Zhong Yuncheng, Lai Chao-Jen, Wang Tianpeng, Shaw Chris C
Department of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas 77054.
Med Phys. 2015 Sep;42(9):5238-51. doi: 10.1118/1.4928214.
Digital tomosynthesis (DTS) has been shown to be useful for reducing the overlapping of abnormalities with anatomical structures at various depth levels along the posterior-anterior (PA) direction in chest radiography. However, DTS provides crude three-dimensional (3D) images that have poor resolution in the lateral view and can only be displayed with reasonable quality in the PA view. Furthermore, the spillover of high-contrast objects from off-fulcrum planes generates artifacts that may impede the diagnostic use of the DTS images. In this paper, the authors describe and demonstrate the use of a dual-view DTS technique to improve the accuracy of the reconstructed volume image data for more accurate rendition of the anatomy and slice images with improved resolution and reduced artifacts, thus allowing the 3D image data to be viewed in views other than the PA view.
With the dual-view DTS technique, limited angle scans are performed and projection images are acquired in two orthogonal views: PA and lateral. The dual-view projection data are used together to reconstruct 3D images using the maximum likelihood expectation maximization iterative algorithm. In this study, projection images were simulated or experimentally acquired over 360° using the scanning geometry for cone beam computed tomography (CBCT). While all projections were used to reconstruct CBCT images, selected projections were extracted and used to reconstruct single- and dual-view DTS images for comparison with the CBCT images. For realistic demonstration and comparison, a digital chest phantom derived from clinical CT images was used for the simulation study. An anthropomorphic chest phantom was imaged for the experimental study. The resultant dual-view DTS images were visually compared with the single-view DTS images and CBCT images for the presence of image artifacts and accuracy of CT numbers and anatomy and quantitatively compared with root-mean-square-deviation (RMSD) values computed using the digital chest phantom or the CBCT images as the reference in the simulation and experimental study, respectively. High-contrast wires with vertical, oblique, and horizontal orientations in a PA view plane were also imaged to investigate the spatial resolutions and how the wire signals spread in the PA view and lateral view slice images.
Both the digital phantom images (simulated) and the anthropomorphic phantom images (experimentally generated) demonstrated that the dual-view DTS technique resulted in improved spatial resolution in the depth (PA) direction, more accurate representation of the anatomy, and significantly reduced artifacts. The RMSD values corroborate well with visual observations with substantially lower RMSD values measured for the dual-view DTS images as compared to those measured for the single-view DTS images. The imaging experiment with the high-contrast wires shows that while the vertical and oblique wires could be resolved in the lateral view in both single- and dual-view DTS images, the horizontal wire could only be resolved in the dual-view DTS images. This indicates that with single-view DTS, the wire signals spread liberally to off-fulcrum planes and generated wire shadow there.
The authors have demonstrated both visually and quantitatively that the dual-view DTS technique can be used to achieve more accurate rendition of the anatomy and to obtain slice images with improved resolution and reduced artifacts as compared to the single-view DTS technique, thus allowing the 3D image data to be viewed in views other than the PA view. These advantages could make the dual-view DTS technique useful in situations where better separation of the objects-of-interest from the off-fulcrum structures or more accurate 3D rendition of the anatomy are required while a regular CT examination is undesirable due to radiation dose considerations.
数字断层合成(DTS)已被证明有助于减少胸部X线摄影中后前(PA)方向不同深度层面异常与解剖结构的重叠。然而,DTS提供的粗略三维(3D)图像在侧位视图中分辨率较差,且仅在PA视图中能以合理质量显示。此外,来自非支点平面的高对比度物体的溢出会产生伪影,可能会妨碍DTS图像的诊断应用。在本文中,作者描述并展示了一种双视图DTS技术的应用,以提高重建体图像数据的准确性,从而更准确地呈现解剖结构和切片图像,提高分辨率并减少伪影,进而允许在PA视图以外的视图中查看3D图像数据。
采用双视图DTS技术,进行有限角度扫描,并在两个正交视图(PA和侧位)中采集投影图像。使用最大似然期望最大化迭代算法将双视图投影数据一起用于重建3D图像。在本研究中,使用锥束计算机断层扫描(CBCT)的扫描几何结构在360°范围内模拟或实验采集投影图像。虽然所有投影都用于重建CBCT图像,但提取选定的投影并用于重建单视图和双视图DTS图像,以便与CBCT图像进行比较。为了进行实际演示和比较,在模拟研究中使用了从临床CT图像导出的数字胸部模型。在实验研究中对一个拟人化胸部模型进行成像。将所得的双视图DTS图像与单视图DTS图像和CBCT图像在视觉上比较图像伪影的存在情况以及CT值和解剖结构的准确性,并在模拟和实验研究中分别与以数字胸部模型或CBCT图像为参考计算的均方根偏差(RMSD)值进行定量比较。还对PA视图平面中具有垂直、倾斜和水平方向的高对比度金属丝进行成像,以研究空间分辨率以及金属丝信号在PA视图和侧位视图切片图像中的传播情况。
数字模型图像(模拟)和拟人化模型图像(实验生成)均表明,双视图DTS技术在深度(PA)方向上提高了空间分辨率,更准确地呈现了解剖结构,并显著减少了伪影。RMSD值与视觉观察结果吻合良好,与单视图DTS图像相比,双视图DTS图像的RMSD值显著更低。对高对比度金属丝的成像实验表明,虽然在单视图和双视图DTS图像的侧位视图中垂直和倾斜金属丝都能分辨,但水平金属丝仅在双视图DTS图像中能分辨。这表明在单视图DTS中,金属丝信号会大量扩散到非支点平面并在那里产生金属丝阴影。
作者通过视觉和定量方法均证明,与单视图DTS技术相比,双视图DTS技术可用于更准确地呈现解剖结构,并获得分辨率更高、伪影更少的切片图像,从而允许在PA视图以外的视图中查看3D图像数据。这些优势使得双视图DTS技术在因辐射剂量考虑而不适合进行常规CT检查,但需要更好地将感兴趣物体与非支点结构分离或更准确地进行解剖结构的3D呈现的情况下可能会很有用。