Clinical dual energy computed tomography (DECT) scanners have a material decomposition application to display the contrast-enhanced computed tomography (CT) scan as if it were scanned without contrast agent: virtual-non-contrast (VNC) imaging. The clinical benefit of VNC imaging can potentially be increased using photon counting detector-based multi energy CT (MECT) scanners. Furthermore, dose efficiency and contrast- to-noise ratio (CNR) may be improved in MECT. Effectively, the material decomposition can be performed in image domain. However, material decomposition increases the noise of the material images. Therefore, we generalized an image filter to achieve less noisy decomposed material images. The image-based noise reduction for the material images can be achieved by adding the highpass of the CNR optimized energy image to the lowpass filtered material image. In this way, the image-based noise reduction has the potential to recover some subtle structures that are less visible in the unfiltered images. In this study, we generalize the measurement-dependent filter of Macovski et al. to the case of MECT. The method is performed using phantom measurements from the Siemens SOMATOM Definition Flash scanner in single energy scan mode at tube voltages 80 kV, 100 kV, 120 kV and 140 kV to mimic 4 energy bins of a photon counting CT. Using the image-based noise reduction, a factor of 4 noise reduction in the material images can be achieved.
Dynamic CT perfusion acquisitions are intrinsically high-dose examinations, due to repeated scanning. To keep radiation dose under control, relatively noisy images are acquired. Noise is then further enhanced during the extraction of functional parameters from the post-processing of the time attenuation curves of the voxels (TACs) and normally some smoothing filter needs to be employed to better visualize any perfusion abnormality, but sacrificing spatial resolution. In this study we propose a new method to detect perfusion abnormalities keeping both high spatial resolution and high CNR. To do this we first perform the singular value decomposition (SVD) of the original noisy spatial temporal data matrix to extract basis functions of the TACs. Then we iteratively cluster the voxels based on a smoothed version of the three most significant singular vectors. Finally, we create high spatial resolution 3D volumes where to each voxel is assigned a distance from the centroid of each cluster, showing how functionally similar each voxel is compared to the others. The method was tested on three noisy clinical datasets: one brain perfusion case with an occlusion in the left internal carotid, one healthy brain perfusion case, and one liver case with an enhancing lesion. Our method successfully detected all perfusion abnormalities with higher spatial precision when compared to the functional maps obtained with a commercially available software. We conclude this method might be employed to have a rapid qualitative indication of functional abnormalities in low dose dynamic CT perfusion datasets. The method seems to be very robust with respect to both spatial and temporal noise and does not require any special a priori assumption. While being more robust respect to noise and with higher spatial resolution and CNR when compared to the functional maps, our method is not quantitative and a potential usage in clinical routine could be as a second reader to assist in the maps evaluation, or to guide a dataset smoothing before the modeling part.
We aim at improving low dose CT perfusion functional parameters maps and CT images quality, preserving quantitative information. In a dynamic CT perfusion dataset, each voxel is measured T times, where T is the number of acquired time points. In this sense, we can think about a voxel as a point in a T-dimensional space, where the coordinates of the voxels would be the values of its time attenuation curve (TAC). Starting from this idea, a k-means algorithm was designed to group voxels in K classes. A modified guided time-intensity profile similarity (gTIPS) filter was implemented and applied only for those voxels belonging to the same class. The approach was tested on a digital brain perfusion phantom as well as on clinical brain and body perfusion datasets, and compared to the original TIPS implementation. The TIPS filter showed the highest CNR improvement, but lowest spatial resolution. gTIPS proved to have the best combination of spatial resolution and CNR improvement for CT images, while k-gTIPS was superior to both gTIPS and TIPS in terms of perfusion maps image quality. We demonstrate k-means clustering analysis can be applied to denoise dynamic CT perfusion data and to improve functional maps. Beside the promising results, this approach has the major benefit of being independent from the perfusion model employed for functional parameters calculation. No similar approaches were found in literature.
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