K-edge digital subtraction imaging based on a dichromatic and compact x-ray source

This work proposes a compact dichromatic imaging system for the application of the K-edge digital subtraction technique based on a conventional x-ray tube and a monochromator system. A quasi-monochromatic x-ray beam at the energy of iodine K-edge is produced by Bragg diffraction on a mosaic crystal. Two thin adjacent beams with energies that bracket the K-edge discontinuity are obtained from the diffracted beam by means of a proper collimation system. They are then detected using an array of Si detectors. A home-made phantom is used to study the image quality as a function of iodine concentration. Signal and signal-to-noise ratio analysis has also been performed. The results are compared with theoretical expectations.     

Radiation dose in diagnostic radiology: Monte Carlo simulation studies

We applied Monte Carlo calculations to determine the radiation dose absorbed in water phantoms. Monoenergetic incident x-ray beams with energies from 15 to 100 keV and phantom thicknesses from 5 to 20 cm were considered in this study. We calculated the spatial distributions of energy absorption in the phantom, the rad/R conversion factors, the average rad/R conversion factors, and the scatter-to-primary ratios of absorbed dose. We also compared the relative absorbed doses under various imaging conditions when the transmitted radiation produced a given optical density on radiographic film. The information provided will be useful for the estimation of radiation doses in various radiographic procedures.     

Photon counting spectral CT: improved material decomposition with K-edge-filtered x-rays

Photon counting spectral computed tomography (PCSCT) provides material selective CT imaging at a single CT scan and fixed tube voltage. The PCSCT data are acquired in several energy ranges (bins) arranged over the x-ray spectrum. The quasi-monoenergetic CT images are acquired in these energy bins and are used for material decomposition. The PCSCT exhibits inherent limitations when material decomposition is performed using energy bins. For effective material decomposition, the energy bins used for material decomposition should be sufficiently narrow and well separated. However, when narrow bins are used, a large fraction of the detected x-ray counts is lost and statistical noise is increased. Alternatively, the x-ray spectrum can be split into a few larger bins with no gap in between and all detected x-ray photons can be used for material decomposition. However, in this case the energy bins are too wide and not well separated, which results in suboptimal material decomposition. The above contradictory requirements can be resolved if the x-ray photons are physically removed from the regions of the energy spectrum between the energy bins. Such a selective removal can be performed using filtration of the x-ray beam by high-Z filter materials with appropriate positions of K-edge energies. The K-edge filtration of x-rays can, therefore, provide necessary gaps between the energy bins with no dose penalty to the patient. In the current work, we proposed using selective K-edge filtration of x-rays in PCSCT and performed the first experimental investigation of this approach. The PCSCT system included a cadmium zinc telluride semiconductor detector with 2 × 256 pixels and 1 × 1 mm(2) pixel size, and five energy bins. The CT phantom had 14 cm diameter and included contrast elements of iodine, gold and calcifications with clinically relevant concentrations. The tube voltages of 60, 90 and 120 kVp were used. K-edge filters based on Ba (E(k) = 37.44 keV) were used for a 60 kVp tube voltage and Gd (E(k) = 50.24 keV) was used for the 90 and 120 kVp tube voltages, respectively. The material selective CT images were also acquired with conventional Al filtration for comparison. The half-value layers of x-ray beams after K-edge and Al filtration were matched. The mean entrance skin exposure was 280 mR for all tube voltages and filters. The contrast-to-noise ratio (CNR) in material-decomposed images was approximately 30%-50% higher when K-edge filters were used instead of Al filters. It was concluded that K-edge filtration of x-rays provides substantial improvement of the CNR in material-selective PCSCT. Further optimization of K-edge filter materials, tube voltages, detector technology and energy bin settings will provide even higher CNR in decomposed images.     

A K alpha dual energy x-ray source for coronary angiography

The use of characteristic-line radiation from rare-earth targets bombarded by high-energy (up to 1 MeV) electron beams has been evaluated as an x-ray source for dual energy K-edge subtraction imaging of the human coronary arteries. Two characteristic-line x-ray sources, one using the split K alpha 1 and K alpha 2 lines of lanthanum excited by a high-energy electron beam and the other using the K alpha lines of barium and cerium, were studied. A Monte Carlo electron-photon simulation was used to calculate x-ray spectra and energy deposition profiles from targets of these elements bombarded by electrons in the energy range 140 keV to 1 MeV. A general dual-energy imaging model was developed that used these calculated source spectra to numerically investigate the dependence of the subtraction image signal-to-noise ratio on such factors as the ratio of K-line to x-ray continuum yield, continuum spectral shape, x-ray filtering, and detector response. A signal averaging technique for enhancing the signal-to-noise ratio was also evaluated. The results of these calculations were used to identify an optimum electron beam, target, filter, and detector configuration. A compact electron accelerator capable of providing the required electron beam parameters was designed. Calculations indicate that under ideal conditions the optimized system would be capable of imaging 2 mg/cm2 of iodine contrast agent in 20 g/cm2 of tissue with a signal-to-noise ratio of 5, a detector pixel size of 0.25 mm2, and a total image acquisition time of 10 ms. These parameters are consistent with those needed to image the human coronary arteries after an intravenous injection of iodine contrast agent. These capabilities, along with the relatively modest hardware requirements of this system, make it attractive as an x-ray source for dual energy transvenous coronary angiography.     

Sensitivity study of proton radiography and comparison with kV and MV x-ray imaging using GEANT4 Monte Carlo simulations

The imaging sensitivity of proton radiography has been studied and compared with kV and MV x-ray imaging using Monte Carlo simulations. A phantom was specifically modeled using 21 different material inserts with densities ranging from 0.001 to 1.92 g?cm(-3). These simulations were run using the MGH double scattered proton beam, scanned pencil proton beams from 200 to 490 MeV, as well as pure 50 keV, 100 keV, 1 MeV and 2 MeV gamma x-ray beams. In order to compare the physics implied in both proton and photon radiography without being biased by the current state of the art in detector technology, the detectors were considered perfect. Along with spatial resolution, the contrast-to-noise ratio was evaluated and compared for each material. These analyses were performed using radiographic images that took into account the following: only primary protons, both primary and secondary protons, and both contributions while performing angular and energetic cuts. Additionally, tissue-to-tissue contrasts in an actual lung cancer patient case were studied for simulated proton radiographs and compared against the original kV x-ray image which corresponds to the current patient set-up image in the proton clinic. This study highlights the poorer spatial resolution of protons versus x-rays for radiographic imaging purposes, and the excellent density resolution of proton radiography. Contrasts around the tumor are higher using protons in a lung cancer patient case. The high-density resolution of proton radiography is of great importance for specific tumor diagnostics, such as in lung cancer, where x-ray radiography operates poorly. Furthermore, the use of daily proton radiography prior to proton therapy would ameliorate patient set-up while reducing the absorbed dose delivered through imaging.     

Monte Carlo feasibility study of orthogonal bremsstrahlung beams for improved radiation therapy imaging

The basic characteristics of orthogonal bremsstrahlung beams are studied and the feasibility of improved contrast imaging with such a beam is evaluated. In the context of this work, orthogonal bremsstrahlung beams represent the component of the bremsstrahlung distribution perpendicular to the electron beam impinging on an accelerator target. The BEAMnrc Monte Carlo code was used to study target characteristics, energy spectra and relative fluences of orthogonal beams to optimize target design. The reliability of the simulations was verified by comparing our results with benchmark experiments. Using the results of the Monte Carlo optimization, the targets with various materials and a collimator were designed and built. The primary pencil electron beam from the research port of a Varian Clinac-18 accelerator striking on Al, Pb and C targets was used to create orthogonal beams. For these beams, diagnostic image contrast was tested by placing simple Lucite objects in the path of the beams and comparing image contrast obtained in the orthogonal direction to the one obtained in the forward direction. The simulations for various target materials and various primary electron energies showed that a width of 80% of the continuous-slowing-down approximation range (RCSDA) is sufficient to remove electron contamination in the orthogonal direction. The photon fluence of the orthogonal beam for high Z targets is larger compared to low Z targets, i.e. by a factor of 20 for W compared to Be. For a 6 MeV electron beam, the mean energy for low Z targets is calculated to be 320 keV for Al and 150 keV for Be, and for a high Z target like Pb to be 980 keV. For irradiation times of 1.2 s in an electron mode of the linac, the contrast of diagnostic images created with orthogonal beams from the Al target is superior to that in the forward direction. The image contrast and the beam profile of the bremsstrahlung beams were also studied. Both the Monte Carlo study and experiment showed an improvement of the contrast for lower Z target materials. This study confirms the feasibility, both in terms of intensity and image contrast, of orthogonal bremsstrahlung beams for radiation therapy imaging.     

Calculation of x-ray spectra emerging from an x-ray tube. Part I. electron penetration characteristics in x-ray targets

The penetration characteristics of electron beams into x-ray targets are investigated for incident electron kinetic energies in the range 50-150 keV. The frequency densities of electrons penetrating to a depth x in a target, with a fraction of initial kinetic energy, u, are calculated using Monte Carlo methods for beam energies of 50, 80, 100, 120 and 150 keV in a tungsten target. The frequency densities for 100 keV electrons in Al, Mo and Re targets are also calculated. A mixture of simple modeling with equations and interpolation from data is used to generalize the calculations in tungsten. Where possible, parameters derived from the Monte Carlo data are compared to experimental measurements. Previous electron transport approximations in the semiempirical models of other authors are discussed and related to this work. In particular, the crudity of the use of the Thomson-Whiddington law to describe electron penetration and energy loss is highlighted. The results presented here may be used towards calculating the target self-attenuation correction for bremsstrahlung photons emitted within a tungsten target.     

Thimble ionization chambers in medium-energy x-ray beams and the role of constructive details of the central electrode: Monte Carlo simulations and measurements

This paper presents investigations of thimble ionization chamber response in medium-energy kilovoltage x-ray beams (70-280 kVp, 0.09-3.40 mm Cu HVL). Two thimble ionization chambers (PTW30015 and PTW30016) were investigated, regarding the influence of the central electrode dimensions made of aluminum. Measurements were carried out in photon fields of different beam quality. Corresponding Monte Carlo simulations employing the EGSnrc Monte Carlo code system were performed. The simulations included the modelling of the x-ray tube and measurement setup for generation of x-ray spectra. These spectra were subsequently used to calculate the absorbed energy in the air cavity of the two thimble ionization chamber models and the air kerma at the reference point of the chambers. Measurements and simulations revealed an optimal diameter of the central electrode, concerning an almost energy-independent response of the ionizaton chamber. The Monte Carlo simulations are in good agreement with the measured values, expressed in beam quality correction factors k(Q). The agreement was generally within 0.6% but could only be achieved with an accurate model of the central electrode including its exact shape. Otherwise, deviations up to 8.5% resulted, decreasing with higher photon energies, which can be addressed to the high yield of the photoelectric effect in the electrode material aluminum at low photon energies.     

Quantitative analysis of the effect of energy separation in k-edge digital subtraction imaging

The aim of the work is to quantitatively compare the effect of the energy separation in the k-edge digital subtraction imaging technique. Images of a custom-made, iodine filled (k-edge = 33.17 keV) test object have been acquired with monochromatic x-ray beams (energy spread <0.1 keV) at the ID17 biomedical beamline of the ESRF. Image acquisition has been performed using two energy separations, namely 0.65 keV (32.85 keV and 33.5 keV, respectively) and 4.4 keV (31.2 keV and 35.6 keV, respectively), using beams of energies on either side of the iodine k-edge. Signal and signal-to-noise ratio (SNR) analysis has been performed as a function of DeltaE and the contrast medium concentrations. The results show that the SNR values measured for DeltaE < 1 keV are only slightly higher than those measured for DeltaE = 4.4 keV. This preliminary study shows that monochromaticity and the energy separation obtained with quasi monochromatic beams from conventional x-ray sources might be suitable for this imaging technique.     

Monte Carlo studies of x-ray scattering in transmission diagnostic radiology

Monte Carlo methods have been used to simulate the scattering of x rays in polystyrene and water phantoms. In particular, the ratio of the scattered to total x-ray fluence (scatter fraction) has been calculated for monoenergetic x-ray beams in the energy region relevant to diagnostic radiology and nuclear medicine (30-660 keV). Simulations have been made for representative values of the pertinent geometrical factors; phantom thickness from 5 to 21 cm, x-ray beam diameters of 10 and 25 cm, and scatterer-to-image-plane separations from 0 to 20 cm. As a function of x-ray energy, the scatter fraction was found to vary slowly between 30 and 100 keV, and to decrease between 100 and 660 keV. The present results were generated with a special transport code which included the effects of special geometries and the response of the x-ray detector. With the inclusion of these effects, the results resolved inconsistencies and showed good agreement with previous measured and calculated data.     

Some properties of photon scattering in water phantoms in diagnostic radiology

Monte Carlo simulation was applied to study the histories of photon interactions in a soft-tissue-equivalent medium under diagnostic imaging conditions. We examined the dependence on incident x-ray energy and phantom thickness of the basic properties of photon scattering, including the probabilities of occurrence of the various interaction processes, and the frequency distributions of scattering events. We investigated the properties of scattered radiation for monoenergetic incident x rays, which provide a basis for deriving the physical properties of scattered radiation for any polyenergetic incident beam. We also included four incident x-ray beams with broad spectra; these represented the incident x rays typically used for diagnostic imaging.     

Analysis of spectral blur effects in x-ray scatter imaging.

Previous analysis in our research program investigating the potential use of scattered photons for medical x-ray imaging has been for monoenergetic beams. In practice, polyenergetic beams are almost always used due to their higher photon fluence rate. The effects of beam polychromaticity on x-ray scatter imaging are determined with the aid of our semianalytic model that images a target object against a background material of the same dimensions when both are situated within a water phantom. Our analysis involves four different photon beams with constant incident energy fluence: (1) a monoenergetic beam with photon energy E0, (2) a dual peak beam with two separate monoenergetic peaks of energies E1 and E2, (3) a clinical x-ray beam, and (4) a rectangular beam with uniform energy fluence between energies Emin and Emax. A comparison between the polyenergetic spectra is accomplished by matching the centroids and standard deviations of the dual peak and rectangular spectra to those of the clinical x-ray spectrum. For the task of imaging liver versus fat structures 1 cm thick in a 25-cm-diam spherical water phantom with the scattered photons between 2 degrees and 12 degrees, the predicted signal-to-noise ratio (SNR) obtained with a 100 kV beam is 87.5% of the SNR acquired with the optimum monoenergetic beam (SNRopt). The SNR for the corresponding dual peak beam is 84.4% of SNRopt and for the rectangular beam is 86.3%. Our analysis shows that monoenergetic x-ray beams are not necessary for x-ray scatter imaging.     

A Monte Carlo simulation study of the effect of energy windows in computed tomography images based on an energy-resolved photon counting detector

The energy-resolved photon counting detector provides the spectral information that can be used to generate images. The novel imaging methods, including the K-edge imaging, projection-based energy weighting imaging and image-based energy weighting imaging, are based on the energy-resolved photon counting detector and can be realized by using various energy windows or energy bins. The location and width of the energy windows or energy bins are important because these techniques generate an image using the spectral information defined by the energy windows or energy bins. In this study, the reconstructed images acquired with K-edge imaging, projection-based energy weighting imaging and image-based energy weighting imaging were simulated using the Monte Carlo simulation. The effect of energy windows or energy bins was investigated with respect to the contrast, coefficient-of-variation (COV) and contrast-to-noise ratio (CNR). The three images were compared with respect to the CNR. We modeled the x-ray computed tomography system based on the CdTe energy-resolved photon counting detector and polymethylmethacrylate phantom, which have iodine, gadolinium and blood. To acquire K-edge images, the lower energy thresholds were fixed at K-edge absorption energy of iodine and gadolinium and the energy window widths were increased from 1 to 25 bins. The energy weighting factors optimized for iodine, gadolinium and blood were calculated from 5, 10, 15, 19 and 33 energy bins. We assigned the calculated energy weighting factors to the images acquired at each energy bin. In K-edge images, the contrast and COV decreased, when the energy window width was increased. The CNR increased as a function of the energy window width and decreased above the specific energy window width. When the number of energy bins was increased from 5 to 15, the contrast increased in the projection-based energy weighting images. There is a little difference in the contrast, when the number of energy bin is increased from 15 to 33. The COV of the background in the projection-based energy weighting images is only slightly changed as a function of the number of energy bins. In the image-based energy weighting images, when the number of energy bins were increased, the contrast and COV increased and decreased, respectively. The CNR increased as a function of the number of energy bins. It was concluded that the image quality is dependent on the energy window, and an appropriate choice of the energy window is important to improve the image quality.     

Monte Carlo simulation of diagnostic x-ray scatter

A Monte Carlo method was developed and implemented to simulate x-ray photon transport. Simulations consisted of a pencil beam of monoenergetic photons with energies from 50 to 110 keV incident on water and aluminum slabs. The dependence of scatter fraction and multiple scattering on x-ray energy, scatterer thickness, and material is reported in both number and energy fluence. The average energy of scattered photons reaching the detector plane is also reported. Comparisons are made to previous x-ray scatter computations.     

Polymer gel water equivalence and relative energy response with emphasis on low photon energy dosimetry in brachytherapy

The water equivalence and stable relative energy response of polymer gel dosimeters are usually taken for granted in the relatively high x-ray energy range of external beam radiotherapy based on qualitative indices such as mass and electron density and effective atomic number. However, these favourable dosimetric characteristics are questionable in the energy range of interest to brachytherapy especially in the case of lower energy photon sources such as 103Pd and 125I that are currently utilized. In this work, six representative polymer gel formulations as well as the most commonly used experimental set-up of a LiF TLD detector-solid water phantom are discussed on the basis of mass attenuation and energy absorption coefficients calculated in the energy range of 10 keV-10 MeV with regard to their water equivalence as a phantom and detector material. The discussion is also supported by Monte Carlo simulation results. It is found that water equivalence of polymer gel dosimeters is sustained for photon energies down to about 60 keV and no corrections are needed for polymer gel dosimetry of 169Yb or 192Ir sources. For 125I and 103Pd sources, however, a correction that is source-distance dependent is required. Appropriate Monte Carlo results show that at the dosimetric reference distance of 1 cm from a source, these corrections are of the order of 3% for 125I and 2% for 103Pd. These have to be compared with corresponding corrections of up to 35% for 125I and 103Pd and up to 15% even for the 169Yb energies for the experimental set-up of the LiF TLD detector-solid water phantom.     

Performance of computed tomography for contrast agent concentration measurements with monochromatic x-ray beams: comparison of K-edge versus temporal subtraction

We investigated the performance of monochromatic computed tomography for the quantification of contrast agent concentrations. Two subtraction methods (K-edge subtraction and temporal subtraction) were evaluated and compared theoretically and experimentally in terms of detection limit, precision and accuracy. Measurements were performed using synchrotron x-rays with Lucite phantoms (10 cm and 17.5 cm in diameter) containing iodine or gadolinium solutions ranging from 50 microg ml(-1) to 5 mg ml(-1). The experiments were carried out using monochromators developed at the European Synchrotron Radiation Facility (ESRF) medical beamline. The phantoms were imaged either above and below the contrast agent K-edge, or before and after the addition of the contrast agent. Both methods gave comparable performance for phantoms less than 10 cm in diameter. For large phantoms, equivalent to a human head, the temporal subtraction is more suitable for detecting elements such as iodine, keeping a reasonable x-ray dose delivered to the phantom. A good agreement was obtained between analytical calculations, simulations and measurements. The beam harmonic content was taken into account in the simulations. It explains the performance degradation with high contrast agent concentrations. The temporal subtraction technique has the advantage of energy tunability and is well suited for imaging elements, such as iodine or gadolinium, in highly absorbing samples. For technical reasons, the K-edge method is preferable when the imaged organ is moving since the two measurements can be performed simultaneously, which is mandatory for obtaining a good subtraction.     

Automatic determination of primary electron beam parameters in Monte Carlo simulation

In order to obtain realistic and reliable Monte Carlo simulations of medical linac photon beams, an accurate determination of the parameters that define the primary electron beam that hits the target is a fundamental step. In this work we propose a new methodology to commission photon beams in Monte Carlo simulations that ensures the reproducibility of a wide range of clinically useful fields. For such purpose accelerated Monte Carlo simulations of 2 x 2, 10 x 10, and 20 x 20 cm2 fields at SSD = 100 cm are carried out for several combinations of the primary electron beam mean energy and radial FWHM. Then, by performing a simultaneous comparison with the correspondent measurements for these same fields, the best combination is selected. This methodology has been employed to determine the characteristics of the primary electron beams that best reproduce a Siemens PRIMUS and a Varian 2100 CD machine in the Monte Carlo simulations. Excellent agreements were obtained between simulations and measurements for a wide range of field sizes. Because precalculated profiles are stored in databases, the whole commissioning process can be fully automated, avoiding manual fine-tunings. These databases can also be used to characterize any accelerators of the same model from different sites.     

Comparing two methods for calculating phantom scatter

Two methods are compared for calculating the field-size dependence of the phantom scatter component of dose for x-ray beams. One model sums three Gaussian distributions; the other model is a two-parameter function. With a measurement of the beam quality as input to determine parameters, both models accurately reproduce the relative phantom scatter. However, there are important differences between the models. For all beam energies, the two-parameter model characterizes the absolute phantom scatter as a function of depth and field size, while, also for all beam energies, the six-parameter Gaussian model characterizes the relative phantom scatter at a single depth of 10 cm. For small field sizes, the phantom scatter calculated from the two-parameter model agrees with Monte Carlo calculations better than the Gaussian model. In the Gaussian model, the parameters can be obtained for beam energies between 60Co and 25 MV by linear interpolation based on the measured beam quality. In the two-parameter model, and for energies above 4 MV, the parameters can be obtained using linear functions of the dose-weighted average linear attenuation coefficient, which is related to beam quality.