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Title: MO-FG-CAMPUS-IeP2-05: Feasibility Demonstration of High-Voltage Clinical CT and Impact On X-Ray Penetration Through Metal Objects

Abstract

Purpose: To demonstrate the possibility and quantify the impact of operating a clinical CT scanner at exceptionally high x-ray tube voltage for better penetration through metal objects and facilitating metal artifact reduction. Methods: We categorize metal objects according to the data corruption severeness (level of distortion and complete photon starvation fraction). To demonstrate feasibility and investigate the impact of high voltage scanning we modified a commercial GE LightSpeed VCT scanner (generator and software) to enable CT scans with x-ray tube voltages as high as 175 kVp. A 20 cm diameter water phantom with two metal rods (10 mm stainless and 25 mm titanium) and a water phantom with realistic metal object (spine cage) were used to evaluate the data corruption and image artifacts in the absence of any algorithm correction. We also performed simulations to confirm our understanding of the transmitted photon levels through metal objects with different size and composition. Results: The reconstructed images at 175 kVp still have significant dark shading artifacts, as expected since no special scatter correction or beam hardening was performed but show substantially lower noise and photon starvation than at lower kVp due to better beam penetration. Analysis of the raw data shows thatmore » the photon starved data is reduced from over 4% at 140 kVp to below 0.2% at 175 kVp. The simulations indicate that for clinically relevant titanium and stainless objects a 175 kVp tube voltage effectively avoids photon starvation. Conclusion: The use of exceptionally high tube voltage on a clinical CT system is a practical and effective solution to avoid photon starvation caused by certain metal implants. Sparse and hybrid high-voltage protocols are being considered to maintain low patient dose. This opens the door to algorithmic physics-based corrections rather than treating the data as missing and relying on missing data algorithms. Some of the authors are employees of General Electric.« less

Authors:
;  [1];  [2];  [3];  [4];  [5]; ;  [6]
  1. GE Global Research, Niskayuna, NY (United States)
  2. GE, Global Research, Niskayuna, NY (United States)
  3. Rensselaer Polytechnic Institute, Troy, NY (United States)
  4. Rensselaer Polytechnic Institute Troy, NY (United States)
  5. Massachusetts, General Hospital, Boston, MA (United States)
  6. Massachusetts General Hospital, Boston, MA (United States)
Publication Date:
OSTI Identifier:
22653901
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:
61 RADIATION PROTECTION AND DOSIMETRY; 60 APPLIED LIFE SCIENCES; ALGORITHMS; COMPUTER CODES; COMPUTERIZED TOMOGRAPHY; CORRECTIONS; ELECTRIC POTENTIAL; PHOTONS; X RADIATION; X-RAY TUBES

Citation Formats

Jin, Y, De Man, B, Robinson, V, Gjesteby, L, Wang, G, Verburg, J, Giantsoudi, D, and Paganetti, H. MO-FG-CAMPUS-IeP2-05: Feasibility Demonstration of High-Voltage Clinical CT and Impact On X-Ray Penetration Through Metal Objects. United States: N. p., 2016. Web. doi:10.1118/1.4957353.
Jin, Y, De Man, B, Robinson, V, Gjesteby, L, Wang, G, Verburg, J, Giantsoudi, D, & Paganetti, H. MO-FG-CAMPUS-IeP2-05: Feasibility Demonstration of High-Voltage Clinical CT and Impact On X-Ray Penetration Through Metal Objects. United States. doi:10.1118/1.4957353.
Jin, Y, De Man, B, Robinson, V, Gjesteby, L, Wang, G, Verburg, J, Giantsoudi, D, and Paganetti, H. Wed . "MO-FG-CAMPUS-IeP2-05: Feasibility Demonstration of High-Voltage Clinical CT and Impact On X-Ray Penetration Through Metal Objects". United States. doi:10.1118/1.4957353.
@article{osti_22653901,
title = {MO-FG-CAMPUS-IeP2-05: Feasibility Demonstration of High-Voltage Clinical CT and Impact On X-Ray Penetration Through Metal Objects},
author = {Jin, Y and De Man, B and Robinson, V and Gjesteby, L and Wang, G and Verburg, J and Giantsoudi, D and Paganetti, H},
abstractNote = {Purpose: To demonstrate the possibility and quantify the impact of operating a clinical CT scanner at exceptionally high x-ray tube voltage for better penetration through metal objects and facilitating metal artifact reduction. Methods: We categorize metal objects according to the data corruption severeness (level of distortion and complete photon starvation fraction). To demonstrate feasibility and investigate the impact of high voltage scanning we modified a commercial GE LightSpeed VCT scanner (generator and software) to enable CT scans with x-ray tube voltages as high as 175 kVp. A 20 cm diameter water phantom with two metal rods (10 mm stainless and 25 mm titanium) and a water phantom with realistic metal object (spine cage) were used to evaluate the data corruption and image artifacts in the absence of any algorithm correction. We also performed simulations to confirm our understanding of the transmitted photon levels through metal objects with different size and composition. Results: The reconstructed images at 175 kVp still have significant dark shading artifacts, as expected since no special scatter correction or beam hardening was performed but show substantially lower noise and photon starvation than at lower kVp due to better beam penetration. Analysis of the raw data shows that the photon starved data is reduced from over 4% at 140 kVp to below 0.2% at 175 kVp. The simulations indicate that for clinically relevant titanium and stainless objects a 175 kVp tube voltage effectively avoids photon starvation. Conclusion: The use of exceptionally high tube voltage on a clinical CT system is a practical and effective solution to avoid photon starvation caused by certain metal implants. Sparse and hybrid high-voltage protocols are being considered to maintain low patient dose. This opens the door to algorithmic physics-based corrections rather than treating the data as missing and relying on missing data algorithms. Some of the authors are employees of General Electric.},
doi = {10.1118/1.4957353},
journal = {Medical Physics},
number = 6,
volume = 43,
place = {United States},
year = {Wed Jun 15 00:00:00 EDT 2016},
month = {Wed Jun 15 00:00:00 EDT 2016}
}
  • Purpose: To evaluate the accuracy of size-specific dose estimates (SSDE) in CT in the presence of simulated metal prostheses. Methods: Radiation dose in tissue (f-factor = 0.94) was measured at various chamber positions in a conventional nested CTDI phantom with nominal 0.5 inch metal rods inserted to simulate the presence of prosthetic implant(s). An average weighted tissue dose (AWTD) was calculated in a manner similar to CTDIw. Subsequent scans were performed with varying phantom diameter, number of metal rods and type of metal. The scan acquisition parameters were fixed for all such measurements (i.e. CTDIvol was constant). Axial CT imagesmore » reconstructed both with and without a metal artifact reduction algorithm (SEMAR) were used to calculate the water-equivalent diameter (Dw) per AAPM TG Report 220. The Dw values were subsequently used to determine the SSDE from the known CTDIvol. In addition SSDE was also calculated from the effective diameter per AAPM TG Report 204. Accuracy of the calculated SSDE values were assessed by comparing to the AWTD measurements. Results: In the 32-cm diameter phantom the SSDE calculations from Dw (TG-220) were within ±1% of the AWTD measurements regardless of type of metal and number of metal rods while SSDE calculated from effective diameter (TG-204) overestimated the AWTD by 7–10%. In the 16-cm diameter phantom the SSDE calculations from Dw (TG-220) were within ±4% of the AWTD measurement. The Dw calculations used to determine SSDE varied by less than 0.2% between the images reconstructed with and without the metal artifact reduction algorithm. Conclusion: The TG-220 SSDE method can provide an accurate estimation of tissue dose in the presence of metal while TG-204 SSDE method overestimates the dose. The determination of Dw is independent of reconstruction algorithm.« less
  • Purpose: Advanced dosimetry in CT (e.g. the Monte Carlo method) requires an accurate characterization of the shaped filter and radiation quality used during a scan. The purpose of this work was to develop a method where half value layer (HVL) profiles along shaped filters could be made. From the HVL profiles the beam shaping properties and effective photon spectrum for a particular scan can be inferred. Methods: A measurement rig was developed to allow determinations of the HVL under a scatter-free narrow-beam geometry and constant focal spot to ionization chamber distance for different fan angles. For each fan angle themore » HVL is obtained by fitting the transmission of radiation through different thicknesses of an Al absorber (type 1100) using an appropriate model. The effective Al thickness of shaped filters and effective photon spectra are estimated using a model of photon emission from a Tungsten anode. This method is used to obtain the effective photon spectra and effective Al thickness of shaped filters for a CT scanner recently introduced to the market. Results: This study resulted in a set of effective photon spectra (central ray) for each kVp along with effective Al thicknesses of the different shaped filters. The effective photon spectra and effective Al thicknesses of shaped filters were used to obtain numerically approximated HVL profiles and compared to measured HVL profiles (mean absolute percentage error = 0.02). The central axis HVL found in the vendor’s technical documentation were compared to approximated HVL values (mean absolute percentage error = 0.03). Conclusion: This work has resulted in a unique method of measuring HVL profiles along shaped filters in CT. Further the effective photon spectra and the effective Al thicknesses of shaped filters that were obtained can be incorporated into Monte Carlo simulations.« less
  • Purpose: To discover if a previously published methodology for estimating patient-specific organ dose in a pediatric population (5–55kg) is translatable to the adult sized patient population (> 55 kg). Methods: An adult male anthropomorphic phantom was scanned with metal oxide semiconductor field effect transistor (MOSFET) dosimeters placed at 23 organ locations in the chest and abdominopelvic regions to determine absolute organ dose. Organ-dose-to-SSDE correlation factors were developed by dividing individual phantom organ doses by SSDE of the phantom; where SSDE was calculated at the center of the scan volume of the chest and abdomen/pelvis separately. Organ dose correlation factors developedmore » in phantom were multiplied by 28 chest and 22 abdominopelvic patient SSDE values to estimate organ dose. The median patient weight from the CT examinations was 68.9 kg (range 57–87 kg) and median age was 17 years (range 13–28 years). Calculated organ dose estimates were compared to published Monte Carlo simulated patient and phantom results. Results: Organ-dose-to-SSDE correlation was determined for a total of 23 organs in the chest and abdominopelvic regions. For organs fully covered by the scan volume, correlation in the chest (median 1.3; range 1.1–1.5) and abdominopelvic (median 0.9; range 0.7–1.0) was 1.0 ± 10%. For organs that extended beyond the scan volume (i.e. skin bone marrow and bone surface) correlation was determined to be a median of 0.3 (range 0.1–0.4). Calculated patient organ dose using patient SSDE agreed to better than 6% (chest) and 15% (abdominopelvic) to published values. Conclusion: This study demonstrated that our previous published methodology for calculating organ dose using patient-specific SSDE for the chest and abdominopelvic regions is translatable to adult sized patients for organs fully covered by the scan volume.« less
  • Purpose: To develop new ionization chamber dosimetry of absorbed dose to water in diagnostic kV x-ray beams, by using a beam quality conversion factor, kQ, for Co-60 to kV x-ray and an ionization conversion factor for a water-substitute plastic phantom. Methods: kQ was calculated for aluminum half value-layers (Al-HVLs) of 1.5 mm to 8 mm which were generated by kV x-ray beams of 50 to 120 kVp. Twenty-two energy spectra for ten effective energies (Eeff) were calculated by a SpecCalc program. Depth doses in water were calculated at 5 × 5 to 30 × 30 cm{sup 2} fields. Output factorsmore » were also obtained from the dose ratio for a 10 × 10 cm{sup 2} field. kQ was obtained for a PTW30013 Former ion chamber. In addition, an ionization conversion factor of the PWDT phantom to water was calculated. All calculations were performed with EGSnrc/cavity code and egs-chamber codes. Results: The x-ray beam energies for 1.5 mm to 8 mm Al-HVLs ranged in Eeff of 25.7 to 54.3 keV. kQ for 1.5 mm to 8 mm Al-HVLs were 0.831 to 0.897, at 1 and 2 cm depths for a 10 × 10 cm2 field. Similarly, output factors for 5 × 5 to 30 × 30 cm{sup 2} fields were 0.937 to 1.033 for 25.7 keV and 0.857 to 1.168 for 54.3 keV. The depth dose in a PWDT phantom decreased up to 5% compared to that in water at depth of ten percent of maximum dose for 1.5 mm Al-HVL. The ionization ratios of water/PWDT phantoms for the PTW30013 chamber were 1.012 to 1.007 for 1.5 mm to 8 mm Al-HVLs at 1 cm depth. Conclusion: It became possible to directly measure the absorbed dose to water with the ionization chamber in diagnostic kV x-ray beams, by using kQ and the PWDT phantom.« less
  • Purpose: Liver SBRT patients unable to tolerate breath-hold for radiotherapy are treated free-breathing with image guidance. Target localization using 3D CBCT requires extra margins to accommodate the respiratory motion. The purpose of this study is to evaluate the accuracy and reproducibility of 4D CT-on-rails in target localization for free-breathing liver SBRT. Methods: A Siemens SOMATOM CT-on-Rails 4D with Anzai Pressure Belt system was used both as the simulation and the localization CT. Fiducial marker was placed close to the center of the target prior to the simulation. Amplitude based sorting was used in the scan. Eight or sixteen phases ofmore » reconstructed CT sets (depends on breathing pattern) can be sent to Velocity to create the maximum intensity projection (MIP) image set. Target ITV and fiducial ITV were drawn based on the MIP image. In patient localization, a 4D scan was taken with the same settings as the sim scan. Images were registered to match fiducial ITVs. Results: Ten liver cancer patients treated for 50Gy over 5 fractions, with amplitudes of breathing motion ranging from 4.3–14.5 mm, were analyzed in this study. Results show that the Intra & inter fraction variability in liver motion amplitude significantly less than the baseline inter-fraction shifts in liver position. 90% of amplitude change is less than 3 mm. The differences in the D99 and D95 GTV dose coverage between the 4D CT-on-Rails and the CBCT plan were small (within 5%) for all the selected cases. However, the average PTV volume by using the 4D CT-on-Rails is 37% less than the CBCT PTV volume. Conclusion: Simulation and Registration using 4D CT-on-Rails provides accurate target localization and is unaffected by larger breathing amplitudes as seen with 3D CBCT image registration. Localization with 4D CT-on-Rails can significantly reduce the PTV volume with sufficient tumor.« less