Airway measurements reflect the severity of bronchitis and other airway-related diseases. Airway structures can be objectively evaluated with quantitative computed tomography (CT).

Making CT Dose Monitoring Meaningful: Augmenting Dose with Imaging Quality.

Due to the concerns about radiation dose associated with medical imaging, radiation dose monitoring systems (RDMSs) are now utilized by many radiology providers to collect, process, analyze, and manage radiation dose-related information. Currently, most commercially available RDMSs focus only on radiation dose information and do not track any metrics related to image quality. However, to enable comprehensive patient-based imaging optimization, it is equally important to monitor image quality as well.

Phase-contrast virtual chest radiography.

Respiratory X-ray imaging enhanced by phase contrast has shown improved airway visualization in animal models. Limitations in current X-ray technology have nevertheless hindered clinical translation, leaving the potential clinical impact an open question. Here, we explore phase-contrast chest radiography in a realistic in silico framework.

Emphysema Quantifications With CT Scan: Assessing the Effects of Acquisition Protocols and Imaging Parameters Using Virtual Imaging Trials.

Background: CT scan has notable potential to quantify the severity and progression of emphysema in patients. Such quantification should ideally reflect the true attributes and pathologic conditions of subjects, not scanner parameters. To achieve such an objective, the effects of the scanner conditions need to be understood so the influence can be mitigated.

Oncology-specific radiation dose and image noise reference levels in adult abdominal-pelvic CT.

Objectives: To provide our oncology-specific adult abdominal-pelvic CT reference levels for image noise and radiation dose from a high-volume, oncologic, tertiary referral center.

Methods: The portal venous phase abdomen-pelvis acquisition was assessed for image noise and radiation dose in 13,320 contrast-enhanced CT examinations. Patient size (effective diameter) and radiation dose (CTDI) were recorded using a commercial software system, and image noise (Global Noise metric) was quantified using a custom processing system.

A patient-informed approach to predict iodinated-contrast media enhancement in the liver.

Objective: To devise a patient-informed time series model that predicts liver contrast enhancement, by integrating clinical data and pharmacokinetics models, and to assess its feasibility to improve enhancement consistency in contrast-enhanced liver CT scans.

Methods: The study included 1577 Chest/Abdomen/Pelvis CT scans, with 70-30% training/validation-testing split. A Gaussian function was used to approximate the early arterial, late arterial, and the portal venous phases of the contrast perfusion curve of each patient using their respective bolus tracking and diagnostic scan data.

Task-based validation and application of a scanner-specific CT simulator using an anthropomorphic phantom.

Background: Quantitative analysis of computed tomography (CT) images traditionally utilizes real patient data that can pose challenges with replicability, efficiency, and radiation exposure. Instead, virtual imaging trials (VITs) can overcome these hurdles through computer simulations of models of patients and imaging systems. DukeSim is a scanner-specific CT imaging simulator that has previously been validated with simple cylindrical phantoms, but not with anthropomorphic conditions and clinically relevant measurements.

Can Photon-Counting CT Improve Estimation Accuracy of Morphological Radiomics Features? A Simulation Study for Assessing the Quantitative Benefits from Improved Spatial Resolution in Deep Silicon-Based Photon-Counting CT.

Rationale And Objectives: Deep silicon-based photon-counting CT (Si-PCCT) is an emerging detector technology that provides improved spatial resolution by virtue of its reduced pixel sizes. This article reports the outcomes of the first simulation study evaluating the impact of this advantage over energy-integrating CT (ECT) for estimation of morphological radiomics features in lung lesions.

Materials And Methods: A dynamic nutrient-access-based stochastic model was utilized to generate three distinct morphologies for lung lesions.

Dose coefficients for organ dosimetry in tomosynthesis imaging of adults and pediatrics across diverse protocols.

Purpose: The gold-standard method for estimation of patient-specific organ doses in digital tomosynthesis (DT) requires protocol-specific Monte Carlo (MC) simulations of radiation transport in anatomically accurate computational phantoms. Although accurate, MC simulations are computationally expensive, leading to a turnaround time in the order of core hours for simulating a single exam. This limits their clinical utility.

Development and Clinical Applications of a Virtual Imaging Framework for Optimizing Photon-counting CT.

The purpose of this study was to develop a virtual imaging framework that simulates a new photon-counting CT (PCCT) system (NAEOTOM Alpha, Siemens). The PCCT simulator was built upon the DukeSim platform, which generates projection images of computational phantoms given the geometry and physics of the scanner and imaging parameters. DukeSim was adapted to account for the geometry of the PCCT prototype.

Photon-counting CT versus conventional CT for COPD quantifications: intra-scanner optimization and inter-scanner assessments using virtual imaging trials.

Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory lung disease and a major cause of death and disability worldwide. Quantitative CT is a powerful tool to better understand the heterogeneity and severity of this disease. Quantitative CT is being increasingly used in COPD research, and the recent advancements in CT technology have made it even more encouraging.

A truth-based primal-dual learning approach to reconstruct CT images utilizing the virtual imaging trial platform.

Inherent to Computed tomography (CT) is image reconstruction, constructing 3D voxel values from noisy projection data. Modeling this inverse operation is not straightforward. Given the ill-posed nature of inverse problem in CT reconstruction, data-driven methods need regularization to enhance the accuracy of the reconstructed images.

Inter- and intra-scan variability for lung imaging quantifications via CT.

CT imaging provides physicians valuable insights when diagnosing disease in a clinical setting. In order to provide an accurate diagnosis, is it important to have a high accuracy with controlled variability across CT scans from different scanners and imaging parameters. The purpose of this study was to analyze variability of lung imaging biomarkers across various scanners and parameters using a customized version of a commercially available anthropomorphic chest Phantom (Kyoto Kagaku) with several experimental sample inserts.

Scanner-specific validation of a CT simulator using a COPD-emulated anthropomorphic phantom.

Traditional methods of quantitative analysis of CT images typically involve working with patient data, which is often expensive and limited in terms of ground truth. To counter these restrictions, quantitative assessments can instead be made through Virtual Imaging Trials (VITs) which simulate the CT imaging process. This study sought to validate DukeSim (a scanner-specific CT simulator) utilizing clinically relevant biomarkers for a customized anthropomorphic chest phantom.

Anatomically and physiologically informed computational model of hepatic contrast perfusion for virtual imaging trials.

Purpose: Virtual (in silico) imaging trials (VITs), involving computerized phantoms and models of the imaging process, provide a modern alternative to clinical imaging trials. VITs are faster, safer, and enable otherwise-impossible investigations. Current phantoms used in VITs are limited in their ability to model functional behavior such as contrast perfusion which is an important determinant of dose and image quality in CT imaging.

Reduced-Dose Deep Learning Reconstruction for Abdominal CT of Liver Metastases.

Background Assessment of liver lesions is constrained as CT radiation doses are lowered; evidence suggests deep learning reconstructions mitigate such effects. Purpose To evaluate liver metastases and image quality between reduced-dose deep learning image reconstruction (DLIR) and standard-dose filtered back projection (FBP) contrast-enhanced abdominal CT. Materials and Methods In this prospective Health Insurance Portability and Accountability Act-compliant study (September 2019 through April 2021), participants with biopsy-proven colorectal cancer and liver metastases at baseline CT underwent standard-dose and reduced-dose portal venous abdominal CT in the same breath hold.

A GPU-accelerated framework for individualized estimation of organ doses in digital tomosynthesis.

Purpose: Estimation of organ doses in digital tomosynthesis (DT) is challenging due to the lack of existing tools that accurately and flexibly model protocol- and view-specific collimations and motion trajectories of the source and detector for a variety of exam protocols, and the computational inefficiencies of conducting MC simulations. The purpose of this study was to overcome these limitations by developing and benchmarking a GPU-accelerated MC simulation framework compatible with patient-specific computational phantoms for individualized estimation of organ doses in DT.

Materials And Methods: The framework for individualized estimation of dose in DT was developed as a two-step workflow: (1) a custom MATLAB code that accepts a patient-specific computational phantom and exam description (organ markers for defining the extremities of the anatomical region of interest, tube voltage, source-to-image distance, angular sweep range, number of projection views, and the pivot point to image distance - PPID) to compute the field of views (FOVs) for a clinical DT system, and (2) a MC tool (developed using MC-GPU) modeling the configuration of a clinical DT system to estimate organ doses based on the computed FOVs.

Medical Physics 3.0 and Its Relevance to Radiology.

Medical Physics 3.0 is a grassroots movement within the medical physics community to re-envision a new commitment and engagement of physics in the care process. In this model, a physicist, present in either the clinic or the laboratory, is to practice physics for the direct benefit of the patient, either immediately in the clinical setting or eventually through research.

A scanner-specific framework for simulating CT images with tube current modulation.

Although tube current modulation (TCM) is routinely implemented in modern computed tomography (CT) scans, no existing CT simulator is capable of generating realistic images with TCM. The goal of this study was to develop such a framework to (1) facilitate patient-specific optimization of TCM parameters and (2) enable future virtual imaging trials (VITs) with more clinically realistic image quality and x-ray flux distributions. The framework was created by developing a TCM module and integrating it with an existing CT simulator (DukeSim).