Sieren J P, Hoffman E A, Fuld M K, Chan K S, Guo J, Newell J D
Department of Radiology, University of Iowa, Iowa City, Iowa 52242.
Department of Radiology, University of Iowa, Iowa City, Iowa 52242; Department of Medicine, University of Iowa, Iowa City, Iowa 52242; and Department of Biomedical Engineering, University of Iowa, Iowa City, Iowa 52242.
Med Phys. 2014 Sep;41(9):091910. doi: 10.1118/1.4893498.
Assessing pulmonary emphysema using Quantitative CT of the lung depends on accurate measures of CT density. Sinogram-Affirmed-Iterative-Reconstruction (SAFIRE) is a new approach for reconstructing CT data acquired at significantly lower doses. However, quantitative effects of this method remain unexplored. The authors investigated the effects on the median values of materials in the COPDGene2 test-object as a function of the reconstruction method [weighted filtered back projection (WFBP) versus SAFIRE], test-object size, dose, and material composition using a Siemens SOMATOM Definition FLASH CT scanner.
The COPDGene2 test-object contains eight materials; acrylic, water, four foams (20 lb, 12 lb, lung-equivalent, and 4 lb emphysema-equivalent), internal and external-air. The test-object was scanned with three different outer ring sizes, simulating three different body habitus. There is an average size (36 cm) Ring A, large size (40 cm) Ring B, and small size Ring C (30 cm). The CT protocol used 120 kVp, 0.5 s rotation, 1.0 pitch, and a 0.6 slice collimation with progressively decreasing x-ray exposure values, 11.94-0.74 mGy. With a thorax length of 30 cm, the corresponding effective doses would be 5.01-0.31 mSv. The effects of using SAFIRE versus WFBP were assessed using a two tailed t-test for each ring size, material, and dose. Multivariable linear regression was used to evaluate the relative effects of ring size, material composition, dose, and reconstruction method on the measured median value in HU.
SAFIRE versus WFBP, at the largest ring size and two lowest doses there was a significant difference in median values of 4 lb-foam, p<0.01. Using the smallest ring size at the lowest dose level there was a significant difference in the median value of 4 lb-foam, but the effect size was small, 1 HU. There is a significant difference in median values of both internal and external air using both the small and medium size rings at the three lowest dose levels, p<0.05. There are significant differences noted at both high and low dose levels when using the large ring size in the median values of internal and external air when, p<0.05. These effects on 4 lb-foam, inside and outside air are shown to be in part due to truncation effects on the median value since the lowest HU value in the CT scale used is -1024 HU. Multivariable linear regression results demonstrated significant effects on the measured material median value and standard deviation due to ring size, material composition, dose level, and reconstruction method, p<0.05.
The authors have shown that there is no significant effect on the median values obtained when using WFBP versus SAFIRE in materials with CT density between 120 and -856 HU using three different test-object sizes and CT doses that vary from 11.94 to 0.74 mGy. The authors have demonstrated there are significant effects on median values obtained when using WFBP versus SAFIRE in materials with CT density values between -937 and -1000 HU depending on the ring size and dose used. As expected, there is considerable reduction in image noise (lower standard deviation) using SAFIRE versus WFBP with all ring sizes, doses, and materials in the COPDGene2 test-object.
使用肺部定量CT评估肺气肿依赖于对CT密度的准确测量。正弦图确认迭代重建(SAFIRE)是一种以显著更低剂量采集CT数据的重建新方法。然而,该方法的定量效果仍未得到探索。作者使用西门子SOMATOM Definition FLASH CT扫描仪,研究了重建方法[加权滤波反投影(WFBP)与SAFIRE]、测试物体大小、剂量和材料成分对COPDGene2测试物体中材料中位数的影响。
COPDGene2测试物体包含八种材料;丙烯酸、水、四种泡沫(20磅、1磅、肺等效和4磅肺气肿等效)、内部空气和外部空气。使用三种不同的外环尺寸对测试物体进行扫描,模拟三种不同的体型。有平均尺寸(36厘米)的A环、大尺寸(40厘米)的B环和小尺寸(30厘米)的C环。CT扫描方案采用120千伏峰值、0.5秒旋转、1.0螺距和0.6毫米层厚准直,X射线曝光值逐渐降低,为11.94 - 0.74毫戈瑞。胸部长度为30厘米时,相应的有效剂量为5.01 - 0.31毫希沃特。对于每种环尺寸、材料和剂量,使用双尾t检验评估SAFIRE与WFBP的效果。多变量线性回归用于评估环尺寸、材料成分、剂量和重建方法对测量的HU中位数的相对影响。
在最大环尺寸和两个最低剂量下,SAFIRE与WFBP相比,4磅泡沫的中位数有显著差异,p<0.01。在最低剂量水平使用最小环尺寸时,4磅泡沫的中位数有显著差异,但效应量较小,为1 HU。在三个最低剂量水平,使用中小环尺寸时,内部和外部空气的中位数均有显著差异,p<0.05。使用大环尺寸时,在高剂量和低剂量水平,内部和外部空气的中位数均有显著差异,p<0.05。对4磅泡沫、内部和外部空气的这些影响部分显示是由于对中位数的截断效应,因为所使用的CT尺度中的最低HU值为-1024 HU。多变量线性回归结果表明,环尺寸、材料成分、剂量水平和重建方法对测量的材料中位数和标准差有显著影响,p<0.05。
作者表明,使用三种不同的测试物体尺寸和11.94至0.74毫戈瑞的CT剂量,对于CT密度在120至-856 HU之间的材料,使用WFBP与SAFIRE时获得的中位数没有显著影响。作者证明,对于CT密度值在-937至-1000 HU之间的材料,使用WFBP与SAFIRE时获得的中位数有显著影响,这取决于所使用的环尺寸和剂量。正如预期的那样,在COPDGene2测试物体中,对于所有环尺寸、剂量和材料,使用SAFIRE与WFBP相比,图像噪声有相当大的降低(标准差更低)。