KEYWORDS: Breast, Image quality, X-rays, Sensors, Composites, 3D image reconstruction, Collimation, Monte Carlo methods, X-ray computed tomography, 3D image processing
In this study, we demonstrated the contrast-to-noise ratio (CNR) improvement in breast cone beam CT (CBCT) using the
volume-of-interest (VOI) scanning technique. In VOI breast CBCT, the breast is first scanned at a low exposure level. A
pre-selected VOI is then scanned at a higher exposure level with collimated x-rays. The two image sets are combined
together to reconstruct high quality 3-D images of the VOI. A flat panel detector based system was built to demonstrate
and investigate the CNR improvement in VOI breast CBCT. The CNRs of the 8 plastic cones (Teflon, Delrin,
polycarbonate, Lucite, solid water, high density polystyrene, nylon and polystyrene) in a breast phantom were measured
in images obtained with the VOI CBCT technique and compared to those measured in standard full field CBCT images.
CNRs in VOI CBCT images were found to be higher than those in regular CBCT images in all plastic cones. The mean
glandular doses (MGDs) from the combination of a high exposure VOI scan and a low exposure full-field scan was
estimated to be similar to that from regular full-field scan at standard exposure level. The VOI CBCT technique allows a
VOI to be imaged with enhanced image quality with an MGD similar to that from regular CBCT technique.
To study the effects of overlapping anatomy on microcalcification detection at various incident exposure levels. Images
of an anthropomorphic breast phantom (RMI 169) overlapping with simulated microcalcifications ranging from 150 to
212 μm in size placed in two breast density regions, fatty and heterogeneously dense, were acquired with an a-Si/a-Se
flat panel based digital mammography system (Selenia) operated with Mo-Mo target/filter combination at 28 kVp. The
mammograms were exposed with 20, 30, 40, 60, 80, 120, 160, 240 and 325 mAs for varying the exposure level. A 4-AFC study was performed for evaluation of the detection performance. Four 400×400-pixel images were displayed as 2×2 array on a LCD flat panel based review workstation. One of the four images contained a cluster of five microcalcifications and was randomly placed in one of the four quadrants. A physicist was asked to select the image
containing the microcalcifications and to report the number of visible microcalcifications. The fraction of correct
responses was computed with two different criteria: (1) the selected images contained one or more microcalcifications,
and (2) the selected images contained 4 or 5 visible microcalcifications. The statistical significance of the differences in fractions for different exposure levels and regions was evaluated. The results showed that, if visibility of one or more
microcalcifications is required, the fractions of correct responses were 1 for all size groups and most exposure levels in
both fatty and heterogeneously dense regions. If a visibility of 80% or more of the microcalcifications was required, the
fractions of correct responses significantly decreased in both regions. The results indicated that microcalcification
detection in the fatty region appeared to be mainly limited by the quantum noise, and that in the heterogeneously dense region may be limited by both the anatomic noise and the quantum noise.
Registration and superimposition of images acquired from two different detectors is essential to dual-resolution cone
beam CT. In this study we implemented and tested a method of integration, which is to register and superimpose the high
resolution volume of interest (VOI) only images to the low resolution full field images. First, we acquired two images
sets: One is low exposure low resolution full field images acquired with a low resolution detector; the other is high
exposure high resolution volume of interest (VOI) images acquired with a high resolution detector and VOI mask. To
locate the VOI positions in full field images, the third images set with VOI mask but without phantom was acquired with the low resolution detector. In the third images set, high contrast VOI boundaries were located and used to determine positions of the VOI in full field images. Then high resolution VOI images were superimposed with the full field images to generate integrated images set. Integrated images set was tested by subtraction from full field images set and then used to reconstruct images using regular FDK algorithm. In the reconstructed images, five Al wires (as small as 152 μm) can be clearly seen in the VOI.
In this study, we demonstrated volume of interest (VOI) scanning technique in dual resolution cone beam CT (CBCT)
breast imaging. A paraffin cylinder with a diameter of 130 mm was used to simulate breast. A wire phantom with a
diameter of 15 mm was constructed as VOI. The phantom contains 8 vertically aluminum wires of various diameters
surrounded by paraffin. The wire phantom was inserted into the breast phantom 45 mm away from the center. The
phantoms were first scanned with a bench top experimental CBCT system at a low exposure level with the detector
operated in a binning mode. Then a VOI mask was placed between the x-ray source and the phantoms. The phantoms
were scanned again with high exposure level and the detector operated in the non-binning mode. The VOI mask was
moved to follow the wire phantom during the whole CT scan to limit the exposures to cover the VOI only. The low
resolution and high resolution images were then combined together for reconstruction with FDK algorithm. Visual
review of the regular and dual resolution CBCT images shows that thinnest resolvable wire in the dual resolution CBCT
images has a diameter of 152 μm. The thinnest resolvable wire in regular CBCT images has a diameter of 254 μm. The
estimated dose to the phantom for dual resolution CBCT is 123% of that with regular CBCT at low exposure level. The dual resolution CBCT technique greatly enhances the CT image quality while still remains a low exposure level to the phantom.
Cone beam breast CT technique provides true three dimensional (3D) images of breast anatomy; however the
detectability of calcification is limited due to low exposure levels on each projection. In this study, we investigated the
possibility of using anisotropic exposure distributions to improve the visibility of calcifications in the breast CT images.
Our approach was to measure the CBCT projections with isotropic high and low exposures separately. Reconstruction
was performed upon different combinations of these two sets of projection sequences to investigate the visibility change
due to the limited-angle high exposure projections. Our preliminary results show that the visibility is improved with the
number of high exposure projections in the combinations. In the future we will measure the CBCT projections with
anisotropic exposures while keeping the total exposure constant.
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