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Title: SU-F-J-75: Accuracy and Stability of Electron Density Measurements Across Patient Size Using Dual Energy CT

Abstract

Purpose: Dual energy (DE) CT can be used to characterize tissue composition. One application of DE CT is to measure electron density (ED, rho) and atomic number (Z) for use in radiation therapy treatment planning. This work evaluated the accuracy and stability of ED estimation as patient size varied for both single-energy (SE) and DE CT. Methods: An ED phantom (CIRS) and four torso-shaped water tanks (lateral widths 15, 25, 35 and 45 cm) containing 8 tissue-simulating cylinders of known ED were scanned on a dual-source CT system (Siemens Somatom Force) in SE (120 kV) and DE (90/150Sn) modes. Additional scans were performed on the 15 and 25 cm water tanks using DE techniques of 70/150Sn and 80/150Sn, respectively. CTDIvol was matched for all SE and DE scans for a given phantom size. Images were reconstructed using quantitative kernels to preserve CT number accuracy. ED was estimated in each test cylinder and in solid and liquid water using calibration measurements acquired in the CIRS phantom (SE) and a Rho-Z algorithm (DE). Results: ED estimates showed good agreement with the nominal ED values when using Rho-Z (slope = 1.0051, R2 = 0.9982). Mean percent error was similar between SE (1.21%) andmore » DE (1.28%). Mean deviation across patient size decreased 34% (1.43% with SE, 0.95% with DE). When compared to 90/150Sn, DE techniques of 70/150Sn and 80/150Sn showed mean differences in ED of 0.43% and 0.15%, respectively. Conclusion: While both DE Rho-Z and SE CT number calibration methods are both accurate for estimating ED, Rho-Z offers the advantages of having less variability across patient size, not requiring a phantom calibration, and being able to distinguish between materials of similar attenuation, but different chemical composition. Low kV DE pairs are an option in small patients due to lack of effect on ED accuracy. This research was supported by Siemens Healthcare.« less

Authors:
; ;  [1];  [2];  [3]
  1. Mayo Clinic, Rochester, MN (United States)
  2. Siemens Medical Solutions USA, Inc, Malvern, PA (United States)
  3. Siemens Healthcare - Forchheim (Germany)
Publication Date:
OSTI Identifier:
22632204
Resource Type:
Journal Article
Resource Relation:
Journal Name: Medical Physics; Journal Volume: 43; Journal Issue: 6; Other Information: (c) 2016 American Association of Physicists in Medicine; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
60 APPLIED LIFE SCIENCES; 61 RADIATION PROTECTION AND DOSIMETRY; ACCURACY; ALGORITHMS; ANIMAL TISSUES; ATTENUATION; CALIBRATION; CHEMICAL COMPOSITION; COMPUTERIZED TOMOGRAPHY; ERRORS; IMAGES; KERNELS; PATIENTS; PHANTOMS; RADIOTHERAPY

Citation Formats

Michalak, G, Fletcher, J, McCollough, C, Halaweish, A, and Krauss, B. SU-F-J-75: Accuracy and Stability of Electron Density Measurements Across Patient Size Using Dual Energy CT. United States: N. p., 2016. Web. doi:10.1118/1.4955983.
Michalak, G, Fletcher, J, McCollough, C, Halaweish, A, & Krauss, B. SU-F-J-75: Accuracy and Stability of Electron Density Measurements Across Patient Size Using Dual Energy CT. United States. doi:10.1118/1.4955983.
Michalak, G, Fletcher, J, McCollough, C, Halaweish, A, and Krauss, B. 2016. "SU-F-J-75: Accuracy and Stability of Electron Density Measurements Across Patient Size Using Dual Energy CT". United States. doi:10.1118/1.4955983.
@article{osti_22632204,
title = {SU-F-J-75: Accuracy and Stability of Electron Density Measurements Across Patient Size Using Dual Energy CT},
author = {Michalak, G and Fletcher, J and McCollough, C and Halaweish, A and Krauss, B},
abstractNote = {Purpose: Dual energy (DE) CT can be used to characterize tissue composition. One application of DE CT is to measure electron density (ED, rho) and atomic number (Z) for use in radiation therapy treatment planning. This work evaluated the accuracy and stability of ED estimation as patient size varied for both single-energy (SE) and DE CT. Methods: An ED phantom (CIRS) and four torso-shaped water tanks (lateral widths 15, 25, 35 and 45 cm) containing 8 tissue-simulating cylinders of known ED were scanned on a dual-source CT system (Siemens Somatom Force) in SE (120 kV) and DE (90/150Sn) modes. Additional scans were performed on the 15 and 25 cm water tanks using DE techniques of 70/150Sn and 80/150Sn, respectively. CTDIvol was matched for all SE and DE scans for a given phantom size. Images were reconstructed using quantitative kernels to preserve CT number accuracy. ED was estimated in each test cylinder and in solid and liquid water using calibration measurements acquired in the CIRS phantom (SE) and a Rho-Z algorithm (DE). Results: ED estimates showed good agreement with the nominal ED values when using Rho-Z (slope = 1.0051, R2 = 0.9982). Mean percent error was similar between SE (1.21%) and DE (1.28%). Mean deviation across patient size decreased 34% (1.43% with SE, 0.95% with DE). When compared to 90/150Sn, DE techniques of 70/150Sn and 80/150Sn showed mean differences in ED of 0.43% and 0.15%, respectively. Conclusion: While both DE Rho-Z and SE CT number calibration methods are both accurate for estimating ED, Rho-Z offers the advantages of having less variability across patient size, not requiring a phantom calibration, and being able to distinguish between materials of similar attenuation, but different chemical composition. Low kV DE pairs are an option in small patients due to lack of effect on ED accuracy. This research was supported by Siemens Healthcare.},
doi = {10.1118/1.4955983},
journal = {Medical Physics},
number = 6,
volume = 43,
place = {United States},
year = 2016,
month = 6
}
  • Purpose: The purpose of this study was to evaluate, over a wide range of phantom sizes, CT number stability achieved using two techniques for generating dual-energy computed tomography (DECT) virtual monoenergetic images. Methods: Water phantoms ranging in lateral diameter from 15 to 50 cm and containing a CT number test object were scanned on a DSCT scanner using both single-energy (SE) and dual-energy (DE) techniques. The SE tube potentials were 70, 80, 90, 100, 110, 120, 130, 140, and 150 kV; the DE tube potential pairs were 80/140, 70/150Sn, 80/150Sn, 90/150Sn, and 100/150Sn kV (Sn denotes that the 150 kVmore » beam was filtered with a 0.6 mm tin filter). Virtual monoenergetic images at energies ranging from 40 to 140 keV were produced from the DECT data using two algorithms, monoenergetic (mono) and monoenergetic plus (mono+). Particularly in large phantoms, water CT number errors and/or artifacts were observed; thus, datasets with water CT numbers outside ±10 HU or with noticeable artifacts were excluded from the study. CT numbers were measured to determine CT number stability across all phantom sizes. Results: Data exclusions were generally limited to cases when a SE or DE technique with a tube potential of less than 90 kV was used to scan a phantom larger than 30 cm. The 90/150Sn DE technique provided the most accurate water background over the large range of phantom sizes evaluated. Mono and mono+ provided equally improved CT number stability as a function of phantom size compared to SE; the average deviation in CT number was only 1.4% using 40 keV and 1.8% using 70 keV, while SE had an average deviation of 11.8%. Conclusions: The authors’ report demonstrates, across all phantom sizes, the improvement in CT number stability achieved with mono and mono+ relative to SE.« less
  • Purpose: Virtual-monoenergetic imaging uses dual-energy CT data to synthesize images corresponding to a single photon energy, thereby reducing beam-hardening artifacts. This work evaluated the ability of a commercial virtual-monoenergetic algorithm to achieve stable CT numbers across patient sizes. Methods: Test objects containing a range of iodine and calcium hydroxyapatite concentrations were placed inside 8 torso-shaped water phantoms, ranging in lateral width from 15 to 50 cm, and scanned on a dual-source CT system (Siemens Somatom Force). Single-energy scans were acquired from 70-150 kV in 10 kV increments; dual-energy scans were acquired using 4 energy pairs (low energy: 70, 80, 90,more » and 100 kV; high energy: 150 kV + 0.6 mm Sn). CTDIvol was matched for all single- and dual-energy scans for a given phantom size. All scans used 128×0.6 mm collimation and were reconstructed with 1-mm thickness at 0.8-mm increment and a medium smooth body kernel. Monoenergetic images were generated using commercial software (syngo Via Dual Energy, VA30). Iodine contrast was calculated as the difference in mean iodine and water CT numbers from respective regions-of-interest in 10 consecutive images. Results: CT numbers remained stable as phantom width varied from 15 to 50 cm for all dual-energy data sets (except for at 50 cm using 70/150Sn due to photon starvation effects). Relative to the 15 cm phantom, iodine contrast was within 5.2% of the 70 keV value for phantom sizes up to 45 cm. At 90/150Sn, photon starvation did not occur at 50 cm, and iodine contrast in the 50-cm phantom was within 1.4% of the 15-cm phantom. Conclusion: Monoenergetic imaging, as implemented in the evaluated commercial system, eliminated the variation in CT numbers due to patient size, and may provide more accurate data for quantitative tasks, including radiation therapy treatment planning. Siemens Healthcare.« less
  • Information on electron density is important for radiotherapy treatment planning in order to optimize the dose distribution in the target volume of a patient. At present, the electron density is derived from a computed tomography (CT) number measured in x-ray CT scanning; however, there are uncertainties due to the beam hardening effect and the method by which the electron density is converted from the CT number. In order to measure the electron density with an accuracy of {+-}1%, the authors have developed dual-energy x ray CT using monochromatic x rays. They experimentally proved that the measured linear attenuation coefficients weremore » only a few percent lower than the theoretical ones, which led to an accuracy within 2% for the electron density. There were three factors causing inaccuracy in the linear attenuation coefficient and the electron density: the influence of scattered radiation, the nonlinearity in the detector response function, and a theoretical process to derive the electron density from the linear attenuation coefficients. The linear attenuation coefficients of water were experimentally proved to differ by 1%-2% from the theoretical one even when the scattering effect was negligible. The nonlinearity of the response function played an important role in correcting the difference in the linear attenuation coefficient. Furthermore, the theoretical process used for deriving the electron density from the linear attenuation coefficients introduces about 0.6% deviation from the theoretical value into the resultant electron density. This deviation occurs systematically so that it can be corrected. The authors measured the electron densities for seven samples equivalent to soft tissue in dual-energy x-ray CT, and finally obtained them with an accuracy of around {+-}1%.« less
  • Purpose: To determine the suitability of dual-energy CT (DECT) to calculate relative electron density (RED) of tissues for accurate proton therapy dose calculation. Methods: DECT images of RED tissue surrogates were acquired at 80 and 140 kVp. Samples (RED=0.19−2.41) were imaged in a water-equivalent phantom in a variety of configurations. REDs were calculated using the DECT numbers and inputs of the high and low energy spectral weightings. DECT-derived RED was compared between geometric configurations and for variations in the spectral inputs to assess the sensitivity of RED accuracy versus expected values. Results: RED accuracy was dependent on accurate spectral inputmore » influenced by phantom thickness and radius from the phantom center. Material samples located at the center of the phantom generally showed the best agreement to reference RED values, but only when attenuation of the surrounding phantom thickness was accounted for in the calculation spectra. Calculated RED changed by up to 10% for some materials when the sample was located at an 11 cm radius from the phantom center. Calculated REDs under the best conditions still differed from reference values by up to 5% in bone and 14% in lung. Conclusion: DECT has previously been used to differentiate tissue types based on RED and Z for binary tissue-type segmentation. To improve upon the current standard of empirical conversion of CT number to RED for treatment planning dose calculation, DECT methods must be able to calculate RED to better than 3% accuracy throughout the image. The DECT method is sensitive to the accuracy of spectral inputs used for calculation, as well as to spatial position in the anatomy. Effort to address adjustments to the spectral calculation inputs based on position and phantom attenuation will be required before DECT-determined RED can achieve a consistent level of accuracy for application in dose calculation.« less
  • Calcium concentration may be a useful feature for distinguishing benign from malignant lung nodules in computer-aided diagnosis. The calcium concentration can be estimated from the measured CT number of the nodule and a CT number vs calcium concentration calibration line that is derived from CT scans of two or more calcium reference standards. To account for CT number nonuniformity in the reconstruction field, such calibration lines may be obtained at multiple locations within lung regions in an anthropomorphic phantom. The authors performed a study to investigate the effects of patient body size, anatomic region, and calibration nodule size on themore » derived calibration lines at ten lung region positions using both single energy (SE) and dual energy (DE) CT techniques. Simulated spherical lung nodules of two concentrations (50 and 100 mg/cc CaCO{sub 3}) were employed. Nodules of three different diameters (4.8, 9.5, and 16 mm) were scanned in a simulated thorax section representing the middle of the chest with large lung regions. The 4.8 and 9.5 mm nodules were also scanned in a section representing the upper chest with smaller lung regions. Fat rings were added to the peripheries of the phantoms to simulate larger patients. Scans were acquired on a GE-VCT scanner at 80, 120, and 140 kVp and were repeated three times for each condition. The average absolute CT number separations between the calibration lines were computed. In addition, under- or overestimates were determined when the calibration lines for one condition (e.g., small patient) were used to estimate the CaCO{sub 3} concentrations of nodules for a different condition (e.g., large patient). The authors demonstrated that, in general, DE is a more accurate method for estimating the calcium contents of lung nodules. The DE calibration lines within the lung field were less affected by patient body size, calibration nodule size, and nodule position than the SE calibration lines. Under- or overestimates in CaCO{sub 3} concentrations of nodules were also in general smaller in quantity with DE than with SE. However, because the slopes of the calibration lines for DE were about one-half the slopes for SE, the relative improvement in the concentration estimates for DE as compared to SE was about one-half the relative improvement in the separation between the calibration lines. Results in the middle of the chest thorax section with large lungs were nearly completely consistent with the above generalization. On the other hand, results in the upper-chest thorax section with smaller lungs and greater amounts of muscle and bone were mixed. A repeat of the entire study in the upper thorax section yielded similar mixed results. Most of the inconsistencies occurred for the 4.8 mm nodules and may be attributed to errors caused by beam hardening, volume averaging, and insufficient sampling. Targeted, higher resolution reconstructions of the smaller nodules, application of high atomic number filters to the high energy x-ray beam for improved spectral separation, and other future developments in DECT may alleviate these problems and further substantiate the superior accuracy of DECT in quantifying the calcium concentrations of lung nodules.« less