Li Ke, Gomez-Cardona Daniel, Hsieh Jiang, Lubner Meghan G, Pickhardt Perry J, Chen Guang-Hong
Department of Medical Physics, University of Wisconsin-Madison School of Medicine and Public Health, 1111 Highland Avenue, Madison, Wisconsin 53705 and Department of Radiology, University of Wisconsin-Madison School of Medicine and Public Health, 600 Highland Avenue, Madison, Wisconsin 53792.
Department of Medical Physics, University of Wisconsin-Madison School of Medicine and Public Health, 1111 Highland Avenue, Madison, Wisconsin 53705.
Med Phys. 2015 Sep;42(9):5209-21. doi: 10.1118/1.4927722.
For a given imaging task and patient size, the optimal selection of x-ray tube potential (kV) and tube current-rotation time product (mAs) is pivotal in achieving the maximal radiation dose reduction while maintaining the needed diagnostic performance. Although contrast-to-noise (CNR)-based strategies can be used to optimize kV/mAs for computed tomography (CT) imaging systems employing the linear filtered backprojection (FBP) reconstruction method, a more general framework needs to be developed for systems using the nonlinear statistical model-based iterative reconstruction (MBIR) method. The purpose of this paper is to present such a unified framework for the optimization of kV/mAs selection for both FBP- and MBIR-based CT systems.
The optimal selection of kV and mAs was formulated as a constrained optimization problem to minimize the objective function, Dose(kV,mAs), under the constraint that the achievable detectability index d'(kV,mAs) is not lower than the prescribed value of d'R for a given imaging task. Since it is difficult to analytically model the dependence of d' on kV and mAs for the highly nonlinear MBIR method, this constrained optimization problem is solved with comprehensive measurements of Dose(kV,mAs) and d'(kV,mAs) at a variety of kV-mAs combinations, after which the overlay of the dose contours and d' contours is used to graphically determine the optimal kV-mAs combination to achieve the lowest dose while maintaining the needed detectability for the given imaging task. As an example, d' for a 17 mm hypoattenuating liver lesion detection task was experimentally measured with an anthropomorphic abdominal phantom at four tube potentials (80, 100, 120, and 140 kV) and fifteen mA levels (25 and 50-700) with a sampling interval of 50 mA at a fixed rotation time of 0.5 s, which corresponded to a dose (CTDIvol) range of [0.6, 70] mGy. Using the proposed method, the optimal kV and mA that minimized dose for the prescribed detectability level of d'R=16 were determined. As another example, the optimal kV and mA for an 8 mm hyperattenuating liver lesion detection task were also measured using the developed framework. Both an in vivo animal and human subject study were used as demonstrations of how the developed framework can be applied to the clinical work flow.
For the first task, the optimal kV and mAs were measured to be 100 and 500, respectively, for FBP, which corresponded to a dose level of 24 mGy. In comparison, the optimal kV and mAs for MBIR were 80 and 150, respectively, which corresponded to a dose level of 4 mGy. The topographies of the iso-d' map and the iso-CNR map were the same for FBP; thus, the use of d'- and CNR-based optimization methods generated the same results for FBP. However, the topographies of the iso-d' and iso-CNR map were significantly different in MBIR; the CNR-based method overestimated the performance of MBIR, predicting an overly aggressive dose reduction factor. For the second task, the developed framework generated the following optimization results: for FBP, kV = 140, mA = 350, dose = 37.5 mGy; for MBIR, kV = 120, mA = 250, dose = 18.8 mGy. Again, the CNR-based method overestimated the performance of MBIR. Results of the preliminary in vivo studies were consistent with those of the phantom experiments.
A unified and task-driven kV/mAs optimization framework has been developed in this work. The framework is applicable to both linear and nonlinear CT systems such as those using the MBIR method. As expected, the developed framework can be reduced to the conventional CNR-based kV/mAs optimization frameworks if the system is linear. For MBIR-based nonlinear CT systems, however, the developed task-based kV/mAs optimization framework is needed to achieve the maximal dose reduction while maintaining the desired diagnostic performance.
对于给定的成像任务和患者体型,X射线管电压(kV)和管电流-旋转时间乘积(mAs)的最佳选择对于在保持所需诊断性能的同时实现最大辐射剂量降低至关重要。虽然基于对比噪声比(CNR)的策略可用于为采用线性滤波反投影(FBP)重建方法的计算机断层扫描(CT)成像系统优化kV/mAs,但需要为使用基于非线性统计模型的迭代重建(MBIR)方法的系统开发更通用的框架。本文的目的是为基于FBP和MBIR的CT系统的kV/mAs选择优化提出这样一个统一框架。
kV和mAs的最佳选择被公式化为一个约束优化问题,以在给定成像任务中可实现的可检测性指数d′(kV,mAs)不低于规定值d′R的约束下,最小化目标函数剂量(Dose(kV,mAs))。由于对于高度非线性的MBIR方法,难以解析地建模d′对kV和mAs的依赖性,因此通过在各种kV-mAs组合下对剂量(Dose(kV,mAs))和d′(kV,mAs)进行全面测量来解决这个约束优化问题,之后使用剂量轮廓和d′轮廓的叠加来以图形方式确定最佳kV-mAs组合,以在保持给定成像任务所需可检测性的同时实现最低剂量。例如,使用一个仿真人体腹部模型,在四个管电压(80、100、120和140 kV)和十五个mA水平(25以及50至700,采样间隔为50 mA)下,在固定旋转时间0.5 s时,对检测17 mm低密度肝脏病变任务的d′进行了实验测量,这对应于[0.6, 70] mGy的剂量(CTDIvol)范围。使用所提出的方法,确定了在规定可检测性水平d′R = 16时使剂量最小化的最佳kV和mA。作为另一个例子,还使用所开发的框架测量了检测8 mm高密度肝脏病变任务的最佳kV和mA。体内动物和人体研究均被用作所开发框架如何应用于临床工作流程的示例。
对于第一个任务,FBP的最佳kV和mAs分别测量为100和500,对应剂量水平为24 mGy。相比之下,MBIR的最佳kV和mAs分别为80和150,对应剂量水平为4 mGy。对于FBP,等d′图和等CNR图的地形相同;因此,基于d′和CNR的优化方法对FBP产生相同的结果。然而,在MBIR中,等d′图和等CNR图的地形显著不同;基于CNR的方法高估了MBIR的性能,预测了过度激进的剂量降低因子。对于第二个任务,所开发的框架产生了以下优化结果:对于FBP,kV = 140,mA = 350,剂量 = 37.5 mGy;对于MBIR,kV = 120,mA = 250,剂量 = 18.8 mGy。同样,基于CNR的方法高估了MBIR的性能。初步体内研究结果与体模实验结果一致。
本研究开发了一个统一且任务驱动的kV/mAs优化框架。该框架适用于线性和非线性CT系统,如使用MBIR方法的系统。正如预期的那样,如果系统是线性的,所开发的框架可以简化为传统的基于CNR的kV/mAs优化框架。然而,对于基于MBIR的非线性CT系统,需要所开发的基于任务的kV/mAs优化框架来在保持所需诊断性能的同时实现最大剂量降低。