We present a performance evaluation of a recently introduced dual-source computed tomography (DSCT) system equipped with two X-ray tubes and two corresponding detectors, mounted onto the rotating gantry with an angular offset of 90 degrees . We introduce the system concept and derive its consequences and potential benefits for electrocardiograph [corrected] (ECG)-controlled cardiac CT and for general radiology applications. We evaluate both temporal and spatial resolution by means of phantom scans. We present first patient scans to illustrate the performance of DSCT for ECG-gated cardiac imaging, and we demonstrate first results using a dual-energy acquisition mode. Using ECG-gated single-segment reconstruction, the DSCT system provides 83 ms temporal resolution independent of the patient's heart rate for coronary CT angiography (CTA) and evaluation of basic functional parameters. With dual-segment reconstruction, the mean temporal resolution is 60 ms (minimum temporal resolution 42 ms) for advanced functional evaluation. The z-flying focal spot technique implemented in the evaluated DSCT system allows 0.4 mm cylinders to be resolved at all heart rates. First clinical experience shows a considerably increased robustness for the imaging of patients with high heart rates. As a potential application of the dual-energy acquisition mode, the automatic separation of bones and iodine-filled vessels is demonstrated.
A biaxial nematic phase had been predicted with D(2h) symmetry, wherein the mesogen's long and short transverse axes are simultaneously aligned along the two orthogonal, primary and secondary directors, n and m, respectively. The unique low-angle x-ray diffraction patterns in the nematic phases exhibited by three rigid bent-core mesogens clearly reveal their biaxiality. The results of x-ray diffraction can be readily reproduced by ab initio calculations that explicitly include the bent-core shape in the form factor and assume short-range positional correlations.
Rationale and Objectives-To determine the accuracy and sensitivity for dual-energy computed tomography (DECT) discrimination of uric acid (UA) stones from other (non-UA) renal stones in a commercially implemented product.Materials and Methods-Forty human renal stones comprising uric acid (n = 16), hydroxyapatite (n = 8), calcium ox-alate (n = 8), and cystine (n = 8) were inserted in four porcine kidneys (10 each) and placed inside a 32-cm water tank anterior to a cadaver spine. Spiral dual-energy scans were obtained on a dual-source, 64-slice computed tomography (CT) system using a clinical protocol and automatic exposure control. Scanning was performed at two different collimations (0.6 mm and 1.2 mm) and within three phantom sizes (medium, large, and extra large) resulting in a total of six image datasets. These datasets were analyzed using the dual-energy software tool available on the CT system for both accuracy (number of stones correctly classified as either UA or non-UA) and sensitivity (for UA stones). Stone characterization was correlated with micro-CT.Results-For the medium and large phantom sizes, the DECT technique demonstrated 100% accuracy (40/40), regardless of collimation. For the extra large phantom size and the 0.6-mm collimation (resulting in the noisiest dataset), three (two cystine and one small UA) stones could not be classified (93% accuracy and 94% sensitivity). For the extra large phantom size and the 1.2-mm collimation, the dual-energy tool failed to identify two small UA stones (95% accuracy and 88% sensitivity). Conclusions-In an anthropomorphic phantom model, dual-energy CT can accurately discriminate uric acid stones from other stone types. KeywordsKidney stones; renal calculi; dual-energy computed tomography; uric acid; urolithiasis Symptomatic urinary stone disease affects approximately 900,000 persons in the United States each year, resulting in annual medical cost of $5.3 billion. Nephrolithiasis has traditionally been evaluated using plain film radiographic techniques with or without tomography or administration of intravenous contrast for excretory urography. Over recent years, however, computed tomography (CT) has supplanted these traditional techniques because of increased sensitivity, speed, and the lack of intravenous contrast (1 Although state-of-the-art CT provides accurate submillimeter details of the size and location of renal stones (4,5), current routine clinical image analysis does not differentiate stone composition. This is particularly important in the case of uric acid (UA) stones (~10% of cases), because urinary alkalinization can be prescribed to dissolve UA stones and could thereby be initiated at presentation rather than following lengthy metabolic workup. Therefore simple and reliable differentiation of UA versus non-UA stone composition could potentially allow patients with UA stones to avoid invasive interventional urinary procedures for stone removal or external shock wave lithotripsy, both of which are expensive and might result in renal hemorrh...
In principle, dual-energy CT can only accurately decompose a mixture into two materials. To decompose a mixture into three constitute materials using dual-energy CT measurements, a third criteria must be provided to solve for three unknowns with only two spectral measurements. One solution is to assume that the sum of the volumes of three constituent materials is equivalent to the volume of the mixture (i.e., volume conservation), but this is not always true. A more generalized solution is to use the principle of mass conservation, which assumes that the sum of the masses of the three constituent materials is equivalent to the mass of the mixture. In this article, a mass-conservation based, three-material decomposition dual-energy CT algorithm is described and experimental validation of the accuracy of the technique presented. The results demonstrate that the proposed method can accurately measure elemental concentrations under low noise imaging conditions. Clinically, this may be applied to measure the mass fraction of any chemical element in a three-material mixture of solutions without the requirement of volume conservation.
The use of additional spectral filtration for dual-energy ͑DE͒ imaging using a dual-source CT ͑DSCT͒ system was investigated and its effect on the material-specific DE ratio was evaluated for several clinically relevant materials. The x-ray spectra, data acquisition, and reconstruction processes for a DSCT system ͑Siemens Definition͒ were simulated using information provided by the system manufacturer, resulting in virtual DE images. The factory-installed filtration for the 80 kV spectrum was left unchanged to avoid any further reductions in tube output, and only the filtration for the high-energy spectrum was modified. Only practical single-element filter materials within the atomic number range of 40Յ Z Յ 83 were evaluated, with the aim of maximizing the separation between the two spectra, while maintaining similar noise levels for high-and low-energy images acquired at the same tube current. The differences between mean energies and the ratio of the 140 and 80 kV detector signals, each integrated below 80 keV, were evaluated. The simulations were performed for three attenuation scenarios: Head, body, and large body. The large body scenario was evaluated for the DE acquisition mode using the 100 and 140 kV spectra. The DE ratio for calcium hydroxyapatite ͑simulating bone or calcifications͒, iodine, and iron were determined for CT images simulated using the modified and factory-installed filtration. Several filter materials were found to perform well at proper thicknesses, with tin being a good practical choice. When image noise was matched between the low-and high-energy images, the spectral difference in mean absorbed energy using tin was increased from 25.7 to 42.7 keV ͑head͒, from 28.6 to 44.1 keV ͑body͒, and from 20.2 to 30.2 keV ͑large body͒. The overlap of the signal spectra for energies below 80 keV was reduced from 78% to 31% ͑head͒, from 93% to 27% ͑body͒, and from 106% to 79% ͑large body͒. The DE ratio for the body attenuation scenario increased from 1.45 to 1.91 ͑calcium͒, from 1.84 to 3.39 ͑iodine͒, and from 1.73 to 2.93 ͑iron͒ with the additional tin filtration compared to the factory filtration. This use of additional filtration for one of the x-ray tubes used in dual-source DECT dramatically increased the difference between material-specific DE ratios, e.g., from 0.39 to 1.48 for calcium and iodine or from 0.28 to 1.02 for calcium and iron. Because the ability to discriminate between different materials in DE imaging depends primarily on the differences in DE ratios, this increase is expected to improve the performance of any material-specific DECT imaging task. Furthermore, for the large patient size and in conjunction with a 100/140 kV acquisition, the use of additional filtration decreased noise in the low-energy images and increased contrast in the DE image relative to that obtained with 80/140 kV and no additional filtration.
We present a theoretical overview and a performance evaluation of a novel z-sampling technique for multidetector row CT (MDCT), relying on a periodic motion of the focal spot in the longitudinal direction (z-flying focal spot) to double the number of simultaneously acquired slices. The z-flying focal spot technique has been implemented in a recently introduced MDCT scanner. Using 32 x 0.6 mm collimation, this scanner acquires 64 overlapping 0.6 mm slices per rotation in its spiral (helical) mode of operation, with the goal of improved longitudinal resolution and reduction of spiral artifacts. The longitudinal sampling distance at isocenter is 0.3 mm. We discuss in detail the impact of the z-flying focal spot technique on image reconstruction. We present measurements of spiral slice sensitivity profiles (SSPs) and of longitudinal resolution, both in the isocenter and off-center. We evaluate the pitch dependence of the image noise measured in a centered 20 cm water phantom. To investigate spiral image quality we present images of an anthropomorphic thorax phantom and patient scans. The full width at half maximum (FWHM) of the spiral SSPs shows only minor variations as a function of the pitch, measured values differ by less than 0.15 mm from the nominal values 0.6, 0.75, 1, 1.5, and 2 mm. The measured FWHM of the smallest slice ranges between 0.66 and 0.68 mm at isocenter, except for pitch 0.55 (0.72 mm). In a centered z-resolution phantom, bar patterns up to 15 lp/cm can be visualized independent of the pitch, corresponding to 0.33 mm longitudinal resolution. 100 mm off-center, bar patterns up to 14 lp/cm are visible, corresponding to an object size of 0.36 mm that can be resolved in the z direction. Image noise for constant effective mAs is almost independent of the pitch. Measured values show a variation of less than 7% as a function of the pitch, which demonstrates correct utilization of the applied radiation dose at any pitch. The product of image noise and square root of the slice width (FWHM of the respective SSP) is the same constant for all slices except 0.6 mm. For the thinnest slice, relative image noise is increased by 17%. Spiral windmill-type artifacts are effectively suppressed with the z-flying focal spot technique, which has the potential to maintain a low artifact level up to pitch 1.5, in this way increasing the maximum volume coverage speed that can be clinically used.
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