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In interior cardiac computed tomography (CT) imaging, the x-ray beam is collimated to a limited field-of-view covering the heart volume, which decreases the radiation exposure to surrounding tissues. Spectral CT enables the creation of virtual monochromatic images (VMIs) through a computational material decomposition process. This study investigates the utility of VMIs for beam hardening (BH) reduction in interior cardiac CT, and further, the suitability of VMIs for coronary artery calcium (CAC) scoring and volume assessment is studied using spectral photon counting detector CT (PCD-CT). Ex vivo coronary artery samples (N = 18) were inserted in an epoxy rod phantom. The rod was scanned in the conventional CT geometry, and subsequently, the rod was positioned in a torso phantom and re-measured in the interior PCD-CT geometry. The total energy (TE) 10–100 keV reconstructions from PCD-CT were used as a reference. The low energy 10–60 keV and high energy 60–100 keV data were used to perform projection domain material decomposition to polymethyl methacrylate and calcium hydroxylapatite basis. The truncated basis-material sinograms were extended using the adaptive detruncation method. VMIs from 30–180 keV range were computed from the detruncated virtual monochromatic sinograms using filtered back projection. Detrending was applied as a post-processing method prior to CAC scoring. The results showed that BH artefacts from the exterior structures can be suppressed with high (≥100 keV) VMIs. With appropriate selection of the monoenergy (46 keV), the underestimation trend of CAC scores and volumes shown in Bland-Altman (BA) plots for TE interior PCD-CT was mitigated, as the BA slope values were −0.02 for the 46 keV VMI compared to −0.21 the conventional TE image. To conclude, spectral PCD-CT imaging using VMIs could be applied to reduce BH artefacts interior CT geometry, and further, optimal selection of VMI may improve the accuracy of CAC scoring assessment in interior PCD-CT.

For centuries, reindeer herding has been an integral part of the subsistence and culture among the Sámi of northern Fennoscandia. Despite the importance of this husbandry in their history, the timing and details of early reindeer domestication are still highly debated. Indeed, identifying domesticated individuals in the archaeological record remains complicated because reindeer are still considered to be in the early phases of the domestication process. In this work, we propose solutions for identifying domestic individuals using 3D geometric morphometrics on isolated elements from the long bones of the hindlimb in modern reindeer populations. These bones are important for understanding both the mobility of reindeer and the effect of load carrying or draught. A good level of distinction between the size and shape variables of these bones was found among subspecies, sex and lifestyles. This demonstrates that the long bones of the hindlimb can provide information on changes in locomotor behaviour induced by the domestication process, such as control and reduction of reindeer mobility by humans. This also demonstrates that analysis in geometric morphometrics is useful for exploring the use of draught reindeer in early Sámi reindeer herding and the implications for understanding reindeer domestication and early reindeer herding strategies.

In this work, the accuracy of material decomposition (MD) using an energy discriminating photon counting detector was studied. An MD framework was established and validated using calcium hydroxyapatite (CaHA) inserts of known densities (50 mg/cm³, 100 mg/cm³, 250 mg/cm³, 400 mg/cm³), and diameters (1.2 mm, 3.0 mm, 5.0 mm). These inserts were placed in a cardiac rod phantom that mimics a tissue equivalent heart and measured using an experimental photon counting detector cone beam computed tomography (PCD-CBCT) setup. The quantitative coronary calcium scores (density, mass, and volume) obtained from the MD framework were compared with the nominal values. Additionally, three different calibration techniques, signal-toequivalent thickness calibration (STC), polynomial correction (PC), and projected equivalent thickness calibration (PETC) were compared to investigate the effect of the calibration method on the quantitative values. The obtained MD estimates agreed well with the nominal values for density (mass) with mean absolute percent errors (MAPEs) 8 ± 11% (9 ± 15%) and 4 ± 6% (9 ± 14%) for STC and PETC calibration methods, respectively. PC displayed large MAPEs for density (27 ± 9%), and mass (25 ± 12%). Volume estimation resulted in large deviations between true and measured values with notable MAPEs for STC (40 ± 90%), PC (40 ± 80%), and PETC (40 ± 90%). The framework demonstrated the feasibility of quantitative CaHA mass and density scoring using PCD-CBCT.

Purpose: To investigate the replacement of conventional grid by air gap in axiolateral hip radiographs. The optimal air gap distance was studied with respect to radiation dose and image quality using phantom images, as well as 26 patient axiolateral hip radiographs. Methods: The CDRAD phantom, along with polymethylmethacrylate slabs with thicknesses of 10.0, 14.6, and 20.0 cm was employed. The inverse image quality index and dose area product (DAP), as well as their combination, so called figure‐of‐merit (FOM) parameter, were evaluated for these images, with air gaps from 20 to 50 cm in increments of 10 cm. Images were compared to those acquired using a conventional grid utilized in hip radiography. Radiation dose was measured and kept constant at the surface of the detector by using a reference dosimeter. Verbal consent was asked from 26 patients to participate to the study. Air gap distances from 20 to 50 cm and tube current‐time products from 8 to 50 mAs were employed. Exposure index, DAP, as well as patient height and weight were recorded. Two radiologists evaluated the image quality of 26 hip axiolateral projection images on a 3‐point nondiagnostic — good/sufficiently good — too good scale. Source‐to‐image distance of 200 cm and peak tube voltage of 90 kVp were used in both studies. Results and conclusion: Based on the phantom study, it is possible to reduce radiation dose by replacing conventional grid with air gap without compromising image quality. The optimal air gap distance appears to be 30 cm, based on the FOM analysis. Patient study corroborates this observation, as sufficiently good image quality was found in 24 of 26 patient radiographs, with 7 of 26 images obtained with 30 cm air gap. Thus, air gap method, with an air gap distance of 30 cm, is recommended in axiolateral hip radiography.

Computed tomography (CT) is the reference method for cardiac imaging, but concerns have been raised regarding the radiation dose of CT examinations. Recently, photon counting detectors (PCDs) and interior tomography, in which the radiation beam is limited to the organ-of-interest, have been suggested for patient dose reduction. In this study, we investigated interior PCD-CT (iPCD-CT) for non-enhanced quantification of coronary artery calcium (CAC) using an anthropomorphic torso phantom and ex vivo coronary artery samples. We reconstructed the iPCD-CT measurements with filtered back projection (FBP), iterative total variation (TV) regularization, padded FBP, and adaptively detruncated FBP and adaptively detruncated TV. We compared the organ doses between conventional CT and iPCD-CT geometries, assessed the truncation and cupping artifacts with iPCD-CT, and evaluated the CAC quantification performance of iPCD-CT. With approximately the same effective dose between conventional CT geometry (0.30 mSv) and interior PCD-CT with 10.2 cm field-of-view (0.27 mSv), the organ dose of the heart was increased by 52.3% with interior PCD-CT when compared to CT. Conversely, the organ doses to peripheral and radiosensitive organs, such as the stomach (55.0% reduction), were often reduced with interior PCD-CT. FBP and TV did not sufficiently reduce the truncation artifact, whereas padded FBP and adaptively detruncated FBP and TV yielded satisfactory truncation artifact reduction. Notably, the adaptive detruncation algorithm reduced truncation artifacts effectively when it was combined with reconstruction detrending. With this approach, the CAC quantification accuracy was good, and the coronary artery disease grade reclassification rate was particularly low (5.6%). Thus, our results confirm that CAC quantification can be performed with the interior CT geometry, that the artifacts are effectively reduced with suitable interior reconstruction methods, and that interior tomography provides efficient patient dose reduction.

Medical x-ray imaging is used to visualise patients’ anatomical structures and in some cases their physiology. X-rays are ionizing radiation, thus their use needs to be optimised, as stochastic effects are assumed to increase linearly with the exposure dose. Imaging protocols need to be optimised to a radiation dose level that follows the as low as reasonably achievable principle without compromising the diagnostic value of the image. Different methods can be used to help in the optimisation process, such as simulations, radiation dose and image quality assessments with dosimeters and phantoms and utilising the latest technology in the most efficient way. The purpose of this doctoral thesis was to investigate the applicability of metal-oxide-semiconductor-field-effect-transistor (MOSFET) dosimeters for dose determinations in conventional x-ray and computed tomography (CT) examinations. Additionally, dose optimising methods were investigated in dental panoramic imaging using radiophotoluminescence (RPL) dosimeters. Anthropomorphic phantoms were used in every study to simulate patients, as their structures enable dosimeters to be positioned at locations that correspond to different organs. The MOSFET’s properties for dose determinations were evaluated against the reference dosimeter in a conventional x-ray set-up. Comparisons of absorbed and effective doses in thorax x-ray imaging were made between RPLs, MOSEFTs and Monte Carlo simulations. The effect of the organ-based tube current modulation and bismuth shields were compared against the reference imaging method in a chest CT with one scanner model. Absorbed doses and quantitative image quality were evaluated using each method. Possible dose reduction from segmented dental panoramic tomography (sDPT) imaging was compared against full DPT. Dose measurements were done using RPL dosimeters in pediatric and adult set-up using phantoms. MOSFETs are accurate enough to be used in conventional x-ray and CT, but they require a careful calibration before use as their reproducibility is limited with low doses. Bismuth shields provided the best dose reduction, but with a negative impact on quantitative image quality, especially when metal artefact removal software was used. The final study showed that the use of sDPT programmes and pediatric protocols enable a notably dose reduction compared to the full DPT adult protocol. Tiivistelmä Lääketieteellisessä kuvantamisessa käytetään röntgensäteilyä potilaan anatomian ja joissain tapauksissa fysiologian visualisointiin. Röntgensäteily on ionisoivaa ja stokastisten vaikutusten kasvaessa oletettavasti lineaarisesti säteilyn funktiona, tulee säteilyn olla kokonaisvaltaisesti optimoitua. Kuvauksissa käytetyn röntgensäteilyn käytön tulee noudattaa ALARA-periaatetta, minkä vuoksi kuvauksessa tulee käyttää niin vähän säteilyä kuin vain mahdollista, diagnostiikan vaarantumatta. Optimoinnin apuna voidaan käyttää esim. simulointeja, annos- ja kuvanlaatumäärityksiä dosimetreilla ja fantomeilla, tai laitevalmistajien tuomia uusia teknologioita. Tämän väitöskirjan tarkoituksena oli tutkia metallioksidi-puolijohdekanavatransistorien (MOSFET) soveltuvuutta natiiviröntgentutkimuksissa ja tietokonetomografiassa (TT). Lisäksi työssä tutkittiin hammaskuvauksissa käytettyjä annossäästömenetelmiä radiofotoluminesenssidosimetreilla (RPL). Potilasvasteena työssä käytettiin antropomorfisia fantomeita, minkä ansiosta säteilyannoksia voidaan mitata eri elimiä vastaavilta kohdilta. MOSFET annosmittarin ominaisuuksia arvioitiin natiiviröntgenasetelmassa referenssimittariin nähden. Absorboituneiden ja efektiivisten annosten eroa MOSFET:tien, RPL:ien ja simulointien kesken tutkittiin keuhkoröntgentutkimuksessa. Pintakudoksia säästävän putkivirranmodulointimenetelmän ja vismuttisuojien vaikuttavuutta verrattiin TT:ssä referenssimetelmää vasten. Vaikuttavuutta arvioitiin absorboituneiden annosten ja kvantitatiivisen kuvanlaadun avulla. Segmentoidun hammaspanoraamakuvauksen (sDPT) annossäästömahdollisuuksia verrattiin tavalliseen panoraamakuvaukseen. Annosmääritykset tehtiin käyttäen RPL dosimetreja lapsi- ja aikuisfantomeissa. MOSFET dosimetreja voidaan käyttää annosmäärityksiin natiiviröntgenkuvauksissa ja TT:ssä, mutta niiden kalibrointi ja toistettavuus matalilla annoksilla aiheuttaa kuitenkin rajoituksia niiden käytölle. Vismuttisuojat tuottivat parhaan annossäästön, huonontaen kuitenkin kuvanlaatua. Kuvanlaadun huonontuminen oli erityisen huomattavaa, kun metallista aiheutuvien kuvavirheiden poistamiseen suunniteltua ohjelmaa käytettiin. Viimeinen tutkimus osoitti, että sDPT ohjelmat ja lapsille suunnatut protokollat mahdollistavat huomattavan annossäästön verrattuna aikuisten kokopanoraamaan.

Coronary artery disease (CAD) is a prevalent disease with high annual mortality rates and a substantial societal and economic burden. Computed tomography (CT) is an essential diagnostic tool in the diagnosis and follow-up of CAD, and the 2019 European Society of Cardiology guidelines recommend using CT as the initial diagnostic test for symptomatic patients. Since the use of ionizing examinations in the assessment of CAD is increasing, the imaging hardware, algorithms, and protocols warrant further developments to optimize the radiation dose. This doctoral dissertation evaluates recent hardware and computational advances in CT for the assessment of coronary artery calcium (CAC) with an optimized radiation dose. In particular, an experimental table-top photon counting detector CT (PCD-CT) setup was constructed to investigate the applicability of spectral PCD-CT for quantitative CAC scoring through material decomposition. The suitability of iterative reconstruction (IR) for CAC scoring with reduced radiation dose was assessed. Finally, interior tomography, in which the radiation beam is collimated to the organ-of-interest, was evaluated to investigate further possible radiation dose reduction in peripheral organs. The results showed that the experimental PCD-CT setup yields excellent image quality with a low radiation dose. However, the PCD was observed to require dedicated calibration techniques for optimized reconstruction quality. With the suitable PCD calibration and material decomposition techniques in place, spectral PCD-CT allowed for a quantitative assessment of CAC density and mass. Further, IR and interior reconstruction proved to be effective radiation dose reduction strategies with acceptable CAC scoring accuracy compared to conventionally used non-iterative reconstruction. Finally, interior tomography yielded sufficient image quality and a considerable dose reduction to organs outside the field-of-view. In conclusion, these findings demonstrate the utility of PCDs, IR, and interior reconstruction in the optimization of radiation dose for CAC scoring. Tiivistelmä Sepelvaltimotauti on yleinen ja korkean kuolleisuuden tauti, jolla on merkittävä yhteiskunnallinen ja kansantaloudellinen vaikutus. Tietokonetomografialla (TT) on kriittinen rooli sepelvaltimotaudin diagnostiikassa ja seurannassa. Euroopan kardiologisen seuran 2019 ohjeistuksen mukaisesti TT:n rooli ensisijaisena työkaluna oireellisten potilaiden diagnostiikassa tulee kasvamaan. Lisääntyvän TT:n käytön myötä, uusimmilla teknologiainnovaatioilla on kriittinen rooli diagnostiikassa hyödynnettävän ionisoivan säteilyn käytön optimoinnissa. Tämän väitöskirjan tavoitteena oli soveltaa uusimpia innovaatioita kuvantamislaitteistossa ja rekonstruktioalgoritmeissa sepelvaltimokalkkeutumien kuvantamiseen optimoidulla säteilyannoksella. Projektin alussa kehitettiin kokeellinen fotonilaskenta-TT (FTT)-kuvantamisasetelma, jonka avulla tutkittiin fotonilaskentailmaisimen soveltuvuutta sepelvaltimokalkkeutumien kvantifiointiin. Iteratiivinen rekonstruktio (IR) on mahdollistanut säteilyannoksen laskun useissa TT-protokollissa, mutta IR:n soveltuvuudesta sepelvaltimokalkkeutumien kvantifiointiin on ristiriitaisia tuloksia. Tästä johtuen työssä tutkittiin myös IR-algoritmien tarkkuutta sepelvaltimokalkkeutumien karakterisoinnissa. Lisäksi työssä tarkasteltiin sisätomografiakuvantamista, jossa säteilyannos rajataan tutkittavaan elimeen, mikä saattaa mahdollistaa säteilyannoksen vähentämisen perifeerisissä elimissä. FTT:n kuvanlaatu oli erinomainen ja se alensi säteilyannosta verrattuna diagnostisessa käytössä olevaan TT:hen. FTT:n optimoitu käyttö kuitenkin edellytti sille suunniteltuja kalibrointitekniikoita, jotka mahdollistivat tasaisen kuvanlaadun rekonstruktioissa. Sopivan detektorin kalibrointitekniikan ja materiaalihajotelma-algoritmin myötä kaksoisenergiaa hyödyntävä FTT mahdollisti kalkkeutumien tiheyden ja massan kvantitatiivisen arvioinnin. IR ja sisätomografia puolestaan mahdollistivat säteilyannoksen optimoinnin ja hyvän tarkkuuden sepelvaltimokalkkeutumien kvantifioinnissa. Loppupäätelmänä todetaan, että fotonilaskentailmaisin, IR ja sisätomografia mahdollistavat säteilyannoksen lisäoptimoinnin sepelvaltimokalkkeutumien kuvantamisessa.