Calibration phantoms for accurate water and lipid density quantification using dual energy mammography.

The aim of this study is to investigate the feasibility of water and lipid as calibration phantoms for accurate dual energy breast density quantification. Dual energy calibration was performed on a mammography system based on scanning multi-slit Si strip photon-counting detectors using plastic water and adipose-equivalent phantoms as the basis materials. Two different methods were used to convert the dual energy decomposition measurements in plastic phantom thicknesses into the true water and lipid basis materials. The first method was based entirely on the theoretically calculated effective attenuation coefficients of the investigated materials in the mammographic energy range. The conversion matrix was determined through the linear least-squares fitting of the target material using the calculated effective attenuation coefficients of water and lipid. The second method was based on experimental calibration with plastic water phantom, adipose-equivalent phantom, and its correlation to known water and lipid thicknesses. These two methods were then validated by using an independent measurement of water and lipid mixture phantoms and postmortem breasts. The correlation between the dual energy decomposition measurements and the known values was evaluated using linear regression analysis. The averaged root-mean-square errors for water density quantification derived from the theoretical and experimental conversions were 8.6% and 1.6%, respectively. The postmortem breast tissue study also indicates that the experimentally acquired conversion coefficient improved the accuracy in water density quantification, in comparison with that from the theoretical conversion. The results show that conversion of the dual energy measurements into water and lipid thicknesses improves the accuracy in breast tissue decomposition.

Energy response calibration of photon-counting detectors using x-ray fluorescence: a feasibility study.

Accurate energy calibration is critical for the application of energy-resolved photon-counting detectors in spectral imaging. The aim of this study is to investigate the feasibility of energy response calibration and characterization of a photon-counting detector using x-ray fluorescence. A comprehensive Monte Carlo simulation study was performed using Geant4 Application for Tomographic Emission (GATE) to investigate the optimal technique for x-ray fluorescence calibration. Simulations were conducted using a 100 kVp tungsten-anode spectra with 2.7 mm Al filter for a single pixel cadmium telluride (CdTe) detector with 3 × 3 mm(2) in detection area. The angular dependence of x-ray fluorescence and scatter background was investigated by varying the detection angle from 20° to 170° with respect to the beam direction. The effects of the detector material, shape, and size on the recorded x-ray fluorescence were investigated. The fluorescent material size effect was considered with and without the container for the fluorescent material. In order to provide validation for the simulation result, the angular dependence of x-ray fluorescence from five fluorescent materials was experimentally measured using a spectrometer. Finally, eleven of the fluorescent materials were used for energy calibration of a CZT-based photon-counting detector. The optimal detection angle was determined to be approximately at 120° with respect to the beam direction, which showed the highest fluorescence to scatter ratio (FSR) with a weak dependence on the fluorescent material size. The feasibility of x-ray fluorescence for energy calibration of photon-counting detectors in the diagnostic x-ray energy range was verified by successfully calibrating the energy response of a CZT-based photon-counting detector. The results of this study can be used as a guideline to implement the x-ray fluorescence calibration method for photon-counting detectors in a typical imaging laboratory.

TU-E-217BCD-09: The Feasibility of the Dual-Dictionary Method for Breast Computed Tomography Based on Photon-Counting Detectors.

PURPOSE: To investigate the feasibility of an Iterative Reconstruction (IR) method utilizing the algebraic reconstruction technique coupled with dual-dictionary learning for the application of dedicated breast computed tomography (CT) based on a photon-counting detector. METHODS: Postmortem breast samples were scanned in an experimental fan beam CT system based on a Cadmium-Zinc-Telluride (CZT) photon-counting detector. Images were reconstructed from various numbers of projections with both IR and Filtered-Back-Projection (FBP) methods. Contrast-to-Noise Ratio (CNR) between the glandular and adipose tissue of postmortem breast samples were calculated to evaluate the quality of images reconstructed from IR and FBP. In addition to CNR, the spatial resolution was also used as a metric to evaluate the quality of images reconstructed from the two methods. This is further studied with a high-resolution phantom consisting of a 14 cm diameter, 10 cm length polymethylmethacrylate (PMMA) cylinder. A 5 cm diameter coaxial volume of Interest insert that contains fine Aluminum wires of various diameters was used to determine spatial resolution. RESULTS: The spatial resolution and CNR were better when identical sinograms were reconstructed in IR as compared to FBP. In comparison with FBP reconstruction, a similar CNR was achieved using IR method with up to a factor of 5 fewer projections. CONCLUSIONS: The results of this study suggest that IR method can significantly reduce the required number of projections for a CT reconstruction compared to FBP method to achieve an equivalent CNR. Therefore, the scanning time of a CZT-based CT system using the IR method can potentially be reduced.

Volumetric lean percentage measurement using dual energy mammography.

PURPOSE: Currently, there is no accepted standard for measuring breast density. Dual energy mammography, which has demonstrated accurate measurement in phantoms, has been proposed as one possible method. To examine the use of chemical analysis as a possible means to validate breast density measurements from dual energy mammography, a bovine tissue model was investigated. Known quantities of lean and adipose tissue were compared with composition values measured from dual energy images and chemical analysis. METHODS: Theoretical simulations were performed to assess the impact variations in breast composition would have on measurement of breast density from a single calibration. Fourteen ex-vivo tissue samples composed of varying amounts of pure lean tissue and pure adipose tissue (lean percentage) from 0 to 100%, in increments of 10%, were imaged using dual energy mammography. This was followed by chemical analysis based on desiccation, trituration, and fat extraction with petroleum ether to determine water, lipid, and protein content. The volumetric lean percentage (VLP) as measured from images (VLP(I)) and as derived from chemical analysis data (VLP(CA)) were compared with the VLP calculated from measurements of sample mass with a scale (VLP(M)). Finally, data from the bovine tissue model in this study were compared to compositional data from a previous report of human tissue composition. RESULTS: The results from simulation suggest a substantial impact on measuring breast density is likely due to changes in anatomical breast composition. VLP(I) was related to the VLP(M) by VLP(I) = 1.53 VLP(M) + 10.0 (r2 > 0.99). VLP(CA) was related to VLP(M) by VLP(CA) = 0.76 VLP(M) + 22.8 (r2 > 0.99). VLP(I) was related to VLP(CA) by VLP(I) = 2.00 VLP(CA) - 35.6 (r2 > 0.99). Bovine adipose tissue was shown to be very similar to human adipose tissue in terms of water, lipid, and protein content with RMS differences of 1.2%. Bovine lean tissue was shown to be very similar to human skeletal muscle tissue and somewhat similar to human mammary gland tissue with RMS differences of 0.4 and 22.2%, respectively. CONCLUSIONS: The results of this study show strong linear relationships between volumetric lean percentage measurements using dual energy mammography, chemical analysis and the actual mass. Determining the existence of a relationship between VLP(I) and VLP(CA) was necessary before comparing density results from the dual energy technique to composition data from chemical analysis for samples of unknown composition.

New method to measure coronary velocity and coronary flow reserve.

Coronary flow reserve (CFR) is an important index of coronary microcirculatory function. The objective of this study was to validate the reproducibility and accuracy of intravascular conductance catheter-based method for measurements of baseline and hyperemic coronary flow velocity (and hence CFR). The absolute coronary blood velocity was determined by measuring the time of transit of a saline injection between two pairs of electrodes (known distance) on a conductance catheter during a routine saline injection without the need for reference flow. In vitro validation was made in the velocity range of 5 to 70 cm/s in reference to the volume collection method. In 10 swine, velocity measurements were compared with those from a flow probe in coronary arteries at different CFR attained by microsphere embolization. In vitro, the mean difference between the proposed method and volume collection was 0.7 ± 1.34 cm/s for steady flow and -0.77 ± 2.22 cm/s for pulsatile flow. The mean difference between duplicate measurements was 0 ± 1.4 cm/s. In in vivo experiments, the flow (product of velocity and lumen cross-sectional area that is also measured by the conductance catheter) was determined in both normal and stenotic vessels and the mean difference between the proposed method and flow probe was -1 ± 12 ml/min (flow ranged from 10 to 130 ml/min). For CFR, the mean difference between the two methods was 0.06 ± 0.28 (range of 1 to 3). Our results demonstrate the reproducibility and accuracy of velocity and CFR measurements with a conductance catheter by use of a standard saline injection. The ability of the combined measurement of coronary lumen area (as previously validated) and current velocity and CFR measurements provides an integrative diagnostic tool for interventional cardiology.

Imaging of nanoparticles with dual-energy computed tomography.

A simulation study was performed to determine the feasibility and performance of imaging nanoparticles as contrast agents in dual-energy computed tomography. An analytical simulation model was used to model the relevant signal-to-noise ratio (SNR) in dual-energy imaging for the specific case of a three-material patient phantom consisting of water, calcium hydroxyapatite and contrast agent. Elemental gold and iodine were both considered as contrast agents. Simulations were performed for a range of monoenergetic (20-150 keV) and polyenergetic (20-150 kVp) beam spectra. A reference configuration was defined with beam energies of 80 and 140 kVp to match current clinical practice. The effect of adding a silver filter to the high-energy beam was also studied. A figure of merit (FOM), which normalized the dual-energy SNR to the square root of the patient integral dose, was calculated for all cases. The units of the FOM were keV(-1/2). A simple Rose model of detectability was used to estimate the minimum concentration of either elements needed to be detected (SNR > 5). For monoenergetic beams, the peak FOM of gold was 6.4 × 10(-6) keV(-1/2), while the peak FOM of iodine was 3.1 × 10(-6) keV(-1/2), a factor of approximately 2 greater for gold. For polyenergetic spectra, at the reference energies of 80 and 140 kVp, the FOM for gold and iodine was 1.65 × 10(-6) and 5.0 × 10(-7) keV(-1/2), respectively, a factor of approximately 3.3 greater. Also at these energies, the minimum detectable concentration of gold was estimated to be 58.5 mg mL(-1), while iodine was estimated to be 117.5 mg mL(-1). The results suggest that the imaging of a gold nanoparticle contrast agent is well suited to current conditions used in clinical imaging. The addition of a silver filter of 800 µm further increased the image quality of the gold signal by approximately 50% for the same absorbed dose to the patient.

Scatter correction in digital mammography based on image deconvolution.

X-ray scatter is a major cause of nonlinearity in densitometry measurements using digital mammography. Previous scatter correction techniques have primarily used a single scatter point spread function to estimate x-ray scatter. In this study, a new algorithm to correct x-ray scatter based on image convolution was implemented using a spatially variant scatter point spread function which is energy and thickness dependent. The scatter kernel was characterized in terms of its scattering fraction (SF) and scatter radial extent (k) on uniform Lucite phantoms with thickness of 0.8-8.0 cm. The algorithm operates on a pixel-by-pixel basis by grouping pixels of similar thicknesses into a series of mask images that are individually deconvolved using Fourier image analysis with a distinct kernel for each image. The algorithm was evaluated with three Lucite step phantoms and one anthropomorphic breast phantom using a full-field digital mammography system at energies of 24, 28, 31 and 49 kVp. The true primary signal was measured with a multi-hole collimator. The effect on image quality was also evaluated. For all 16 studies, the average mean percentage error in estimating the true primary signal was found to be -2.13% and the average rms percentage error was 2.60%. The image quality was seen to improve at every energy up to 25% at 49 kVp. The results indicate that a technique based on a spatially variant scatter point spread function can accurately estimate x-ray scatter.

A computer reconstruction of the entire coronary arterial tree based on detailed morphometric data.

A rigorous analysis of blood flow must be based on the branching pattern and vascular geometry of the full vascular circuit of interest. It is experimentally difficult to reconstruct the entire vascular circuit of any organ because of the enormity of the vessels. The objective of the present study was to develop a novel method for the reconstruction of the full coronary vascular tree from partial measurements. Our method includes the use of data on those parts of the tree that are measured to extrapolate the data on those parts that are missing. Specifically, a two-step approach was employed in the reconstruction of the entire coronary arterial tree down to the capillary level. Vessels > 40 microm were reconstructed from cast data while vessels < 40 microm were reconstructed from histological data. The cast data were reconstructed one-bifurcation at a time while histological data were reconstructed one-sub-tree at a time by "cutting" and "pasting" of data from measured to missing vessels. The reconstruction algorithm yielded a full arterial tree down to the first capillary bifurcation with 1.9, 2.04 and 1.15 million vessel segments for the right coronary artery (RCA), left anterior descending (LAD) and left circumflex (LCx) trees, respectively. The node-to-node connectivity along with the diameter and length of every vessel segment was determined. Once the full tree was reconstructed, we automated the assignment of order numbers, according to the diameter-defined Strahler system, to every vessel segment in the tree. Consequently, the diameters, lengths, number of vessels, segments-per-element ratio, connectivity and longitudinal matrices were determined for every order number. The present model establishes a morphological foundation for future analysis of blood flow in the coronary circulation.

Analysis of blood flow in the entire coronary arterial tree.

A hemodynamic analysis of coronary blood flow must be based on the measured branching pattern and vascular geometry of the coronary vasculature. We recently developed a computer reconstruction of the entire coronary arterial tree of the porcine heart based on previously measured morphometric data. In the present study, we carried out an analysis of blood flow distribution through a network of millions of vessels that includes the entire coronary arterial tree down to the first capillary branch. The pressure and flow are computed throughout the coronary arterial tree based on conservation of mass and momentum and appropriate pressure boundary conditions. We found a power law relationship between the diameter and flow of each vessel branch. The exponent is approximately 2.2, which deviates from Murray's prediction of 3.0. Furthermore, we found the total arterial equivalent resistance to be 0.93, 0.77, and 1.28 mmHg.ml(-1).s(-1).g(-1) for the right coronary artery, left anterior descending coronary artery, and left circumflex artery, respectively. The significance of the present study is that it yields a predictive model that incorporates some of the factors controlling coronary blood flow. The model of normal hearts will serve as a physiological reference state. Pathological states can then be studied in relation to changes in model parameters that alter coronary perfusion.

Neoplastic transformation in vitro after exposure to low doses of mammographic-energy X rays: quantitative and mechanistic aspects.

The induction of neoplastic transformation in vitro after exposure of HeLa x skin fibroblast hybrid cells to low doses of mammography-energy (28 kVp) X rays has been studied. The data indicate no evidence of an increase in transformation frequency over the range 0.05 to 22 cGy, and doses in the range 0.05 to 1.1 cGy may result in suppression of transformation frequencies to levels below that seen spontaneously. This finding is not consistent with a linear, no-threshold dose- response curve. The dose range at which possible suppression is evident includes doses typically experienced in mammographic examination of the human breast. Experiments are described that attempt to elucidate any possible role of bystander effects in modulating this low-dose radiation response. Not unexpectedly, inhibition of gap junction intercellular communication (GJIC) with the inhibitor lindane did not result in any significant alteration of transformation frequencies seen at doses of 0.27 or 5.4 cGy in these subconfluent cultures. Furthermore, no evidence of a bystander effect associated with factors secreted into the extracellular medium was seen in medium transfer experiments. Thus, in this system and under the experimental conditions used, bystander effects would not appear to be playing a major role in modulating the shape of the dose-response curve.

Mechanisms of suppression of neoplastic transformation in vitro by low doses of low LET radiation.

Suppression of neoplastic transformation of HeLa x skin fibroblast human hybrid cells in vitro following low doses of low linear energy transfer radiation has been reported previously. The present study represents an exploration of two hypothesized mechanisms that may underlie this observed suppression. These are the up-regulation of reduced glutathione (GSH), a known antioxidant, and induction of DNA repair activity. The hybrid cells were found to have a high endogenous level of GSH and no induction following low doses of 60 kVp X-rays was observed. Buthionine sulfoximine (BSO), a GSH biosynthesis inhibitor, completely suppressed GSH levels in both unirradiated and irradiated cells. Furthermore, there was no significant impact of BSO-induced suppression of GSH on the neoplastic transformation frequency of either unirradiated or low dose irradiated cells indicating that glutathione levels play no role in the low dose suppression of transformation frequency. To assess the possible role of DNA repair in the low dose suppression of transformation the effect of 3-aminobenzamide (3-AB), a poly-ADP-ribose polymerase (PARP) inhibitor was examined. In these experiments, there was no significant effect of 3-AB on the transformation frequency at a dose of Cs-137 gamma rays of 0.5 cGy, however, at a dose of 5 cGy there was a significant increase (P < 0.05) in the transformation frequency in the presence of 3-AB. These findings suggest that the influence of DNA repair on the low dose suppression of transformation is significant at a dose of 5 cGy, but not at the lower dose of 0.5 cGy.

Low doses of diagnostic energy X-rays protect against neoplastic transformation in vitro.

PURPOSE: To investigate the effect of low doses of 60 kVp X-rays on in vitro transformation frequency. MATERIALS AND METHODS: HeLa x skin fibroblast human hybrid cells were used to assay transformation from the non-tumorigenic to the tumorigenic phenotype. Subconfluent cultures of cells were exposed to a range of doses of 60 kVp X-rays and seeded for assay of transformation after 24 h post-irradiation holding. Experiments were repeated at least three times and the data pooled for analysis. Transformation frequencies were compared with those of sham-irradiated controls. RESULTS: At doses < 1 cGy, the observed transformation frequencies were significantly less than those seen in unirradiated cells. CONCLUSION: Low doses (< 1 cGy) of 60 kVp X-rays protect HeLa x skin fibroblast human hybrid cells against neoplastic transformation in vitro.

Quantification of coronary artery lumen volume by digital angiography: in vivo validation.

BACKGROUND: Coronary artery lumen volume may potentially have several advantages over the commonly used variables, such as percent stenosis or minimal lumen diameter, in the assessment of coronary artery disease. The goal of this study is to validate a quantitative assessment of lumen volume using a video densitometry technique. METHODS AND RESULTS: Coronary arteriography was performed in 9 swine (body weight 20 to 55 kg) after power injection of contrast material (2 mL/s for 3 seconds) into the left main coronary artery. Phase-matched subtracted images were used to quantify regional lumen volume by a video densitometry technique. The in vivo volume measurements were validated by a polymer cast of the coronary arterial tree made at physiological pressure. The measured cast volume (V(C)) and video densitometric regional lumen volume (V(VD)) were related by V(VD)=1.06 V(C)-0.01 mL (r=0.99). The root mean square and systematic errors for these measurements were 17% and -3%, respectively. CONCLUSIONS: A video densitometry technique for quantification of coronary lumen volume was validated both in vitro and in vivo in a swine animal model. The present results demonstrated the feasibility and potential utility of the video densitometry technique for accurate measurement of regional lumen volume in vivo. This study contributes to the understanding of the angiographic methods used for the assessment of coronary artery disease and indicates that this technique can potentially be used for quantification of diffuse coronary artery disease during routine coronary arteriography.

X-ray beam equalization: feasibility and performance of an automated prototype system in a phantom and swine.

PURPOSE: To investigate the feasibility of an automated implementation of a beam equalization technique and to evaluate the experimental performance of the prototype system. MATERIALS AND METHODS: X-ray beam equalization involved the process of low-dose image acquisition, attenuator thickness calculation, mask generation, mask positioning, equalized image acquisition, and mask reshaping. The entire equalization process was performed in approximately 7 seconds. The equalized images were assessed both qualitatively and quantitatively by using a humanoid phantom and a swine animal model. The general image quality was assessed for the ability to visualize arterial branches and other anatomic structures. The level of equalization was quantitatively assessed by segmenting the images into an 8 x 8 matrix of square regions. RESULTS: The ratio of the root-mean-squared variance for the equalized and unequalized images from humanoid phantom and swine animal studies was 0.49 and 0.59, respectively. Furthermore, qualitative assessment of the images showed substantial improvement in image quality and visualization of arterial branches after beam equalization in phantom and animal studies. CONCLUSION: Automated area beam equalization is feasible and improves image quality in previously underpenetrated regions of the image.

Cross-sectional area and volume compliance of porcine left coronary arteries.

We have determined the cross-sectional area (CSA) compliance of the first several generations of pig coronary arteries and the volume compliance of the coronary arterial tree (vessels >0.5 mm in diameter) using a videodensitometric technique. The coronary arteries of four KCl-arrested maximally vasodilated pig hearts were perfused with iodine and 3% Cab-O-Sil. Because Cab-O-Sil occludes small arteries, the flow can be stopped and the pressure can be maintained while the trunk of the coronary artery and its subbranches are imaged using digital angiography. The coronary arteries were preconditioned several times with cyclic changes in pressure from 0 to 160 mmHg. The pressure was then varied in a triangular pattern, and the absolute CSA of each vessel and the total arterial volume were calculated using videodensitometry in conjunction with digital subtraction angiography. Our results have shown that the pressure-diameter and pressure-volume relationships are linear in the 60-140 mmHg pressure range. Furthermore, the compliance of the coronary arteries is small; i.e., the diameter of the coronary artery changes by <15% in the 80-mmHg pressure range. The compliance data couples the mechanics of the blood vessel wall to the mechanics of blood flow to yield a pressure-flow relationship for each coronary arterial segment.

Scatter and veiling glare estimation based on sampled primary intensity.

Scatter and veiling glare are predominant sources of error in videodensitometric iodine quantification. Standard beam stop techniques such as lead strips or an array of lead discs, placed before the patients, have previously been used to measure scatter and veiling glare in digital radiographic images. However, these techniques significantly increase patient x-ray exposure. In order to overcome this limitation, a scatter measurement technique based on sampled primary intensity has been investigated. This technique uses an array of apertures in a lead sheet to sample the primary x-ray intensity. The scatter-glare intensity in these locations is calculated by subtracting the sampled primary intensity from an open field image which contains both primary and scatter-glare. The calculated scatter-glare values can be interpolated or combined with digital filtration to estimate the scatter-glare intensity on a pixel by pixel basis. The technique was evaluated using a Lucite step phantom and an anthropomorphic chest phantom. The average rms percentage errors of scatter and veiling glare estimation using bi-cubic interpolation and digital filtration techniques were 8.02% and 7.53%, respectively. The average rms percentage errors of primary intensity estimation using bi-cubic interpolation and digital filtration techniques were 10.01% and 8.91%, respectively. The x-ray exposure-area product (EAP) from the aperture array was only 4.38% of the EAP from the open field. These results indicate that the scatter-glare intensity can be accurately estimated with minimal x-ray exposure using sampled primary intensity.

Area x-ray beam equalization for digital angiography.

An area beam equalization technique has been investigated in order to generate patient-specific compensating filters for digital angiography. An initial image was used to generate the compensating filter, which was fabricated using a deformable compensating material, containing CeO2, and an array of square pistons. The CeO2 attenuator thicknesses were calculated using the gray level information from the initial unequalized image. The array of pistons was pressed against a uniform thickness of attenuating material to generate a filter for x-ray beam equalization. The filter was subsequently inserted into the x-ray beam for the final equalized radiograph. It was positioned close to the focal spot (magnification of 8.0) in order to minimize edge artifacts from the filter. The equalization of x-ray transmission across the field exiting from the object significantly improved the image quality by preserving local contrast throughout the image. The contrast-to-noise ratio (CNR) in the equalized images was increased-by up to fivefold. Phantom studies indicate that equalized images using a relatively small array of pistons (e.g., 8 x 8) produce significant improvement in image quality with negligible perceptible artifacts. Animal studies showed that beam equalization significantly improved fluoroscopic and angiographic image quality. X-ray beam equalization produced an image with a relatively uniform scatter-glare intensity and it reduced the scatter-glare fraction in the previously underpenetrated region of the image from 0.65 to 0.50. Also, x-ray tube loading due to the mask assembly itself was negligible. In conclusion, area beam equalization reduces the scatter-glare fraction and significantly improves CNR in the previously underpenetrated region of the image.

On the design of the coronary arterial tree: a generalization of Murray's law.

Murray's law has been generalized to provide morphometric relationships among various subtrees as well as between a feeding segment and the subtree it perfuses. The equivalent resistance of each subtree is empirically determined to be proportional to the cube of a subtree's cumulative arterial length (L) and inversely proportional to a subtree's arterial volume (V) raised to a power of approximately 2.6. This relationship, along with a minimization of a cost function, and a linearity assumption between flow and cumulative arterial length, provides a power law relationship between V and L. These results, in conjunction with conservation of energy, yield relationships between the diameter of a segment and the length of its distal subtree. The relationships were tested based on a complete set of anatomical data of the coronary arterial trees using two models. The first model, called the truncated tree model, is an actual reconstruction of the coronary arterial tree down to 500 microm in diameter. The second model, called the symmetric tree model, satisfies all mean anatomical data down to the capillary vessels. Our results show very good agreement between the theoretical formulation and the measured anatomical data, which may provide insight into the design of the coronary arterial tree. Furthermore, the established relationships between the various morphometric parameters of the truncated tree model may provide a basis for assessing the extent of diffuse coronary artery disease.

Absolute volumetric coronary blood flow measurement with digital subtraction angiography.

The problems associated with visual interpretation of coronary arteriograms have been well-documented. There is a need for more physiologic means of assessing coronary artery stenosis during routine coronary arteriography. Volumetric coronary blood flow assessed as a function of time can be a valuable aid in the analysis of functional significance of arterial obstruction. A volumetric coronary blood flow measurement technique was investigated in a swine animal model using phase matched temporal subtraction images. The left anterior descending (LAD) coronary artery of swine animal models were instrumented with an ultrasound flow probe (US) and a vascular occluder producing stenosis. Contrast material injections (2-4 ml/sec for 3 sec) were made into the left coronary ostium during image acquisition. Phase-matched temporal subtraction (DSA) images were used to measure volumetric coronary blood flow in the LAD. In addition, a technique for automatic estimation of iodine calibration slope was also investigated. In 49 independent comparisons, the mean coronary blood flow (FPA) correlated extremely well with the mean US flow (FPA = 0.92US + 1.42 ml/min, r = 0.99, standard error of estimate (SEE) = 4.32 ml/min). Further more, the automatic iodine calibration technique was shown to be very accurate. In conclusion, accurate volumetric coronary blood flow measurements can be made before the onset of significant changes in coronary blood flow due to contrast injection.

Scatter-glare estimation for digital radiographic systems: comparison of digital filtration and sampling techniques.

The scatter and veiling glare distribution in images acquired with a digital subtraction angiography imaging system was estimated using a digital filtration and a beam-stop technique. The digital filtration technique utilizes exposure parameters and image gray levels to estimate scatter-glare intensity based on previous phantom measurements. The beam-stop technique uses an array of lead discs in order to sample scatter-glare intensity for each patient. To test the ability of digital filtration and beam-stop techniques to estimate the scatter-glare intensity, they were applied to images of postmortem swine animal models at different projections and beam energies. The systematic and root-mean-square (rms) percentage errors of these estimates were obtained by comparison to directly measured scatter-glare images using a scanning lead strip technique. The average rms percentage error for the digital filtration and beam-stop techniques were 8.07% and 6.67%, respectively. The changes in scatter-glare intensity due to contrast injection during coronary arteriography and ventriculography were also measured using the beam-stop technique. The maximum changes in scatter-glare intensities during coronary arteriography and ventriculography were 19 and 88%, respectively. The results indicate that the digital filtration technique is more suited for applications such as coronary arteriography and ventriculography where the iodinated contrast material significantly changes the scatter-glare intensity.