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Digital breast tomosynthesis (DBT) system is a novel imaging modality which is strongly depended on the performance of a detector. Recently, effective detective quantum efficiency (eDQE) has been introduced to solve the disadvantages of conventional DQE evaluations which do not consider clinical operating conditions. For eDQE evaluation, the variety of patient breast, especially the glandularity and thickness needs to be studied to consider different races of patient. For these reasons, eDQE in a prototype DBT system considering different breast thickness and glandularity was evaluated. In this study, we used the prototype DBT system with CsI(Tl) scintillator/CMOS flat panel digital detector developed by Korea Electrotechnology Research Institute (KERI). A scatter fraction, a transmission factor, an effective modulation transfer function (eMTF) and an effective normalized noise power spectrum (eNNPS) were measured in different thickness and glandularity of breast equivalent phantom. As results, scatter fraction increased and transmission fraction decreased by a factor of 2.09 and 6.25, respectively, as increasing glandularity and thickness. We also found that the breast phantom with small thickness presented high eMTF and low eNNPS. As results, eDQE from 4 cm thick breast phantom with 30% and 70% glandularity showed small changes from 0.20 to 0.19 at 0.1 mm-1, whereas eDQE from 50% glandularity of 3 cm and 5 cm presented relatively significant increase from 0.16 to 0.20 at 0.1 mm-1 spatial frequency. These indicated that eDQE was strongly affected by phantom thickness, but the effect of glandularity seemed to be trivial. According to our study, the whole system evaluation considering the races of patients from standard to abnormal cases is needed to be studied in future works.

The chest digital tomosynthesis(CDT) is recently developed medical device that has several advantage for diagnosing lung disease. For example, CDT provides depth information with relatively low radiation dose compared to computed tomography (CT). However, a major problem with CDT is the image artifacts associated with data incompleteness resulting from limited angle data acquisition in CDT geometry. For this reason, the sensitivity of lung disease was not clear compared to CT. In this study, to improve sensitivity of lung disease detection in CDT, we developed computer aided diagnosis (CAD) systems based on machine learning. For design CAD systems, we used 100 cases of lung nodules cropped images and 100 cases of normal lesion cropped images acquired by lung man phantoms and proto type CDT. We used machine learning techniques based on support vector machine and Gabor filter. The Gabor filter was used for extracting characteristics of lung nodules and we compared performance of feature extraction of Gabor filter with various scale and orientation parameters. We used 3, 4, 5 scales and 4, 6, 8 orientations. After extracting features, support vector machine (SVM) was used for classifying feature of lesions. The linear, polynomial and Gaussian kernels of SVM were compared to decide the best SVM conditions for CDT reconstruction images. The results of CAD system with machine learning showed the capability of automatically lung lesion detection. Furthermore detection performance was the best when Gabor filter with 5 scale and 8 orientation and SVM with Gaussian kernel were used. In conclusion, our suggested CAD system showed improving sensitivity of lung lesion detection in CDT and decide Gabor filter and SVM conditions to achieve higher detection performance of our developed CAD system for CDT.

Chest digital tomosynthesis (CDT) is a new 3D imaging technique that can be expected to improve clinical diagnosis over conventional chest radiography. We investigated the effect of the angular range of data acquisition on the image quality using newly developed CDT system. The four different acquisition sets were studied using ±15°, ±20°, ±30°, and ±35° angular ranges with 21 projection views (PVs). The point spread function (PSF), modulation transfer function (MTF), artifact spread function (ASF), and normalized contrast-to-noise ratio (CNR) were used to evaluate the image quality. We found that increasing angular ranges improved vertical resolution. The results indicated that there was the opposite relationship of the CNR with angular range for the two tissue types. While CNR for heart tissue increased with increasing angular range, CNR for spine bone decreased. The results showed that the angular range is an important parameter for the CDT exam.

Lung cancer is the leading cause of cancer death worldwide and the early diagnosis of lung cancer has recently become more important. For early screening lung cancer, computed tomography (CT) has been used as a gold standard for early diagnosis of lung cancer [1]. The major advantage of CT is that it is not susceptible to the problem of misdiagnosis caused by anatomical overlapping while CT has extremely high radiation dose and cost compared to chest radiography. Chest digital tomosynthesis (CDT) is a recently introduced new modality for lung cancer screening with relatively low radiation dose compared to CT [2] and also showing high sensitivity and specificity to prevent anatomical overlapping occurred in chest radiography. Dual energy material decomposition method has been proposed for better detection of pulmonary nodules as means of reducing the anatomical noise [3]. In this study, possibility of material decomposition in CDT was tested by simulation study and actual experiment using prototype CDT. Furthermore organ absorbed dose and effective dose were compared with single energy CDT. The Gate v6 (Geant4 application for tomographic emission), and TASMIP (Tungsten anode spectral model using the interpolating polynomial) code were used for simulation study and simulated cylinder shape phantom consisted of 4 inner beads which were filled with spine, rib, muscle and lung equivalent materials. The patient dose was estimated by PCXMC 1.5 Monte Carlo simulation tool [4]. The tomosynthesis scan was performed with a linear movement and 21 projection images were obtained over 30 degree of angular range with 1.5° degree of angular interval. The proto type CDT system has same geometry with simulation study and composed of E7869X (Toshiba, Japan) x-ray tube and FDX3543RPW (Toshiba, Japan) detector. The result images showed that reconstructed with dual energy clearly visualize lung filed by removing unnecessary bony structure. Furthermore, dual energy CDT could enhance spine bone hidden by heart effectively. The effective dose in dual energy CDT was slightly higher than single energy CDT, while only 10% of average thoracic CT [5]. Dual energy tomosynthesis is a new technique; therefore, there is little guidance for its integration into the clinical practice and this study can be used to improve diagnosis efficiency of lung field screening using CDT

Breast cancer is one of the most common malignancies in women. For years, mammography has been used as the gold standard for localizing breast cancer, despite its limitation in determining cancer composition. Therefore, the purpose of this simulation study is to confirm the feasibility of obtaining tumor composition using dual energy digital mammography. To generate X-ray sources for dual energy mammography, 26 kVp and 39 kVp voltages were generated for low and high energy beams, respectively. Additionally, the energy subtraction and inverse mapping functions were applied to provide compositional images. The resultant images showed that the breast composition obtained by the inverse mapping function with cubic fitting achieved the highest accuracy and least noise. Furthermore, breast density analysis with cubic fitting showed less than 10% error compare to true values. In conclusion, this study demonstrated the feasibility of creating individual compositional images and capability of analyzing breast density effectively.

Digital tomosynthesis system (DTS), which scans an object in a limited angle, has been considered as an innovative imaging modality which can present lower patient dose than computed tomography and solve the problem of poor depth resolution in conventional digital radiography. Although it has many powerful advantages, only breast tomosynthesis system has been adopted in many hospitals. In order to reduce the patient dose while maintaining image quality, the acquisition conditions need to be studied. In this study, we analyzed effective dose and image qualities of chest phantom using commercialized universal chest digital tomosynthesis (CDT) R/F system to study the optimized exposure parameters. We set 10 different acquisition conditions including the default acquisition condition by user manual of Shimadzu (100 kVp with 0.5 mAs). The effective dose was calculated from PCXMC software version 1.5.1 by utilizing the total X-ray exposure measured by ion chamber. The image quality was evaluated by signal difference to noise ratio (SDNR) in the regions of interest (ROIs) pulmonary arteries at different axial in-plane. We analyzed a figure of merit (FOM) which considers both the effective dose and the SDNR in order to determine the optimal acquisition condition. The results indicated that the most suitable acquisition parameters among 10 conditions were condition 7 and 8 (120 kVp with 0.04 mAs and 0.1 mAs, respectively), which indicated lower effective dose while maintaining reasonable SDNRs and FOMs for three specified regions. Further studies are needed to be conducted for detailed outcomes in CDT acquisition conditions.

Cone-beam computed tomography (CBCT) has widely been used and studied in both medical imaging and radiation therapy. The aim of this study was to evaluate our newly developed CBCT system by implementing a distance-driven system modeling technique in order to produce excellent and accurate cross-sectional images. For the purpose of comparing the performance of the distance-driven methods, we also performed pixel-driven and ray-driven techniques when conducting forward- and back-projection schemes. We conducted the Feldkamp-Davis-Kress (FDK) algorithm and simultaneous algebraic reconstruction technique (SART) to retrieve a volumetric information of scanned chest phantom. The results indicated that contrast-to-noise (CNR) of the reconstructed images by using FDK and SART showed 8.02 and 15.78 for distance-driven, whereas 4.02 and 5.16 for pixel-driven scheme and 7.81 and 13.01 for ray-driven scheme, respectively. This could demonstrate that distance-driven method described more closely the chest phantom compared to pixel- and ray-driven. However, both elapsed time for modeling a system matrix and reconstruction time took longer time when performing the distance-driven scheme. Therefore, future works will be directed toward reducing computational time to acceptable limits for real applications.

Image evaluation is necessary in digital radiography (DR) which is widely used in medical imaging. Among parameters of image evaluation, modulation transfer function (MTF) is the important factor in the field of medical imaging and necessary to obtain detective quantum efficiency (DQE) which represents overall performance of the detector signal-to-noise ratio. However, the accurate measurement of MTF is still not easy because of geometric effect, electric noise, quantum noise, and truncation error. Therefore, in order to improve accuracy of MTF, four experimental methods were tested in this study such as changing the tube current, applying smoothing method in edge spread function (ESF), adjusting line spread function (LSF) range, and changing tube angle. Our results showed that MTF’s fluctuation was decreased by high tube current and smoothing method. However, tube current should not exceed detector saturation and smoothing in ESF causes a distortion in ESF and MTF. In addition, decreasing LSF range diminished fluctuation and the number of sampling in MTF and high tube angle generates degradation in MTF. Based on these results, excessively low tube current and the smoothing method should be avoided. Also, optimal range of LSF considering reduction of fluctuation and the number of sampling in MTF was necessary and precise tube angle is essential to obtain an accurate MTF. In conclusion, our results demonstrated that accurate MTF can be acquired.

Algorithmic system modeling which includes a geometric motion of source, phantom, and detector for reconstructing the tomographic images is well-known in medical imaging field. Especially in a digital X-ray tomosynthesis system (DTS) which scans an object in limited angle, not a full 360-degree, an accurate system modeling should be derived to reconstruct an excellent cross sectional image. In this study, we analytically modeled a ray-driven forward projector and a pixel-driven back-projector. We firstly acquired forward projected images of a computerized Shepp-Logan phantom over an ±20° angular range using ray-driven projector. On top of that, we reconstructed the analytically scanned phantom using pixel-driven back-projector based on a conventional filtered back-projection (FBP) in tomosynthesis. We evaluated root-mean-square errors (RMSEs) and horizontal profiles of normalized pixel values in the reconstructed axial cross sectional images. The results indicated that pixel-driven back-projector combined with ray-driven projector showed low RMSEs of 0.25, 0.49, 0.80, 1.46, and 0.94 among five different regions-of-interests (ROIs). Illustrated horizontal profiles of normalized pixel values between the referenced phantom and reconstructed object showed similar values, which demonstrated that both ray- and pixel-driven projector/back-projector could be utilized in linear motion DTS.

Scattered radiation is inevitably generated in the object. The distribution of the scattered radiation is influenced by object thickness, filed size, object-to-detector distance, and primary energy. One of the investigations to measure scatter intensities involves measuring the signal detected under the shadow of the lead discs of a beam-stop array (BSA). The measured scatter by BSA includes not only the scattered radiation within the object (object scatter), but also the external scatter source. The components of external scatter source include the X-ray tube, detector, collimator, x-ray filter, and BSA. Excluding background scattered radiation can be applied to different scanner geometry by simple parameter adjustments without prior knowledge of the scanned object. In this study, a method using BSA to differentiate scatter in phantom (object scatter) from external background was used. Furthermore, this method was applied to BSA algorithm to correct the object scatter. In order to confirm background scattered radiation, we obtained the scatter profiles and scatter fraction (SF) profiles in the directions perpendicular to the chest wall edge (CWE) with and without scattering material. The scatter profiles with and without the scattering material were similar in the region between 127 mm and 228 mm from chest wall. This result indicated that the measured scatter by BSA included background scatter. Moreover, the BSA algorithm with the proposed method could correct the object scatter because the total radiation profiles of object scatter correction corresponded to original image in the region between 127 mm and 228 mm from chest wall. As a result, the BSA method to measure object scatter could be used to remove background scatter. This method could apply for different scanner geometry after background scatter correction. In conclusion, the BSA algorithm with the proposed method is effective to correct object scatter.

In previous study, to improve both sensitivity and spatial resolution, we recommended to use a pixelated parallel-hole collimator with equal hole and pixel sizes based on CdTe pixelated semiconductor SPECT system. However, the tradeoff between sensitivity and spatial resolution is needed before determination of pixelated parallel-hole collimator geometric designs. The detective quantum efficiency (DQE) is a concept which takes both the sensitivity and spatial resolution into account to provide an overall measure and may be better suited for optimization. The purpose of this study was to optimize and evaluate the above-mentioned collimators using DQE to determine the best image performance of CdTe pixelated semiconductor SPECT system. We conducted a simulation study using a Geant4 Application for Tomographic Emission (GATE) simulation. To evaluate the DQE from modulation transfer function (MTF) and sensitivity, the collimator septal heights were varied from 15 to 30 mm in 5 mm increments at step and source-to-collimator distances were 4, 5, 6, and 7 cm. According to the results, the DQE decreased with increasing source-to-collimator distance and septal height. We have presented the evaluation results of pixelated parallel-hole collimators with various geometric designs. In conclusion, we successfully optimized the pixelated parallel-hole collimator, and based on our results, we recommended using lower septal height with smaller source-to-collimator distance with CdTe pixelated semiconductor SPECT system.

The purpose of this study was to investigate the effect of different acquisition parameters and to characterize their relationships in order to improve the detection of microcalcifications using digital breast tomosynthesis (DBT). DBT imaging parameters were optimized using 32 different acquisition sets with six angular ranges (±5°, ±10°, ±13°, ±17°, ±21°, and ±25°) and eight projection views (5, 11, 15, 21, 25, 31, 41, and 51 projections). To investigate the effects of variable angular dose distribution, the acquisition sets were evaluated with delivering more dose toward the central views. Our results show that a wide angular range improved the reconstructed image quality in the z-direction. If a large number of projections are acquired, then electronic noise may dominate the contrast-to-noise ratio (CNR) due to reduced radiation dose per projection. With delivering more dose toward the central views, it was found that the vertical resolution was reduced with increasing dose in the central PVs. On the other hand, the CNR clearly increased with increasing concentration of dose distribution in central views. Although it was found that increasing angular range improved the vertical resolution, it was also found that the image quality of microcalcifications in the in-focus plane did not improve by increasing the noise due to greater effective breast thickness. Angular dose distributions, with more dose delivered to the central views, generally yielded a higher quality factor (QF) than uniform dose distributions.

The pediatric patients are more susceptible to the effects of ionizing radiation than adults. Pediatric patients are smaller, more radiosensitive than adult patients and many cannot stand unassisted. Their characteristics affect the method of imaging projection and how dose is optimized. The purpose of this study was to investigate the effect of various technical parameters for the dose optimization in pediatric chest radiological examinations by evaluating effective dose and effective detective quantum efficiency (eDQE) including the scatter radiation from the object, the blur caused by the focal spot, geometric magnification and detector characteristics. For the tube voltages ranging from 40 to 90 kV in 10 kV increments at the focus-to-detector distance of 100, 110, 120, 150, 180 cm, the eDQE was evaluated at same effective dose. The results showed that the eDQE was largest at 60 kVp without and with an anti-scatter grid. Especially, the eDQE was considerably higher without the use of an anti-scatter grid on equivalent effective dose. This indicates that the reducing the scatter radiation did not compensate for the loss of absorbed effective photons in the grid. When the grid is not used the eDQE increased with increasing focus-to-detector distance because of the greater effective modulation transfer function (eMTF) with the lower focal spot blurring. In conclusion, for pediatric patients, the amount of scattered radiation is less, and the amount of grid attenuation increased unnecessary radiation dose.

The dual-energy computed tomography (CT) techniques can be adopted to separate the materials having similar Houndsfield Unit (HU) value such as tissues. In the technique, CT image values can be described as effective atomic number and electron density using the dual-energy equation. In this work, we measured effective atomic number and electron density using dual-energy CT images and assessed the image quality in vascular application. For the effective atomic number assessment, the measurements of a Polymethyl methacrylate (PMMA) and water demonstrated small discrepancies of 3.28 % and 5.56 %, respectively. For electron density measurement, the experimental errors of PMMA and water were 7.83 % and 4.00 %, respectively. The trend obtained when comparing the HU values and absolute values such as effective atomic number and electron density demonstrates that the CNR of the HU values is higher than that of the absolute values such as effective atomic number and electron density. With contrast media having low concentration, it is remarkable that the effective atomic number image occasionally has higher CNR values than the HU images. In this study, small discrepancies between the experimental values and known values were obtained. The CNR values provided meaningful results for the absolute measurements in a dual-energy CT technique.