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Purpose. Fast kV-switching (FKS) and dual-layer flat-panel detector (DL-FPD) technologies have been actively studied as promising dual-energy spectral imaging solutions for FPD-based cone-beam computed tomography (CT). However, cone-beam CT (CBCT) spectral imaging is known to face challenges in obtaining accurate and robust material discrimination performance. That is because the energy separation by either FKS or DL-FPD, alone, is still limited, along with apparently unpaired signal levels in the effective low- and high-energy projections in real applications, not to mention the x-ray scatter in cone-beam scan which will make the material decomposition almost impossible if no correction is applied. To further improve CBCT spectral imaging capability, this work aims to promote a source-detector joint multi-energy spectral imaging solution which takes advantages of both FKS and DL-FPD, and to conduct a feasibility study on the first tabletop CBCT system with the joint spectral imaging capability developed. Methods. For CBCT, development of multi-energy spectral imaging can be jointly realized by using an x-ray source with a generator whose kilo-voltages can alternate in tens of Hertz (i.e. FKS), and a DL-FPD whose top- and bottom-layer projections corresponds to different effective energy levels. Thanks to the complimentary characteristics inherent in FKS and DL-FPD, the overall energy separation will be significantly better when compared with FKS or DL-FPD alone, and the x-ray photon detection efficiency will be also improved when compared with FKS alone. In this work, a noise performance analysis using the Cramér–Rao lower bound (CRLB) method is conducted. The CRLB for basis material after a projection-domain material decomposition is derived, followed by a set of numerical calculations of CRLBs, for the FKS, the DL-FPD and the joint solution, respectively. To compensate for the slightly angular mismatch between low- and high- projections in FKS, a dual-domain projection completion scheme is implemented. Afterwards material decomposition from the complete projection data is carried out by using the maximum-likelihood method, followed by reconstruction of basis material and virtual monochromatic images (VMI). In this work, the first FKS and DL-FPD jointly enabled multi-energy tabletop CBCT system, to the best of our knowledge, has been developed in our laboratory. To evaluate its spectral imaging performance, a set of physics experiments are conducted, where the multi-energy and head phantoms are scanned using the 80/105/130 kVp switching pairs and projection data are collected using a prototype DL-FPD, whose both top and bottom layer of panels are composed of 550 μ m of cesium iodine (CsI) scintillators with no intermediate metal filter in-between. Results. The numerical simulations show that the joint spectral imaging solution can lead to a significant improvement in energy separation and lower noise levels in most of material decomposition cases. The physics experiments confirmed the feasibility and superiority of the joint spectral imaging, whose CNRs in the selected regions of interest of the multi-energy phantom were boosted by an average improvement of 21.9%, 20.4% for water basis images and 32.8%, 62.8% for iodine images when compared with that of the FKS and DL-FPD, respectively. For the head phantom case, the joint spectral imaging can effectively reduce the streaking artifacts as well, and the standard deviation in the selected regions of interest are reduced by an average decrement of 19.5% and 8.1% for VMI when compared with that of the FKS and DL-FPD, respectively. Conclusions. A feasibility study of the joint spectral imaging solution for CBCT by utilizing both the FKS and DL-FPD was conducted, with the first tabletop CBCT system having such a capability being developed, which exhibits improved CNR and is more effective in avoiding streaking artifacts as expected. [ABSTRACT FROM AUTHOR]

Cone-beam computed tomography (CBCT) has emerged in recent years as an adequate alternative to mammography and tomosynthesis due to the several advantages over traditional mammography, including its ability to provide 3D images, its reduced radiation dose, and its ability to image dense breasts more effectively and conduct more effective breast compressions, etc. Furthermore, CBCT is capable of providing images with high sensitivity and specificity, allowing a more accurate evaluation, even of dense breasts, where mammography and tomosynthesis may lead to a false diagnosis. Clinical and experimental CBCT systems rely on cesium iodine (CsI:Tl) scintillators for X-ray energy conversion. This study comprises an investigation among different novel CBCT detector technologies, consisting either of scintillators (BGO, LSO:Ce, LYSO:Ce, LuAG:Ce, CaF2:Eu, LaBr3:Ce) or semiconductors (Silicon, CZT) in order to define the optimum detector design for a future experimental setup, dedicated to breast imaging. For this purpose, a micro-CBCT system was adapted, using GATE v9.2.1, consisting of the aforementioned various detection schemes. Two phantom configurations were selected: (a) an aluminum capillary positioned at the center of the field of view in order to calculate the system's spatial resolution and (b) a breast phantom consisting of spheres of different materials, such that their characteristics are close to the breast composition. Breast phantom contrast-to-noise ratios (CNRs) were extracted from the phantom's tomographic images. The images were reconstructed with filtered back projection (FBP) and ordered subsets expectation-maximization (OSEM) algorithms. The semiconductors acted satisfactorily in low-density matter, while LYSO:Ce, LaBr3:Ce, and LuAG:Ce presented adequate CNRs for all the different spheres' densities. The energy converters that are presented in this study were evaluated for their performance against the standard CsI:Tl crystal. [ABSTRACT FROM AUTHOR]

Background: Conventional x‐ray imaging and fluoroscopy have limitations in quantitation due to several challenges, including scatter, beam hardening, and overlapping tissues. Dual‐energy (DE) imaging, with its capability to quantify area density of specific materials, is well‐suited to address such limitations, but only if the dual‐energy projections are acquired with perfect spatial and temporal alignment and corrected for scatter. Purpose: In this work, we propose single‐shot quantitative imaging (SSQI) by combining the use of a primary modulator (PM) and dual‐layer (DL) detector, which enables motion‐free DE imaging with scatter correction in a single exposure. Methods: The key components of our SSQI setup include a PM and DL detector, where the former enables scatter correction for the latter while the latter enables beam hardening correction for the former. The SSQI algorithm allows simultaneous recovery of two material‐specific images and two scatter images using four sub‐measurements from the PM encoding. The concept was first demonstrated using simulation of chest x‐ray imaging for a COVID patient. For validation, we set up SSQI geometry on our tabletop system and imaged acrylic and copper slabs with known thicknesses (acrylic: 0–22.5 cm; copper: 0–0.9 mm), estimated scatter with our SSQI algorithm, and compared the material decomposition (MD) for different combinations of the two materials with ground truth. Second, we imaged an anthropomorphic chest phantom containing contrast in the coronary arteries and compared the MD with and without SSQI. Lastly, to evaluate SSQI in dynamic applications, we constructed a flow phantom that enabled dynamic imaging of iodine contrast. Results: Our simulation study demonstrated that SSQI led to accurate scatter correction and MD, particularly for smaller focal blur and finer PM pitch. In the validation study, we found that the root mean squared error (RMSE) of SSQI estimation was 0.13 cm for acrylic and 0.04 mm for copper. For the anthropomorphic phantom, direct MD resulted in incorrect interpretation of contrast and soft tissue, while SSQI successfully distinguished them quantitatively, reducing RMSE in material‐specific images by 38%–92%. For the flow phantom, SSQI was able to perform accurate dynamic quantitative imaging, separating contrast from the background. Conclusions: We demonstrated the potential of SSQI for robust quantitative x‐ray imaging. The integration of SSQI is straightforward with the addition of a PM and upgrade to a DL detector, which may enable its widespread adoption, including in techniques such as radiography and dynamic imaging (i.e., real‐time image guidance and cone‐beam CT). [ABSTRACT FROM AUTHOR]

The feasibility of full-scan, offset-detector geometry cone-beam CT has been demonstrated for several clinical applications. For full-scan acquisition with offset-detector geometry, data redundancy from complementary views can be exploited during image reconstruction. Envisioning an upright breast CT system, we propose to acquire short-scan data in conjunction with offset-detector geometry. To tackle the resulting incomplete data, we have developed a self-supervised attenuation field network (AFN). AFN leverages the inherent redundancy of cone-beam CT data through coordinate-based representation and known imaging physics. A trained AFN can query attenuation coefficients using their respective coordinates or synthesize projection data including the missing projections. The AFN was evaluated using clinical cone-beam breast CT datasets (n = 50). While conventional analytical and iterative reconstruction methods failed to reconstruct the incomplete data, AFN reconstruction was not statistically different from the reference reconstruction obtained using full-scan, full-detector data in terms of image noise, image contrast, and the full width at half maximum of calcifications. This study indicates the feasibility of a simultaneous short-scan and offset-detector geometry for dedicated breast CT imaging. The proposed AFN technique can potentially be expanded to other cone-beam CT applications. [ABSTRACT FROM AUTHOR]

Background: Improving imaging speed has always been the focus of research in CT technology, which is related to the radiation dose and imaging quality of moving organs, including heart and blood vessels. However, it is difficult to achieve further improvement by increasing the rotation speed of the gantry due to its structural strength limitation. Differing from the conventional CTs, the static CT employs dozens of ray sources to acquire projection data from different angular ranges, and each source only needs to be rotated in a small range to finish a full 360° scan, thus greatly increasing the scanning speed. Purpose: As sources of static CT need to be evenly distributed over 360°, the sources and detectors have to be arranged on two parallel rings independently. Such a geometry can be considered as a special case of CT systems with a significantly large cone angle, that is, a part of the detector is missing in the vicinity of the mid‐plane. Due to restriction of upper and lower bounds of the cone angle of the static CT, there are uneven projection data varying in each portion of the reconstruction volume, the conventional analytical or iterative reconstruction methods may introduce artifacts in the reconstructed outcomes. Methods: Following the weighting approach extended FDK (xFDK) by Grimmer et al., we propose an improved bilateral xFDK algorithm (bixFDK), which focuses on the reconstruction of the expanded volume. With the same philosophy as xFDK in terms of weighting function design, bixFDK takes the longitudinal offset of the detector with respect to the source into consideration, making our method applicable to a wide range of CT geometries, especially for the static CT. Based on the proposed bixFDK, a new iterative scheme bixFDK‐IR is also constructed to extend the applications to a wide range of scan protocols such as sparse‐view scan. Results: The proposed method has been validated with the simulated phantom data and the actual clinical data of the static CT, and demonstrates that it can ensure good image quality and enlarge the reconstruction volume in z‐direction of the static CT. Conclusions: The bixFDK algorithm is an ideal reconstruction approach for static CT geometry, and the iterative scheme of bixFDK‐IR is applicable to a wide range of CT geometries and scan protocols, thus providing a wide range of application scenarios. [ABSTRACT FROM AUTHOR]

Cone beam CT (CBCT) remains the clinical standard for image-guided radiotherapy (IGRT) but can suffer from poor image quality including artifacts arising from patient motion occurring during slow image acquisition. Increasing image acquisition speed through faster gantry rotation and larger detector panels enabling short-scan protocols may decrease sensitivity to patient motion. This work systematically assesses the impact of CBCT acquisition speed on image quality in terms of normal tissue structure localization at varying subject motion amplitudes using a phantom imaged using a novel CBCT system with 6 s acquisition time. Images of an anthropomorphic abdomen phantom were acquired with one diagnostic fan beam CT with 0.5 s/gantry rotation, an advanced closed ring CBCT system with 16.6 s/acquisition and a novel high-speed CBCT system with 6 s/acquisition, denoted FB-0.5, CB-16.6, and CB-6, respectively. Sinusoidal motions with 4 s period and amplitudes ranging from ±0.0 to ±10.0 mm were applied during image acquisition on all systems. 27 bony and 9 soft tissue thoracic and abdominal structures were automatically segmented on each image using a validated open-source deep learning approach (TotalSegmentator, 3DSlicer). All images were rigidly registered to a common frame of reference, and contours were compared using distance-to-agreement (DTA) with the stationary FB-0.5 scenario as the comparison benchmark. Key results are summarized in Table 1. Both CBCT systems provided accurate detection and localization of most normal tissue structures compared to diagnostic FBCT. The CB-6 and CB-16.6 exhibited similar trends in performance for the motion amplitudes ≤ ± 2.5 mm, but the CB-6 scanner exhibited improved performance at motion amplitudes ≥ ± 5.0 mm. At ±5.0 mm motion amplitude, mean ± SD DTA were 0.47 ± 0.43 mm and 0.95 ± 0.69 mm for the CB-6 and CB-16.6 scanners, respectively. Increasing CBCT acquisition speed from 16.6 s/image to 6 s/image reduced bony and soft tissue contouring error for motion amplitudes ≥ ± 5.0 mm. Fast CBCT holds promise to significantly improve image quality in the presence of patient motion for advanced IGRT workflows. [ABSTRACT FROM AUTHOR]

In dental cone-beam computed tomography (CBCT), the image quality often degrades when patients have metallic objects such as metal implants and/or metal prostheses. Metal artifacts typically appear as streaks and shadows in the reconstructed CT images, limiting their clinical usefulness. Although various metal artifact reduction (MAR) methods are used in dental CBCT, no algorithm that can robustly remove metal artifacts has been universally accepted. Recent research has explored the potential benefits of using of a photon-counting detector (PCD) to advance enhanced MAR. PCD can classify x-ray photons into several different energy bins, allowing for more precise measurements of x-ray attenuation. Therefore, in this study, we propose a new MAR method based on the use of a PCD, named the high-energy trace normalized-MAR (HT-NMAR) algorithm, to ensure improved image quality. The proposed MAR algorithm consists of three main steps: 1) Segmentation of the metal trace using a high-energy binned sinogram, 2) Generation of a residual artifact-reduced prior, 3) Sinogram completion with the segmented metal trace and the prior, followed by CBCT reconstruction. We conducted a simulation on a numerical head phantom with metal inserts using a PCD simulation toolkit to demonstrate its efficacy. Our simulation study indicates that the proposed MAR method considerably reduces metal artifacts in CBCT and shows a better image performance than other existing MAR methods in reducing streak artifacts without any contrast anomaly. • High-energy trace normalized-MAR (HT-NMAR), a new MAR method based on the use of a PCD, is proposed. • Dental CBCT's image quality degrades with metallic objects, hindering clinical usefulness. • The proposed high-energy trace normalized-MAR (HT-NMAR) algorithm uses PCD for improved image quality. • Simulation study shows the proposed MAR method considerably reduces metal artifacts and outperforms other methods. [ABSTRACT FROM AUTHOR]