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Dual energy computed tomography (DECT) enhances tissue characterization by obtaining two or three material images from two measurements with different X-ray spectra. Recently, multi-material decomposition (MMD) in DECT has been studied to obtain decomposed material images for more than three basis materials. However, the MMD method is highly sensitive to noise fluctuation due to the direct inversion and the material triplet selection for each pixel. Although several studies have reported to reduce the noise resulting from direct inversion, no studies have researched reduction in the image quality degradation caused by material triplet selection. We proposed a MMD framework for DECT that includes pre-decomposition and post-decomposition stages to reduce image quality degradation due to material triplet selection and direct inversion. The total variation denoising method was applied to the pre-decomposition and the post-decomposition stages as a noise suppression algorithm. The digital phantom, tissue characterization phantom, and Catphan phantom were employed as test objects in this study. The volume fraction accuracy (VFA) and the standard deviation (STD) were quantitatively calculated to evaluate the quality of the decomposed images. The results of the proposed method were compared to those of the direct MMD (DMMD) and the MMD with total variation denoising (MMD-TVD) methods. Compared to the DMMD method, the proposed method improved average the VFA value by 11.40%, 17.31%, and 19.13% in the digital phantom, the tissue characterization phantom, and the Catphan phantom studies, respectively. The STD values for the proposed method are better than those of the DMMD method, and are similar to those of the MMD-TVD method. Our method successfully improved quantification accuracy and suppressed noise. In conclusion, the proposed method resulted in quantitatively better multi-material images for DECT.

To evaluate a feasibility of normal distribution transform (NDT) algorithm compared with the iterative closest point (ICP) method as a useful surface registration in stereotactic body radiotherapy (SBRT)/stereotactic radiosurgery (SRS).Point cloud images using the 3D triangulation technology were obtained from a depth camera-based optical imaging (OSI) system equipped in a radiosurgery room. Two surface registration algorithms, NDT and ICP, were used to measure and compare the discrepancy values between the reference and the current surfaces during the positioning of the patient. The performance evaluation was investigated by calculating the registration error and root-mean-square (RMS) values for the surface model, reposition, and target accuracy, which were analyzed statistically using a paired t-test.For surface model accuracy, the average of the registration error and RMS values were measured as 3.56 ± 2.20 mm and 6.98 ± 1.89 mm for ICP method, and 1.76 ± 1.32 mm and 3.58 ± 1.30 mm for NDT method (p 0.05). For reposition accuracy, the average registration error and RMS values were calculated as 1.41 ± 0.98 mm and 2.53 ± 1.64 mm using ICP method, and 0.92 ± 0.61 mm and 1.75 ± 0.80 mm using NDT method (p = 0.005). The overall target accuracy using the NDT method reduced the average of the reposition error and overall RMS value by 0.71 and 1.32 mm, respectively, compared to the ICP method (p = 0.03).We found that the surface registration algorithm based on NDT method provides more reliable accuracy in the values of surface model, reposition, and target accuracies than the classic ICP method. The NDT method in OSI systems offers reasonable accuracy in SBRT/SRS.

Background: In malalignment syndrome, the spino-pelvic alignment correction with foot orthotics can be applied only to a standing position in the coronal plane. Considering the fact that the average time Koreans spend sitting in a chair is 7.5 hours per day, studies on spino-pelvic correction in sitting position is needed. The purpose of this study is to investigate the pressure changes and radiographic assessment of spino-pelvic alignment using a chair equipped with a height-adjustable seat-plate.Methods: Experiments were conducted on 30 research participants. The inclusion criteria for the participants were as follows: The volunteers of nonstructural malignment syndrome with shoulder height differences (SHDs) or iliac flea height differences (ICHDs) greater than 5 mm in radiographic images excluding participants with structural deformity. All participants were subjected to measure buttocks interface pressure while seated using a smart chair in three consecutive steps: (1) on initial seated, (2) on balancing seated, and then (3) on 1hr balancing seated. Radiographically, the five spino-pelvic parameters such as SHD, ICHD, LLD, POA, and coronal imbalance were analyzed to investigate the effect of pelvic imbalance compensation on spino-pelvic alignment.Results: Pelvic imbalance was compensated with seat plate height adjustment in average of 3.6 ± 1.8 mm, so that the pressure discrepancy improvement between buttocks from 36.4 ± 32.3 on initial seated to 15.7 ± 20.3 on balancing, 12.7 ± 10.9 on 1hr balancing seated (Ω, p=0.008). The radiographic changes before and after pelvic imbalance compensation demonstrated a statistically significant improvements of spino-pelvic parameters on sitting and standing: at the average value of -0.9 to -0.8 and 9.5 to 2.5, SHD and ICHD, respectively (mm, p=0.005, 0.037) and -3.0 to -1.0, 1.8 to 0.8, and 0.8 to 0.1, SHD, ICHD, and LLD, respectively (mm, p=0.005, 0.016, 0.033).Conclusions: Spino-pelvic malalignment can be improved by individually customized pelvic compensation using balanced seat plate height adjustments under the real-time pressure sensing and monitoring on the buttocks while seated.

Recently, digital tomosynthesis systems have been actively investigated to reduce radiation dose in medical imaging. In this work, we present various beam modulation schemes for low-dose digital tomosynthesis; we compared the effects of the various acquisition schemes on image quality. A prototype chest digital tomosynthesis (CDT) system (LISTEM, Korea) and the LUNGMAN phantom (Kyoto Kagaku, Japan) with lung nodules were used in this study. A total of 81 projection data obtained through various beam modulation schemes over a 40° angular range were reconstructed using the filtered back projection (FBP) algorithm. The contrast noise ratio (CNR), structural similarity index (SSIM), and peak signal-to-noise ratio (PSNR) of the lung nodules were calculated to evaluate the image quality depending on the acquisition scheme. The reconstructed images obtained based on the proposed beam modulation schemes showed enhanced contrast in addition to a reduction of the area dose. It was determined that the beam modulation schemes affect the image quality. Among beam modulation schemes we investigated, the bunched view acquisition (outer focused) showed promising results within the region of interest (ROI). The reconstructed image obtained using the bunched view showed an increase of the CNR value by 63% compared to the conventional acquisition method. In addition, shutter scan acquisition showed promising results for the restoration information for the outside ROI. We determined that the beam modulation schemes in the prototype CDT system affect the image quality. It is also expected that the patient exposure dose can be reduced by modulating the beam size in the prototype CDT system.

The present study aimed to introduce a recently developed digital tomosynthesis system for the chest and describe the procedure for acquiring dual energy bone decomposed tomosynthesis images. Various beam quality and reconstruction algorithms were evaluated for acquiring dual energy chest digital tomosynthesis (CDT) images and the effective dose was calculated with ion chamber and Monte Carlo simulations. The results demonstrated that dual energy CDT improved visualization of the lung field by eliminating the bony structures. In addition, qualitative and quantitative image quality of dual energy CDT using iterative reconstruction was better than that with filtered backprojection (FBP) algorithm. The contrast-to-noise ratio and figure of merit values of dual energy CDT acquired with iterative reconstruction were three times better than those acquired with FBP reconstruction. The difference in the image quality according to the acquisition conditions was not noticeable, but the effective dose was significantly affected by the acquisition condition. The high energy acquisition condition using 130 kVp recorded a relatively high effective dose. We conclude that dual energy CDT has the potential to compensate for major problems in CDT due to decomposed bony structures, which induce significant artifacts. Although there are many variables in the clinical practice, our results regarding reconstruction algorithms and acquisition conditions may be used as the basis for clinical use of dual energy CDT imaging.

Dose reduction techniques have been studied in medical imaging. We propose shutter scan acquisition for region of interest (ROI) imaging to reduce the patient exposure dose received from a digital tomosynthesis system. A prototype chest digital tomosynthesis (CDT) system (LISTEM, Wonju, Korea) and the LUNGMAN phantom (Kyoto Kagaku, Japan) with lung nodules 8, 10, and 12 mm in size were used for this study. A total of 41 projections with shutter scan acquisition consisted of 21 truncated projections and 20 non‐truncated projections. For comparison, 41 projections using conventional full view scan acquisition were also acquired. Truncated projections obtained by shutter scan acquisition were corrected by proposed image processing procedure to remove the truncation artifacts. The image quality was evaluated using the contrast to noise ratio (CNR), coefficient of variation (COV), and figure of merit (FOM). We measured the dose area product (DAP) value to verify the dose reduction using shutter scan acquisition. The ROI of the reconstructed image from shutter scan acquisition showed enhanced contrast. The results showed that CNR values of 8 and 12 mm lung nodules increased by 6.38% and 21.21%, respectively, and the CNR value of 10 mm lung nodule decreased by 3.63%. COV values of the lung nodules were lower in a shutter scan image than in a full view scan image. FOM values of 8, 10, and 12 mm lung nodules increased by 3.06, 2.25, and 2.33 times, respectively. This study compared the proposed shutter scan and conventional full view scan acquisition. In conclusion, using a shutter scan acquisition method resulted in enhanced contrast images within the ROI and higher FOM values. The patient exposure dose of the proposed shutter scan acquisition method can be reduced by limiting the field of view (FOV) to focus on the ROI.

Digital tomosynthesis offers the advantage of low radiation doses compared to conventional computed tomography (CT) by utilizing small numbers of projections (~80) acquired over a limited angular range. It produces 3D volumetric data, although there are artifacts due to incomplete sampling. Based upon these characteristics, we developed a prototype digital tomosynthesis R/F system for applications in chest imaging. Our prototype chest digital tomosynthesis (CDT) R/F system contains an X-ray tube with high power R/F pulse generator, flat-panel detector, R/F table, electromechanical radiographic subsystems including a precise motor controller, and a reconstruction server. For image reconstruction, users select between analytic and iterative reconstruction methods. Our reconstructed images of Catphan700 and LUNGMAN phantoms clearly and rapidly described the internal structures of phantoms using graphics processing unit (GPU) programming. Contrast-to-noise ratio (CNR) values of the CTP682 module of Catphan700 were higher in images using a simultaneous algebraic reconstruction technique (SART) than in those using filtered back-projection (FBP) for all materials by factors of 2.60, 3.78, 5.50, 2.30, 3.70, and 2.52 for air, lung foam, low density polyethylene (LDPE), Delrin® (acetal homopolymer resin), bone 50% (hydroxyapatite), and Teflon, respectively. Total elapsed times for producing 3D volume were 2.92 s and 86.29 s on average for FBP and SART (20 iterations), respectively. The times required for reconstruction were clinically feasible. Moreover, the total radiation dose from our system (5.68 mGy) was lower than that of conventional chest CT scan. Consequently, our prototype tomosynthesis R/F system represents an important advance in digital tomosynthesis applications.

In this study, we estimated the characteristics of the optically stimulated luminescence dosimeter (OSLD), and confirmed the evaluation of the OSLD for intensity modulated radiation therapy (IMRT) dose verification. For the estimation of the characteristics of the OSLD, reproducibility, dose linearity, energy dependence, dose-rate dependence, and angular dependence were evaluated. To minimize the effect of the reproducibility on the other studies, we selected 17 OSLDs which had the reproducibility variation margin of ±1.5%. The result showed the linearity of the OSLD from 0.5 to 2 Gy, but from 2 to 6 Gy, supra-linearity was observed. The photon-rays and electron-rays energy dependences of the OSLD were ±1% and ±0.9%, respectively. The dose-rate dependences were ±0.4% for photon-rays, ±0.3% for electrons, and the angular dependence was ±0.7%. To estimate the evaluation of the OSLD for IMRT dose verification, 5 IMRT dose verification cases and 5 RapidArc dose verification cases were selected. The correction factors which were measured in the estimation of the characteristics of the OSLD were used in the dose conversion and the IMRT dose verification standard ±5% were increased to ±7%, because of the relatively high combined uncertainty of the OSLD. In this study, we estimate the characteristics of the OSLD in photon-rays and electron-rays, and confirm the evaluation of the OSLD for IMRT dose assessment through the logic flow chart, which concerned the size of the cancer and partiality of the radiation therapy center.

A shutter scan acquisition (SSA) method is proposed to reduce patient exposure dose in a chest digital tomosynthesis system. Projections obtained using the SSA constitute a combination of truncated and non-truncated projections. The truncated projections are images in which the lung field is set within a region-of-interest (ROI), and the non-truncated projections are full images in which the ROI is not set at all. We proposed a shutter weighting factor (SWF) as an acquisition parameter for SSA. We call the number of truncated projections divided by the number of non-truncated projections as SWF. We used a prototype CDT system and the LUNGMAN phantom with 8 and 10 mm lung nodules. 81 projections were obtained using SSA in five sets according to the SWFs. The image quality was quantified based on the contrast-to-noise ratio (CNR). We also calculated the figure of merit (FOM) to determine the proper acquisition parameters of the five sets. Both the CNR and FOM values of the 8 mm lung nodule in the selected ROI increased with increases of the SWF. However, the CNR value of the 10 mm lung nodule outside the ROI decreased with increases of the SWF, while the FOM value was maximized when the SWF was 3.05. We investigated the effect of the composition ratio of the truncated and non-truncated projections on the reconstructed images of the SSA based on the FOM values. In conclusion, we determined the proper SSA parameters in a prototype CDT system.

During breast image acquisition from the mammography, the inner regions of the breast are relatively thicker and denser than the peripheral areas, which can lead to overexposure to the periphery. Some images show low visibility of tissue structures in the breast peripheral areas due to the intensity change. It has a negative effect on diagnosis for breast cancer detection. To improve image quality, we have proposed pre-processing technique based on distance transformation to enhance the visibility of peripheral areas. The distance transform method aims to calculate the distance between each zero pixel and the nearest nonzero pixel in the binary images. For each pixel with the distance to the skin-line, the intensity of pixel is iteratively corrected by multiplying a propagation ratio. To evaluate the quality of processed images, the texture features were extracted using gray-level co-occurrence matrices (GLCM). And the breast density is quantitatively calculated. According to the results, the structure of breast tissues in the overexposed peripheral areas was well observed. The processed images showed more complexity and improved contrast. On the other hand, the homogeneity tended to be similar to the original images. The pixel values of peripheral areas were normalized without losing information and weighted to reduce the intensity variation. In this study, the pre-processing technique based on distance transformation was used to overcome the problem of overexposed peripheral areas in the breast images. The results demonstrated that appropriate pre-processing techniques are useful for improving image quality and accuracy of density measurement.

In medical imaging field, various dose reduction techniques have been studied. We proposed shutter scan acquisition for region of interest (ROI) imaging to reduce the patient exposure dose in digital tomosynthesis system. Projections obtained by shutter scan acquisition is a combination of truncated projections and non-truncated projections. In this study, we call the number of truncated projections divided by the number of non-truncated projections as shutter weighting factor. The shutter scan acquisition parameters were optimized using 5 different acquisition sets with the shutter weighting factor (0.16, 0.35, 1.03, 3.05 and 7.1). A prototype CDT system (LISTEM, Korea) and the LUNGMAN phantom (Kyoto Kagaku, Japan) with an 8 mm lung nodule were used. A total of 81 projections with shutter scan acquisition were obtained in 5 sets according to shutter weighting factor. The image quality was investigated using the contrast noise ratio (CNR). We also calculated figure of merit (FOM) to determine optimal acquisition parameters for the shutter scan acquisition. The ROI of the reconstructed image with shutter scan acquisition showed enhanced contrast. The highest CNR and FOM value, shutter weighting factor 7.1, is the acquisition set consisting of 71 truncated projections and 10 non-truncated projections. In this study, we investigated the effects of composition ratio of the truncated and non-truncated projections on reconstructed images through the shutter scan acquisition. In addition, the optimal acquisition conditions for the shutter scan acquisition were determined by deriving the FOM values. In conclusion, we can suggest optimal shutter scan acquisition parameters on the lesion within the ROI to be diagnosed.

Quantitative imaging analysis has become a focus of medical imaging fields in recent days. In this study, Fourier-based imaging metrics for task-based quantitative assessment of lung nodules were applied in low-dose chest tomosynthesis. Compared to the conventional filtered back-projection (FBP), a compressed-sensing (CS) image reconstruction has been proposed for dose and artifact reduction. We implemented the CS-based low-dose reconstruction scheme to a sparsely sampled projection dataset and compared the lung nodule detectability index (d’) between the FBP and CS methods. We used the non-prewhitening (NPW) model observer to estimate the in-plane slice detectability in tomosynthesis and theoretically calculated d’ using the weighted amounts of local noise, spatial resolution, and task function in Fourier domain. We considered spatially varying noise and spatial resolution properties because the iterative reconstruction showed non-stationary characteristics. For analysis of task function, we adopted a simple binary hypothesis-testing model which discriminates outer and inner region of the encapsulated shape of lung nodule. The results indicated that the local noise power spectrum showed smaller intensities with increasing the number of projections, whereas the local transfer function provided similar appearances between the FBP and CS schemes. The resulted task functions for the same size of lung nodules showed the same pattern with different intensity, whereas the task function for different size of lung nodules presented different shapes due to different object functions. The theoretically calculated d’ values showed that the CS schemes provided higher values than the FBP method by factors of 2.64-3.47 and 2.50-3.10 for two different lung nodules among all projection views. This could demonstrate that the low-dose CS algorithm provide a comparable lung nodule images in comparison to FBP from 37.9% up to 28.8% reduced dose in the same projection views. Moreover, we observed that the CS method implemented with small number of projections provided similar or somewhat higher d’ values compared to the FBP method with large number of projections. In conclusion, the CS scheme may present a potential dose reduction for lung nodule detection in the chest tomosynthesis by showing higher d’ in comparison to the conventional FBP method.

Quantitative imaging performance analysis has recently been the focus in medical imaging fields. It would not only provide objective information but also it could aid a patient diagnosis by giving optimized system parameters for various imaging tasks. However, the previous studies on task-based metric in breast tomosynthesis usually take into account a cascaded system modeling for generalized noise equivalent quanta. In this study, the authors have been focused on the experimental study for calculating task-based detectability index ( d' ) in the prototype breast tomosynthesis system for different angular ranges. According to the summarized d' the authors observed that the highest d' could be found in the angular range of ±10.5° (1.5° angle step) among several cases for detection of 4.7 mm mass in our prototype breast tomosynthesis system. Our study would be easily applied in practical breast tomosynthesis for the quantitative performance analysis of imaging parameter is needed. More various imaging tasks with different parameter combinations would be conducted in the future for generalized optimization of breast tomosynthesis study.

Digital breast tomosynthesis (DBT) is a recently developed system for three-dimensional imaging that offers the potential to reduce the false positives of mammography by preventing tissue overlap. Many qualitative evaluations of digital breast tomosynthesis were previously performed by using a phantom with an unrealistic model and with heterogeneous background and noise, which is not representative of real breasts. The purpose of the present work was to compare reconstruction algorithms for DBT by using various breast phantoms; validation was also performed by using patient images. DBT was performed by using a prototype unit that was optimized for very low exposures and rapid readout. Three algorithms were compared: a back-projection (BP) algorithm, a filtered BP (FBP) algorithm, and an iterative expectation maximization (EM) algorithm. To compare the algorithms, three types of breast phantoms (homogeneous background phantom, heterogeneous background phantom, and anthropomorphic breast phantom) were evaluated, and clinical images were also reconstructed by using the different reconstruction algorithms. The in-plane image quality was evaluated based on the line profile and the contrast-to-noise ratio (CNR), and out-of-plane artifacts were evaluated by means of the artifact spread function (ASF). Parenchymal texture features of contrast and homogeneity were computed based on reconstructed images of an anthropomorphic breast phantom. The clinical images were studied to validate the effect of reconstruction algorithms. The results showed that the CNRs of masses reconstructed by using the EM algorithm were slightly higher than those obtained by using the BP algorithm, whereas the FBP algorithm yielded much lower CNR due to its high fluctuations of background noise. The FBP algorithm provides the best conspicuity for larger calcifications by enhancing their contrast and sharpness more than the other algorithms; however, in the case of small-size and low-contrast microcalcifications, the FBP reduced detectability due to its increased noise. The EM algorithm yielded high conspicuity for both microcalcifications and masses and yielded better ASFs in terms of the full width at half maximum. The higher contrast and lower homogeneity in terms of texture analysis were shown in FBP algorithm than in other algorithms. The patient images using the EM algorithm resulted in high visibility of low-contrast mass with clear border. In this study, we compared three reconstruction algorithms by using various kinds of breast phantoms and patient cases. Future work using these algorithms and considering the type of the breast and the acquisition techniques used (e.g., angular range, dose distribution) should include the use of actual patients or patient-like phantoms to increase the potential for practical applications.

The purpose of this study is to determine the optimal non-uniform angular dose distribution to improve the quality of the 3D reconstructed images and to acquire extra 2D projection images. In this analysis, 7 acquisition sets were generated by using four different values for the number of projections (11, 15, 21, and 29) and total angular range (±14°, ±17.5°, ±21°, and ±24.5° ). For all acquisition sets, the zero-degree projection was used as the 2D image that was close to that of standard conventional mammography (CM). Exposures used were 50, 100, 150, and 200 mR for the zero-degree projection, and the remaining dose was distributed over the remaining projection angles. To quantitatively evaluate image quality, we computed the CNR (contrast-to-noise ratio) and the ASF (artifact spread function) for the same radiation dose. The results indicate that, for microcalcifications, acquisition sets with approximately 4 times higher exposure on the zero-degree projection than the average exposure for the remaining projection angles yielded higher CNR values and were 3% higher than the uniform distribution. However, very high dose concentrations toward the zero-degree projection may reduce the quality of the reconstructed images due to increasing noise in the peripheral views. The zero-degree projection of the non-uniform dose distribution offers a 2D image similar to that of standard CM, but with a significantly lower radiation dose. Therefore, we need to evaluate the diagnostic potential of extra 2D projection image when diagnose breast cancer by using 3D images with non-uniform angular dose distributions.

PURPOSE This work describes the hardware and software developments of a prototype chest digital tomosynthesis (CDT) R/F system. The purpose of this study was to validate the developed system for its possible clinical application on low-dose chest tomosynthesis imaging. METHODS The prototype CDT R/F system was operated by carefully controlling the electromechanical subsystems through a synchronized interface. Once a command signal was delivered by the user, a tomosynthesis sweep started to acquire 81 projection views (PVs) in a limited angular range of ±20°. Among the full projection dataset of 81 images, several sets of 21 (quarter view) and 41 (half view) images with equally spaced angle steps were selected to represent a sparse view condition. GPU-accelerated and total-variation (TV) regularization strategy-based compressed sensing (CS) image reconstruction was implemented. The imaged objects were a flat-field using a copper filter to measure the noise power spectrum (NPS), a Catphan® CTP682 quality assurance (QA) phantom to measure a task-based modulation transfer function (MTFTask ) of three different cylinders' edge, and an anthropomorphic chest phantom with inserted lung nodules. The authors also verified the accelerated computing power over CPU programming by checking the elapsed time required for the CS method. The resultant absorbed and effective doses that were delivered to the chest phantom from two-view digital radiographic projections, helical computed tomography (CT), and the prototype CDT system were compared. RESULTS The prototype CDT system was successfully operated, showing little geometric error with fast rise and fall times of R/F x-ray pulse less than 2 and 10 ms, respectively. The in-plane NPS presented essential symmetric patterns as predicted by the central slice theorem. The NPS images from 21 PVs were provided quite different pattern against 41 and 81 PVs due to aliased noise. The voxel variance values which summed all NPS intensities were inversely proportional to the number of PVs, and the CS method gave much lower voxel variance by the factors of 3.97-6.43 and 2.28-3.36 compared to filtered backprojection (FBP) and 20 iterations of simultaneous algebraic reconstruction technique (SART). The spatial frequencies of the f50 at which the MTFTask reduced to 50% were 1.50, 1.55, and 1.67 cycles/mm for FBP, SART, and CS methods, respectively, in the case of Bone 20% cylinder using 41 views. A variety of ranges of TV reconstruction parameters were implemented during the CS method and we could observe that the NPS and MTFTask preserved best when the regularization and TV smoothing parameters α and τ were in a range of 0.001-0.1. For the chest phantom data, the signal difference to noise ratios (SDNRs) were higher in the proposed CS scheme images than in the FBP and SART, showing the enhanced rate of 1.05-1.43 for half view imaging. The total averaged reconstruction time during 20 iterations of the CS scheme was 124.68 s, which could match-up a clinically feasible time (

A compressed-sensing (CS) technique has been rapidly applied in medical imaging field for retrieving volumetric data from highly under-sampled projections. Among many variant forms, CS technique based on a total-variation (TV) regularization strategy shows fairly reasonable results in cone-beam geometry. In this study, we implemented the TV-based CS image reconstruction strategy in our prototype chest digital tomosynthesis (CDT) R/F system. Due to the iterative nature of time consuming processes in solving a cost function, we took advantage of parallel computing using graphics processing units (GPU) by the compute unified device architecture (CUDA) programming to accelerate our algorithm. In order to compare the algorithmic performance of our proposed CS algorithm, conventional filtered back-projection (FBP) and simultaneous algebraic reconstruction technique (SART) reconstruction schemes were also studied. The results indicated that the CS produced better contrast-to-noise ratios (CNRs) in the physical phantom images (Teflon region-of-interest) by factors of 3.91 and 1.93 than FBP and SART images, respectively. The resulted human chest phantom images including lung nodules with different diameters also showed better visual appearance in the CS images. Our proposed GPU-accelerated CS reconstruction scheme could produce volumetric data up to 80 times than CPU programming. Total elapsed time for producing 50 coronal planes with 1024×1024 image matrix using 41 projection views were 216.74 seconds for proposed CS algorithms on our GPU programming, which could match the clinically feasible time (~ 3 min). Consequently, our results demonstrated that the proposed CS method showed a potential of additional dose reduction in digital tomosynthesis with reasonable image quality in a fast time.

Chest digital tomosynthesis (CDT) is a new 3D imaging technique that can be expected to improve the detection of subtle lung disease over conventional chest radiography. Algorithm development for CDT system is challenging in that a limited number of low-dose projections are acquired over a limited angular range. To confirm the feasibility of algebraic reconstruction technique (ART) method under variations in key imaging parameters, quality metrics were conducted using LUNGMAN phantom included grand-glass opacity (GGO) tumor. Reconstructed images were acquired from the total 41 projection images over a total angular range of ±20°. We evaluated contrast-to-noise ratio (CNR) and artifacts spread function (ASF) to investigate the effect of reconstruction parameters such as number of iterations, relaxation parameter and initial guess on image quality. We found that proper value of ART relaxation parameter could improve image quality from the same projection. In this study, proper value of relaxation parameters for zero-image (ZI) and back-projection (BP) initial guesses were 0.4 and 0.6, respectively. Also, the maximum CNR values and the minimum full width at half maximum (FWHM) of ASF were acquired in the reconstructed images after 20 iterations and 3 iterations, respectively. According to the results, BP initial guess for ART method could provide better image quality than ZI initial guess. In conclusion, ART method with proper reconstruction parameters could improve image quality due to the limited angular range in CDT system.

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.

Digital tomosynthesis has an advantage of low radiation dose compared to conventional computed tomography (CT) by utilizing small number of projections (~80) acquired over a limited angular range. It can produce 3D volumetric data although they may have some artifacts due to incomplete sampling. Based upon these attractive merits, we developed a prototype digital tomosynthesis R/F system especially for the purpose of applications in chest imaging. Prototype chest digital tomosynthesis (CDT) R/F system contains an X-ray tube with high power R/F pulse generator, flat-panel detector, R/F table, electromechanical radiographic subsystems including precise motor controller, and a reconstruction server. For image reconstruction, users could select the reconstruction option between analytic and iterative methods. Reconstructed images of Catphan700 and LUNGMAN phantoms clearly and rapidly described the internal structures of the phantoms using graphics processing unit (GPU) programming. Contrast-to-noise ratio (CNR) values of the CTP682 module was higher in images using the simultaneous algebraic reconstruction technique (SART) than those using filtered backprojection (FBP) for all materials by factors of 2.60, 3.78, 5.50, 2.30, 3.70, and 2.52 for air, lung foam, low density polyethylene (LDPE), Delrin (acetal homopolymer resin), bone 50% (hydroxyapatite), and Teflon, respectively. Total elapsed times for producing 3D volume were 2.92 sec and 86.29 sec on average for FBP and SART (20 iterations), respectively. The times required for reconstruction were clinically feasible. Moreover, the total radiation dose from the system (5.68 mGy) could demonstrate a significant lowered radiation dose compared to conventional chest CT scan. Consequently, our prototype tomosynthesis R/F system represents an important advance in digital tomosynthesis applications.

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.

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.

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.

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.

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.

Recently, digital breast tomosynthesis (DBT) has been investigated to overcome the limitation of conventional mammography for overlapping anatomical structures and high patient dose with cone-beam computed tomography (CBCT). However incomplete sampling due to limited angle leads to interference on the neighboring slices. Many studies have investigated to reduce artifacts such as interference. Moreover, appropriate filters for tomosynthesis have been researched to solve artifacts resulted from incomplete sampling. The primary purpose of this study is finding appropriate filter scheme with FBP reconstruction for DBT system to reduce artifacts. In this study, we investigated characteristics of various filter schemes with simulation and prototype digital breast tomosynthesis under same acquisition parameters and conditions. We evaluated artifacts and noise with profiles and COV (coefficinet of variation) to study characteristic of filter. As a result, the noise with parameter 0.25 of Spectral filter reduced by 10% in comparison to that with only Ramp-lak filter. Because unbalance of information reduced with decreasing B of Slice thickness filter, artifacts caused by incomplete sampling reduced. In conclusion, we confirmed basic characteristics of filter operations and improvement of image quality by appropriate filter scheme. The results of this study can be utilized as base in research and development of DBT system by providing information that is about noise and artifacts depend on various filter schemes.