Technical Note: Phantom study to evaluate the dose and image quality effects of a computed tomography Organ-based Tube Current Modulation Technique

Purpose This technical note quantifies the dose and image quality performance of a clinically available organ-dose-based tube current modulation (ODM) technique, using experimental and simulation phantom studies. The investigated ODM implementation reduces the tube current for the anterior source positions, without increasing current for posterior positions, although such an approach was also evaluated for comparison. Methods Axial CT scans at 120 kV were performed on head and chest phantoms on an ODM-equipped scanner (Optima CT660, GE Healthcare, Chalfont St. Giles, England). Dosimeters quantified dose to breast, lung, heart, spine, eye lens, and brain regions for ODM and 3D-modulation (SmartmA) settings. Monte Carlo simulations, validated with experimental data, were performed on 28 voxelized head phantoms and 10 chest phantoms to quantify organ dose and noise standard deviation. The dose and noise effects of increasing the posterior tube current were also investigated. Results ODM reduced the dose for all experimental dosimeters with respect to SmartmA, with average dose reductions across dosimeters of 31% (breast), 21% (lung), 24% (heart), 6% (spine), 19% (eye lens), and 11% (brain), with similar results for the simulation validation study. In the phantom library study, the average dose reduction across all phantoms was 34% (breast), 20% (lung), 8% (spine), 20% (eye lens), and 8% (brain). ODM increased the noise standard deviation in reconstructed images by 6%–20%, with generally greater noise increases in anterior regions. Increasing the posterior tube current provided similar dose reduction as ODM for breast and eye lens, increased dose to the spine, with noise effects ranging from 2% noise reduction to 16% noise increase. At noise equal to SmartmA, ODM increased the estimated effective dose by 4% and 8% for chest and head scans, respectively. Increasing the posterior tube current further increased the effective dose by 15% (chest) and 18% (head) relative to SmartmA. Conclusions ODM reduced dose in all experimental and simulation studies over a range of phantoms, while increasing noise. The results suggest a net dose/noise benefit for breast and eye lens for all studied phantoms, negligible lung dose effects for two phantoms, increased lung dose and/or noise for eight phantoms, and increased dose and/or noise for brain and spine for all studied phantoms compared to the reference protocol

Reducing Radiation Dose to the Female Breast during CT Coronary Angiography: A Simulation Study Comparing Breast Shielding, Angular Tube Current Modulation, Reduced kV, and Partial Angle Protocols Using an Unknown-location Signal-detectability Metric

Purpose: The authors compared the performance of five protocols intended to reduce dose to the breast during computed tomography (CT) coronary angiography scans using a model observer unknown-location signal-detectability metric. Methods: The authors simulated CT images of an anthropomorphic female thorax phantom for a 120 kV reference protocol and five “dose reduction” protocols intended to reduce dose to the breast: 120 kV partial angle (posteriorly centered), 120 kV tube-current modulated (TCM), 120 kV with shielded breasts, 80 kV, and 80 kV partial angle (posteriorly centered). Two image quality tasks were investigated: the detection and localization of 4-mm, 3.25 mg/ml and 1-mm, 6.0 mg/ml iodine contrast signals randomly located in the heart region. For each protocol, the authors plotted the signal detectability, as quantified by the area under the exponentially transformed free response characteristic curve estimator (AˆFE), as well as noise and contrast-to-noise ratio (CNR) versus breast and lung dose. In addition, the authors quantified each protocol\u27s dose performance as the percent difference in dose relative to the reference protocol achieved while maintaining equivalentAˆFE. Results: For the 4-mm signal-size task, the 80 kV full scan and 80 kV partial angle protocols decreased dose to the breast (80.5% and 85.3%, respectively) and lung (80.5% and 76.7%, respectively) withAˆFE= 0.96, but also resulted in an approximate three-fold increase in image noise. The 120 kV partial protocol reduced dose to the breast (17.6%) at the expense of increased lung dose (25.3%). The TCM algorithm decreased dose to the breast (6.0%) and lung (10.4%). Breast shielding increased breast dose (67.8%) and lung dose (103.4%). The 80 kV and 80 kV partial protocols demonstrated greater dose reductions for the 4-mm task than for the 1-mm task, and the shielded protocol showed a larger increase in dose for the 4-mm task than for the 1-mm task. In general, the CNR curves indicate a similar relative ranking of protocol performance as the correspondingAˆFEcurves, however, the CNR metric overestimated the performance of the shielded protocol for both tasks, leading to corresponding underestimates in the relative dose increases compared to those obtained when using theAˆFEmetric. Conclusions: The 80 kV and 80 kV partial angle protocols demonstrated the greatest reduction to breast and lung dose, however, the subsequent increase in image noise may be deemed clinically unacceptable. Tube output for these protocols can be adjusted to achieve a more desirable noise level with lesser breast dose savings. Breast shielding increased breast and lung dose when maintaining equivalentAˆFE. The results demonstrated that comparisons of dose performance depend on both the image quality metric and the specific task, and that CNR may not be a reliable metric of signal detectability

Quantifying the Tibiofemoral Joint Space Using X-ray Tomosynthesis

Purpose: Digital x-ray tomosynthesis (DTS) has the potential to provide 3D information about the knee joint in a load-bearing posture, which may improve diagnosis and monitoring of knee osteoarthritis compared with projection radiography, the current standard of care. Manually quantifying and visualizing the joint space width (JSW) from 3D tomosynthesis datasets may be challenging. This work developed a semiautomated algorithm for quantifying the 3D tibiofemoral JSW from reconstructed DTS images. The algorithm was validated through anthropomorphic phantom experiments and applied to three clinical datasets. Methods: A user-selected volume of interest within the reconstructed DTS volume was enhanced with 1D multiscale gradient kernels. The edge-enhanced volumes were divided by polarity into tibial and femoral edge maps and combined across kernel scales. A 2D connected components algorithm was performed to determine candidate tibial and femoral edges. A 2D joint space width map (JSW) was constructed to represent the 3D tibiofemoral joint space. To quantify the algorithm accuracy, an adjustable knee phantom was constructed, and eleven posterior–anterior (PA) and lateral DTS scans were acquired with the medial minimum JSW of the phantom set to 0–5 mm in 0.5 mm increments (VolumeRadTM, GE Healthcare, Chalfont St. Giles, United Kingdom). The accuracy of the algorithm was quantified by comparing the minimum JSW in a region of interest in the medial compartment of the JSW map to the measured phantom setting for each trial. In addition, the algorithm was applied to DTS scans of a static knee phantom and the JSW map compared to values estimated from a manually segmented computed tomography (CT) dataset. The algorithm was also applied to three clinical DTS datasets of osteoarthritic patients. Results: The algorithm segmented the JSW and generated a JSW map for all phantom and clinical datasets. For the adjustable phantom, the estimated minimum JSW values were plotted against the measured values for all trials. A linear fit estimated a slope of 0.887 (R2¼0.962) and a mean error across all trials of 0.34 mm for the PA phantom data. The estimated minimum JSW values for the lateral adjustable phantom acquisitions were found to have low correlation to the measured values (R2¼0.377), with a mean error of 2.13 mm. The error in the lateral adjustable-phantom datasets appeared to be caused by artifacts due to unrealistic features in the phantom bones. JSW maps generated by DTS and CT varied by a mean of 0.6 mm and 0.8 mm across the knee joint, for PA and lateral scans. The tibial and femoral edges were successfully segmented and JSW maps determined for PA and lateral clinical DTS datasets. Conclusions: A semiautomated method is presented for quantifying the 3D joint space in a 2D JSW map using tomosynthesis images. The proposed algorithm quantified the JSW across the knee joint to sub-millimeter accuracy for PA tomosynthesis acquisitions. Overall, the results suggest that x-ray tomosynthesis may be beneficial for diagnosing and monitoring disease progression or treatment of osteoarthritis by providing quantitative images of JSW in the load-bearing knee

Reduction of voluntary dehydration during effort in hot environments

During an experimental marching trip the daily positive fluid balance was preserved by providing a wide choice of beverages during the hours of the day. It was found that the beverage most suitable for drinking in large quantities during periods of effort was a cold drink with sweetened (citrus) fruit taste. Carbonated drinks, including beer, but milk also, were found unsuitable for this purpose

Beyond XSPEC: Towards Highly Configurable Analysis

We present a quantitative comparison between software features of the defacto standard X-ray spectral analysis tool, XSPEC, and ISIS, the Interactive Spectral Interpretation System. Our emphasis is on customized analysis, with ISIS offered as a strong example of configurable software. While noting that XSPEC has been of immense value to astronomers, and that its scientific core is moderately extensible--most commonly via the inclusion of user contributed "local models"--we identify a series of limitations with its use beyond conventional spectral modeling. We argue that from the viewpoint of the astronomical user, the XSPEC internal structure presents a Black Box Problem, with many of its important features hidden from the top-level interface, thus discouraging user customization. Drawing from examples in custom modeling, numerical analysis, parallel computation, visualization, data management, and automated code generation, we show how a numerically scriptable, modular, and extensible analysis platform such as ISIS facilitates many forms of advanced astrophysical inquiry.Comment: Accepted by PASP, for July 2008 (15 pages

Automated quantification and evaluation of motion artifact on coronary CT angiography images

Abstract Purpose This study developed and validated a Motion Artifact Quantification algorithm to automatically quantify the severity of motion artifacts on coronary computed tomography angiography (CCTA) images. The algorithm was then used to develop a Motion IQ Decision method to automatically identify whether a CCTA dataset is of sufficient diagnostic image quality or requires further correction. Method The developed Motion Artifact Quantification algorithm includes steps to identify the right coronary artery (RCA) regions of interest (ROIs), segment vessel and shading artifacts, and to calculate the motion artifact score (MAS) metric. The segmentation algorithms were verified against ground‐truth manual segmentations. The segmentation algorithms were also verified by comparing and analyzing the MAS calculated from ground‐truth segmentations and the algorithm‐generated segmentations. The Motion IQ Decision algorithm first identifies slices with unsatisfactory image quality using a MAS threshold. The algorithm then uses an artifact‐length threshold to determine whether the degraded vessel segment is large enough to cause the dataset to be nondiagnostic. An observer study on 30 clinical CCTA datasets was performed to obtain the ground‐truth decisions of whether the datasets were of sufficient image quality. A five‐fold cross‐validation was used to identify the thresholds and to evaluate the Motion IQ Decision algorithm. Results The automated segmentation algorithms in the Motion Artifact Quantification algorithm resulted in Dice coefficients of 0.84 for the segmented vessel regions and 0.75 for the segmented shading artifact regions. The MAS calculated using the automated algorithm was within 10% of the values obtained using ground‐truth segmentations. The MAS threshold and artifact‐length thresholds were determined by the ROC analysis to be 0.6 and 6.25 mm by all folds. The Motion IQ Decision algorithm demonstrated 100% sensitivity, 66.7% ± 27.9% specificity, and a total accuracy of 86.7% ± 12.5% for identifying datasets in which the RCA required correction. The Motion IQ Decision algorithm demonstrated 91.3% sensitivity, 71.4% specificity, and a total accuracy of 86.7% for identifying CCTA datasets that need correction for any of the three main vessels. Conclusion The Motion Artifact Quantification algorithm calculated accurate

CT Automated Exposure Control Using A Generalized Detectability Index

Purpose Identifying an appropriate tube current setting can be challenging when using iterative reconstruction due to the varying relationship between spatial resolution, contrast, noise, and dose across different algorithms. This study developed and investigated the application of a generalized detectability index (d\u27gen) to determine the noise parameter to input to existing automated exposure control (AEC) systems to provide consistent image quality (IQ) across different reconstruction approaches. Methods This study proposes a task‐based automated exposure control (AEC) method using a generalized detectability index (d\u27gen). The proposed method leverages existing AEC methods that are based on a prescribed noise level. The generalized d\u27gen metric is calculated using lookup tables of task‐based modulation transfer function (MTF) and noise power spectrum (NPS). To generate the lookup tables, the American College of Radiology CT accreditation phantom was scanned on a multidetector CT scanner (Revolution CT, GE Healthcare) at 120 kV and tube current varied manually from 20 to 240 mAs. Images were reconstructed using a reference reconstruction algorithm and four levels of an in‐house iterative reconstruction algorithm with different regularization strengths (IR1–IR4). The task‐based MTF and NPS were estimated from the measured images to create lookup tables of scaling factors that convert between d\u27gen and noise standard deviation. The performance of the proposed d\u27gen‐AEC method in providing a desired IQ level over a range of iterative reconstruction algorithms was evaluated using the American College of Radiology (ACR) phantom with elliptical shell and using a human reader evaluation on anthropomorphic phantom images. Results The study of the ACR phantom with elliptical shell demonstrated reasonable agreement between the d\u27gen predicted by the lookup table and d\u27 measured in the images, with a mean absolute error of 15% across all dose levels and maximum error of 45% at the lowest dose level with the elliptical shell. For the anthropomorphic phantom study, the mean reader scores for images resulting from the d\u27gen‐AEC method were 3.3 (reference image), 3.5 (IR1), 3.6 (IR2), 3.5 (IR3), and 2.2 (IR4). When using the d\u27gen‐AEC method, the observers’ IQ scores for the reference reconstruction were statistical equivalent to the scores for IR1, IR2, and IR3 iterative reconstructions (P \u3e 0.35). The d\u27gen‐AEC method achieved this equivalent IQ at lower dose for the IR scans compared to the reference scans. Conclusions A novel AEC method, based on a generalized detectability index, was investigated. The proposed method can be used with some existing AEC systems to derive the tube current profile for iterative reconstruction algorithms. The results provide preliminary evidence that the proposed d\u27gen‐AEC can produce similar IQ across different iterative reconstruction approaches at different dose levels

Prediction of freezing of gait using analysis of brain effective connectivity

© 2014 IEEE. Freezing of gait (FOG) is a debilitating symptom of Parkinson's disease (PD), in which patients experience sudden difficulties in starting or continuing locomotion. It is described by patients as the sensation that their feet are suddenly glued to the ground. This, disturbs their balance, and hence often leads to falls. In this study, directed transfer function (DTF) and partial directed coherence (PDC) were used to calculate the effective connectivity of neural networks, as the input features for systems that can detect FOG based on a Multilayer Perceptron Neural Network, as well as means for assessing the causal relationships in neurophysiological neural networks during FOG episodes. The sensitivity, specificity and accuracy obtained in subject dependent analysis were 82%, 77%, and 78%, respectively. This is a significant improvement compared to previously used methods for detecting FOG, bringing this detection system one step closer to a final version that can be used by the patients to improve their symptoms

Dynamic Load Measurement of Ballistic Gelatin Impact Using an Instrumented Tube

Bird strikes are a common problem for the aerospace industry and can cause serious damage to an aircraft. Ballistic gelatin is frequently used as a surrogate for actual bird carcasses in bird strike tests. Numerical simulations of these tests are used to supplement experimental data, therefore it is necessary to use numerical modeling techniques that can accurately capture the dynamic response of ballistic gelatin. An experimental technique is introduced to validate these modeling techniques. A ballistic gelatin projectile is fired into a strike plate attached to a 36 in. long sensor tube. Dynamic load is measured at two locations relative to the strike plate using strain gages configured in a full Wheatstone bridge. Data from these experiments are used to validate a gelatin constitutive model. Simulations of the apparatus are analyzed to investigate its performance