In this paper, the performance of focused lamellar anti-scatter grids, which are currently used in fluoroscopy, is studied in order to determine guidelines of grid usage for flat detector based cone beam CT. The investigation aims at obtaining the signal to noise ratio improvement factor by the use of anti-scatter grids. First, the results of detailed Monte Carlo simulations as well as measurements are presented. From these the general characteristics of the impinging field of scattered and primary photons are derived. Phantoms modeling the head, thorax and pelvis regions have been studied for various imaging geometries with varying phantom size, cone and fan angles and patient-detector distances. Second, simulation results are shown for ideally focused and vacuum spaced grids as best case approach as well as for grids with realistic spacing materials. The grid performance is evaluated by means of the primary and scatter transmission and the signal to noise ratio improvement factor as function of imaging geometry and grid parameters. For a typical flat detector cone beam CT setup, the grid selectivity and thus the performance of anti-scatter grids is much lower compared to setups where the grid is located directly behind the irradiated object. While for small object-to-grid distances a standard grid improves the SNR, the SNR for geometries as used in flat detector based cone beam CT is deteriorated by the use of an anti-scatter grid for many application scenarios. This holds even for the pelvic region. Standard fluoroscopy anti-scatter grids were found to decrease the SNR in many application scenarios of cone beam CT due to the large patient-detector distance and have, therefore, only a limited benefit in flat detector based cone beam CT.

In flat detector cone-beam computed tomography and related applications, sparse angular sampling frequently leads to characteristic streak artifacts. To overcome this problem, it has been suggested to generate additional views by means of interpolation. The practicality of this approach is investigated in combination with a dedicated method for angular interpolation of 3-D sinogram data. For this purpose, a novel dedicated shape-driven directional interpolation algorithm based on a structure tensor approach is developed. Quantitative evaluation shows that this method clearly outperforms conventional scene-based interpolation schemes. Furthermore, the image quality trade-offs associated with the use of interpolated intermediate views are systematically evaluated for simulated and clinical cone-beam computed tomography data sets of the human head. It is found that utilization of directionally interpolated views significantly reduces streak artifacts and noise, at the expense of small introduced image blur.

Scattered radiation is a major source of image degradation and nonlinearity in flat detector based cone-beam CT. Due to the bigger irradiated volume the amount of scattered radiation in true cone-beam geometry is considerably higher than for fan beam CT. This on the one hand reduces the signal to noise ratio, since the additional scattered photons contribute only to the noise and not to the measured signal, and on the other hand cupping and streak artifacts arise in the reconstructed volume. Anti-scatter grids composed of lead lamellae and interspacing material decrease the SNR for flat detector based CB-CT geometry, because the beneficial scatter attenuating effect is overcompensated by the absorption of primary radiation. Additionally, due to the high amount of scatter that still remains behind the grid, cupping and streak artifacts cannot be reduced sufficiently. Computerized scatter correction schemes are therefore essential for achieving artifact-free reconstructed images in cone-beam CT. In this work, a fast model based scatter correction algorithm is proposed, aiming at accurately estimating the level and spatial distribution of scattered radiation background in each projection. This will allow for effectively reducing streak and cupping artifacts due to scattering in cone-beam CT applications.