To facilitate rigorous virtual clinical trials using model observers for breast imaging optimization and evaluation, we
demonstrated a method of defining statistical models, based on 177 sets of breast CT patient data, in order to generate
tens of thousands of unique digital breast phantoms.
In order to separate anatomical texture from variation in breast shape, each training set of breast phantoms were
deformed to a consistent atlas compressed geometry. Principal component analysis (PCA) was then performed on the
shape-matched breast CT volumes to capture the variation of patient breast textures. PCA decomposes the training set of
N breast CT volumes into an N-1-dimensional space of eigenvectors, which we call eigenbreasts. By summing weighted
combinations of eigenbreasts, a large ensemble of different breast phantoms can be newly created.
Different training sets can be used in eigenbreast analysis for designing basis models to target sub-populations defined
by breast characteristics, such as size or density. In this work, we plan to generate ensembles of 30,000 new phantoms
based on glandularity for an upcoming virtual trial of lesion detectability in digital breast tomosynthesis.
Our method extends our series of digital and physical breast phantoms based on human subject anatomy, providing the
capability to generate new, unique ensembles consisting of tens of thousands or more virtual subjects. This work
represents an important step towards conducting future virtual trials for tasks-based assessment of breast imaging, where
it is vital to have a large ensemble of realistic phantoms for statistical power as well as clinical relevance.
KEYWORDS: Computed tomography, Motion models, 3D modeling, Data modeling, Monte Carlo methods, Image segmentation, Image quality, Detection and tracking algorithms, 3D acquisition, 3D image processing
With the increased use of CT examinations, the associated radiation dose has become a large concern, especially for pediatrics. Much research has focused on reducing radiation dose through new scanning and reconstruction methods. Computational phantoms provide an effective and efficient means for evaluating image quality, patient-specific dose, and organ-specific dose in CT. We previously developed a set of highly-detailed 4D reference pediatric XCAT phantoms at ages of newborn, 1, 5, 10, and 15 years with organ and tissues masses matched to ICRP Publication 89 values. We now extend this reference set to a series of 64 pediatric phantoms of a variety of ages and height and weight percentiles, representative of the public at large. High resolution PET-CT data was reviewed by a practicing experienced radiologist for anatomic regularity and was then segmented with manual and semi-automatic methods to form a target model. A Multi-Channel Large Deformation Diffeomorphic Metric Mapping (MC-LDDMM) algorithm was used to calculate the transform from the best age matching pediatric reference phantom to the patient target. The transform was used to complete the target, filling in the non-segmented structures and defining models for the cardiac and respiratory motions. The complete phantoms, consisting of thousands of structures, were then manually inspected for anatomical accuracy. 3D CT data was simulated from the phantoms to demonstrate their ability to generate realistic, patient quality imaging data. The population of pediatric phantoms developed in this work provides a vital tool to investigate dose reduction techniques in 3D and 4D pediatric CT.
KEYWORDS: 3D modeling, Motion models, Computed tomography, Image segmentation, Medical imaging, Monte Carlo methods, Medical research, Imaging devices, Computer simulations, Data modeling
Computerized phantoms are finding an increasingly important role in medical imaging research. With the ability to
simulate various imaging conditions, they offer a practical means with which to quantitatively evaluate and improve
imaging devices and techniques. This is especially true in CT due to the high radiation levels involved with it. Despite
their utility, due to the time required to develop them, only a handful of computational models currently exist of varying
detail. Most phantoms available are limited to 3D and not capable of modeling patient motion. We have previously
developed a technique to rapidly create highly detailed 4D extended cardiac-torso (XCAT) phantoms based on patient
CT data [1].
In this study, we utilize this technique to generate 58 new adult XCAT phantoms to be added to our growing library of
virtual patients available for imaging research. These computerized patients provide a valuable tool for investigating
imaging devices and the effects of anatomy and motion in imaging. They also provide the essential tools to investigate
patient-specific dose estimation and optimization for adults undergoing CT procedures.
Purpose: In the early development of new imaging modalities - such as tomosynthesis and cone-beam CT (CBCT) - an accurate predictive model for imaging performance is particularly valuable in identifying the physical factors that govern image quality and guiding system optimization. In this work, a task-based cascaded systems model for detectability index is proposed that describes not only the signal and noise propagation in the 2D (projection) and 3D (reconstruction) imaging chain but also the influence of background anatomical noise. The extent to which generalized detectability index
provides a valid metric for imaging performance was assessed through direct comparison to human observer experiments.
Methods: Detectability index (d') was generalized to include anatomical background noise in the same manner as the generalized noise-equivalent quanta (NEQ) proposed by Barrett et al. (Proc. SPIE Med. Imaging, Vol. 1090, 1989).
Anatomical background noise was measured from a custom phantom designed to present power-law spectral density
comparable to various anatomical sites (e.g., breast and lung). Theoretical calculations of d' as a function of the sourcedetector
orbital extent (θtot) was obtained from a 3D cascaded systems analysis model for tomosynthesis and cone-beam
CT (CBCT). Four model observers were considered in the calculation of d': prewhitening (PW), non-prewhitening
(NPW), prewhitening with eye filter and internal noise (PWE), and non-prewhitening with eye filter and internal noise
(NPWE). Human observer performance was measured from 9AFC tests for a variety of idealized imaging tasks
presented within a clutter phantom. Theoretical results (d') were converted to area under the ROC curve (Az) and
compared directly to human observer performance as a function of imaging task and orbital extent.
Results: Theoretical results demonstrated reasonable correspondence with human observer response for all tasks across
the continuum in θtot ranging from low-angle tomosynthesis (θtot ~10o) to CBCT (θtot ~180o). Both theoretical and
experimental Az were found to increase with acquisition angle, consistent with increased rejection of out-of-plane clutter
for larger tomosynthesis angle. Of the four theoretical model observers considered, the prewhitening models tended to
overestimate real observer performance, while the non-prewhitening models demonstrated reasonable agreement.
Conclusions: Generalized detectability index was shown to provide a meaningful metric for imaging performance, helping to bridge the gap between real observer performance and prevalent Fourier-based metrics based in first principles of spatial-frequency-dependent NEQ and imaging task.
Tomosynthesis is an imaging technique that has gained renewed interest with recent advancements of flat-panel
digital detectors. Because of the wide range of potential applications, a systematic analysis of 3D tomosynthesis
imaging systems would contribute to the understanding and development. This paper extends a systematic evaluation
of thoracic tomosynthetic imaging performance as a function of imaging parameters, such as the number
of projections, tomosynthesis orbital extent, and reconstruction filters. We evaluate lung nodule detectability
and anatomical clutter as a function of tomosynthesis orbital extent using anthropomorphic phantoms and a
table-top acquisition system. Tomosynthesis coronal slices were reconstructed using the FDK algorithm for
cone-beam geometry from 91 projections uniformly distributed over acquisition orbital extents (θ) ranging from
10° to 180°. Visual comparisons of different tomosynthesis reconstructions of a lung nodule show the progressive
decrease of anatomical clutter as θ increases. Additionally, three quantitative figures of merit were computed
and compared: signal-difference-to-noise ratio (SDNR), anatomical clutter power spectrum (PS), and theoretical
detectability index (DI). Lung nodule SDNR increases as θ increases from 0° to 120°. Anatomical clutter PS
shows that the clutter magnitude and correlation decrease as θ increases, increasing detectability. Similarly, 2D
and 3D DI increase as θ increases in the anatomical dominated exposure ranges. On the other hand, 2D slice
DI is lower than the 3D DI for larger θ (e.g. 120°), because of the information loss in the depth direction for 2D
slices. In other words, inspecting 3D is better for larger acquisition orbital extents, because the extra information
acquired at larger angles cannot be fully recovered from 2D tomosynthesis reconstruction slices. In summary,
detectability in tomosynthesis reconstructions for thoracic imaging increases as fixed dose is distributed over a
larger acquisition orbital extent (up to 120°).
KEYWORDS: 3D modeling, 3D metrology, 3D image processing, Sensors, Imaging systems, Modulation transfer functions, Interference (communication), Systems modeling, Stereoscopy, X-rays
Crucial to understanding the factors that govern imaging performance is a rigorous analysis of signal and noise transfer
characteristics (e.g., MTF, NPS, and NEQ) applied to a task-based performance metric (e.g., detectability index). This
paper advances a theoretical framework for calculation of the NPS, NEQ, and DQE of cone-beam CT (CBCT) and
tomosynthesis based on cascaded systems analysis. The model considers the 2D projection NPS propagated through a
series of reconstruction stages to yield the 3D NPS, revealing a continuum (from 2D projection radiography to limited-angle
tomosynthesis and fully 3D CBCT) for which NEQ and detectability index may be investigated as a function of
any system parameter. Factors considered in the cascade include: system geometry; angular extent of source-detector
orbit; finite number of views; log-scaling; application of ramp, apodization, and interpolation filters; back-projection;
and 3D noise aliasing - all of which have a direct impact on the 3D NEQ and DQE. Calculations of the 3D NPS were
found to agree with experimental measurements across a broad range of imaging conditions. The model presents a
theoretical framework that unifies 3D Fourier-based performance metrology in tomosynthesis and CBCT, providing a
guide to optimization that rigorously considers the system configuration, reconstruction parameters, and imaging task.
The statistical properties of medical images are central in characterizing the performance of imaging systems. The noise
in cone-beam CT (CBCT) is often characterized using Fourier-based metrics, such as the 3D noise-power spectrum
(NPS). Under a stationarity assumption, the NPS provides a complete representation of the covariance of the images,
since the covariance matrix of the Fourier transform of the image is diagonal. In practice, such assumptions are obeyed
to varying degrees. The objective of this work is to investigate the degree to which such assumptions apply in CBCT and
to experimentally characterize the NPS and off-diagonal elements under a range of experimental conditions. A benchtop
CBCT system was used to acquire 3D image reconstructions of various objects (air and a water cylinder) across a range
of experimental conditions that could affect stationarity (bowtie filter and dose). We test the stationarity assumption
under such varying experimental conditions using both spatial and frequency domain measures of stationarity. The
results indicate that experimental conditions affect the degree of stationarity and that under some imaging conditions,
local descriptions of the noise need to be developed to appropriately describe CBCT images. The off-diagonal elements
of the DFT covariance matrix may not always be ignored.
The relationship between theoretical descriptions of imaging performance (Fourier-based cascaded systems analysis)
and the performance of real human observers was investigated for various detection and discrimination
tasks. Dual-energy (DE) imaging provided a useful basis for investigating this relationship, because it presents a
host of acquisition and processing parameters that can significantly affect signal and noise transfer characteristics
and, correspondingly, human observer performance. The detectability index was computed theoretically using:
1) cascaded systems analysis of the modulation transfer function (MTF), and noise-power spectrum (NPS) for
DE imaging; 2) a Fourier description of imaging task; and 3.) integration of MTF, NPS, and task function
according to various observer models, including Fisher-Hotelling and non-prewhitening with and without an eye
filter and internal noise. Three idealized tasks were considered: sphere detection, shape discrimination (sphere
vs. disk), and texture discrimination (uniform vs. textured disk). Using images of phantoms acquired on a
prototype DE imaging system, human observer performance was assessed in multiple-alternative forced choice
(MAFC) tests, giving an estimate of area under the ROC curve (AΖ). The degree to which the theoretical
detectability index correlated with human observer performance was investigated, and results agreed well over
a broad range of imaging conditions, depending on the choice of observer model. Results demonstrated that
optimal DE image acquisition and decomposition parameters depend significantly on the imaging task. These
studies provide important initial validation that the detectability index derived theoretically by Fourier-based
cascaded systems analysis correlates well with actual human observer performance and represents a meaningful
metric for system optimization.
Mounting evidence suggests that the superposition of anatomical clutter in a projection radiograph poses a major
impediment to the detectability of subtle lung nodules. Through decomposition of projections acquired at multiple kVp,
dual-energy (DE) imaging offers to dramatically improve lung nodule detectability and, in part through quantitation of
nodule calcification, increase specificity in nodule characterization. The development of a high-performance DE chest
imaging system is reported, with design and implementation guided by fundamental imaging performance metrics. A
diagnostic chest stand (Kodak RVG 5100 digital radiography system) provided the basic platform, modified to include:
(i) a filter wheel, (ii) a flat-panel detector (Trixell Pixium 4600), (iii) a computer control and monitoring system for
cardiac-gated acquisition, and (iv) DE image decomposition and display. Computational and experimental studies of
imaging performance guided optimization of key acquisition technique parameters, including: x-ray filtration, allocation
of dose between low- and high-energy projections, and kVp selection. A system for cardiac-gated acquisition was
developed, directing x-ray exposures to within the quiescent period of the heart cycle, thereby minimizing anatomical
misregistration. A research protocol including 200 patients imaged following lung nodule biopsy is underway, allowing
preclinical evaluation of DE imaging performance relative to conventional radiography and low-dose CT.
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