Image acquisition, geometric correction and display of images from a 2×2 x-ray detector array based on Electron Multiplying Charge Coupled Device (EMCCD) technology.

A high resolution (up to 11.2 lp/mm) x-ray detector with larger field of view (8.5 cm × 8.5 cm) has been developed. The detector is a 2 × 2 array of individual imaging modules based on EMCCD technology. Each module outputs a frame of size 1088 × 1037 pixels, each 12 bits. The frames from the 4 modules are acquired into the processing computer using one of two techniques. The first uses 2 CameraLink communication channels with each carrying information from two modules, the second uses a application specific custom integrated circuits, the Multiple Module Multiplexer Integrated Circuit (MMMIC), 3 of which are used to multiplex the data from 4 modules into one CameraLink channel. Once the data is acquired using either of the above mentioned techniques, it is decoded in the graphics processing unit (GPU) to form one single frame of size 2176 × 2074 pixels each 16 bits. Each imaging module uses a fiber optic taper coupled to the EMCCD sensor. To correct for mechanical misalignment between the sensors and the fiber optic tapers and produce a single seamless image, the images in each module may be rotated and translated slightly in the x-y plane with respect to each other. To evaluate the detector acquisition and correction techniques, an aneurysm model was placed over an anthropomorphic head phantom and a coil was guided into the aneurysm under fluoroscopic guidance using the detector array. Image sequences before and after correction are presented which show near-seamless boundary matching and are well suited for fluoroscopic imaging.

Dose Reduction in Fluoroscopic Interventions Using a Combination of a Region of Interest (ROI) X-Ray Attenuator and Spatially-Different, Temporally-Variable Temporal Filtering.

A novel dose reduction technique for fluoroscopic interventions involving a combination of a material x-ray region of interest (ROI) attenuator and spatially different, temporally variable ROI temporal recursive filter, was used to guide the catheter to the ROI in three live animal studies, two involving rabbits and one involving a sheep. In the two rabbit studies presented, a catheter was guided to the entrance of the carotid artery. With the added ROI attenuator the image under the high attenuation region is very noisy. By using temporal filtering with a filter weight of 0.6 on previous frames, the noise is reduced. In the sheep study the catheter was guided to the descending aorta of the animal. The sheep offered a relatively higher attenuation to the incident x-rays and thus a higher temporal filter weight of 0.8 on previous frames was used during the procedure to reduce the noise to levels acceptable by the interventionalist. The image sequences from both studies show that significant dose reduction of 5-6 times can be achieved with acceptable image quality outside the ROI by using the above mentioned technique. Even though the temporal filter weighting outside the ROI is higher, the consequent lag does not prevent perception of catheter movement.

Evaluation of intracranial aneurysm coil embolization in phantoms and patients using a high-resolution Microangiographic Fluoroscope (MAF).

Intracranial aneurysm (IA) embolization using Gugliemi Detachable Coils (GDC) under x-ray fluoroscopic guidance is one of the most important neuro-vascular interventions. Coil deposition accuracy is key and could benefit substantially from higher resolution imagers such as the micro-angiographic fluoroscope (MAF). The effect of MAF guidance improvement over the use of standard Flat Panels (FP) is challenging to assess for such a complex procedure. We propose and investigate a new metric, inter-frame cross-correlation sensitivity (CCS), to compare detector performance for such procedures. Pixel (P) and histogram (H) CCS's were calculated as one minus the cross-correlation coefficients between pixel values and histograms for the region of interest at successive procedure steps. IA treatment using GDC's was simulated using an anthropomorphic head phantom which includes an aneurysm. GDC's were deposited in steps of 3 cm and the procedure was imaged with a FP and the MAF. To measure sensitivity to detect progress of the procedure by change in images of successive steps, an ROI was selected over the aneurysm location and pixel-value and histogram changes were calculated after each step. For the FP, after 4 steps, the H and P CCSs between successive steps were practically zero, indicating that there were no significant changes in the observed images. For the MAF, H and P CCSs were greater than zero even after 10 steps (30 cm GDC), indicating observable changes. Further, the proposed quantification method was applied for evaluation of seven patients imaged using the MAF, yielding similar results (H and P CCSs greater than zero after the last GDC deposition). The proposed metric indicates that the MAF can offer better guidance during such procedures.

Two dimensional extensible array configuration for EMCCD-based solid state x-ray detectors.

We have designed and developed from the discrete component level a high resolution dynamic x- ray detector to be used for fluoroscopic and angiographic medical imaging. The heart of the detector is a 1024 × 1024 pixel electron multiplying charge coupled device (EMCCD) with a pixel size of 13 × 13 µm(2) (Model CCD201-20, e2v Technologies, Inc.), bonded to a fiber optic plate (FOP), and optically coupled to a 350 µm thick micro-columnar CsI(TI) scintillator via a fiber optic taper (FOT). Our aim is to design an array of these detectors that could be extended to any arbitrary X × Y size in two dimensions to provide a larger field of view (FOV). A physical configuration for a 3×3 array is presented that includes two major sub-systems. First is an optical front end that includes (i) a phosphor to convert the x-ray photons into light photons, and (ii) a fused array of FOTs that focuses light photons from the phosphor onto an array of EMCCD's optically coupled using FOPs. Second is an electronic front end that includes (i) an FPGA board used for generating clocks and for data acquisition (ii) driver boards to drive and digitize the analog output from the EMCCDs, (iii) a power board, and (iv) headboards to hold the EMCCD's while they are connected to their respective driver board using flex cables. This configuration provides a larger FOV as well as region-of- interest (ROI) high-resolution imaging as required by modern neurovascular procedures.

Dose Reduction Technique Using a Combination of a Region of Interest (ROI) Material X-Ray Attenuator and Spatially Different Temporal Filtering for Fluoroscopic Interventions.

We demonstrate a novel approach for achieving patient dose savings during image-guided neurovascular interventions, involving a combination of a material x-ray region of interest (ROI) attenuator and a spatially different ROI temporal filtering technique. The part of the image under the attenuator is reduced in dose but noisy and less bright due to fewer x-ray quanta reaching the detector, as compared to the non-attenuating (or less attenuating) region. First the brightness is equalized throughout the image by post processing and then a temporal filter with higher weights is applied to the high attenuating region to reduce the noise, at the cost of increased lag; however, in the regions where less attenuation is present, a lower temporal weight is needed and is applied to preserve temporal resolution. A simulation of the technique is first presented on an actual image sequence obtained from an endovascular image guided interventional (EIGI) procedure. Then the actual implementation of the technique with a physical ROI attenuator is presented. Quantitative analysis including noise analysis and integral dose calculations are presented to validate the proposed technique.

Graphics Processing Unit (GPU) implementation of image processing algorithms to improve system performance of the Control, Acquisition, Processing, and Image Display System (CAPIDS) of the Micro-Angiographic Fluoroscope (MAF).

We present the image processing upgrades implemented on a Graphics Processing Unit (GPU) in the Control, Acquisition, Processing, and Image Display System (CAPIDS) for the custom Micro-Angiographic Fluoroscope (MAF) detector. Most of the image processing currently implemented in the CAPIDS system is pixel independent; that is, the operation on each pixel is the same and the operation on one does not depend upon the result from the operation on the other, allowing the entire image to be processed in parallel. GPU hardware was developed for this kind of massive parallel processing implementation. Thus for an algorithm which has a high amount of parallelism, a GPU implementation is much faster than a CPU implementation. The image processing algorithm upgrades implemented on the CAPIDS system include flat field correction, temporal filtering, image subtraction, roadmap mask generation and display window and leveling. A comparison between the previous and the upgraded version of CAPIDS has been presented, to demonstrate how the improvement is achieved. By performing the image processing on a GPU, significant improvements (with respect to timing or frame rate) have been achieved, including stable operation of the system at 30 fps during a fluoroscopy run, a DSA run, a roadmap procedure and automatic image windowing and leveling during each frame.

Spatially different, real-time temporal filtering and dose reduction for dynamic image guidance during neurovascular interventions.

Fluoroscopic systems have excellent temporal resolution, but are relatively noisy. In this paper we present a recursive temporal filter with different weights (lag) for different user selected regions of interest (ROI) to assist the neurointerventionalist during an image guided catheter procedure. The filter has been implemented on a Graphics Processor (GPU), enabling its usage for fast frame rates such as during fluoroscopy. We first demonstrate the use of this GPU-implemented rapid temporal filtering technique during an endovascular image guided intervention with normal fluoroscopy. Next we demonstrate its use in combination with ROI fluoroscopy where the exposure is substantially reduced in the peripheral region outside the ROI, which is then software-matched in brightness and filtered using the differential temporal filter. This enables patient dose savings along with improved image quality.

EMCCD-based high resolution dynamic x-ray detector for neurovascular interventions.

We have designed and developed from the discrete component level a high resolution dynamic detector for neurovascular interventions. The heart of the detector is a 1024 × 1024 pixel electron multiplying charge coupled device (EMCCD) with a pixel size of 13 × 13 µm(2), bonded to a fiber optic plate (FOP), and optically coupled to a 350 µm micro-columnar CsI(TI) scintillator via a 3.3:1 fiber optic taper (FOT). The detector provides x-ray images of 9 cycles/mm resolution at 15 frames/sec and real time live video at 30 frames/sec with binning at a lower resolution, both independent of gain applied to EMCCD, as needed for region-of-interest (ROI) image guidance during neurovascular interventions.