Metal artifact reduction in cone beam computed tomography using forward projected reconstruction information.

In this work we present a new method to reduce artifacts, produced by high-density objects, especially metal implants, in X-ray cone beam computed tomography (CBCT). These artifacts influence clinical diagnostics and treatments using CT data, if metal objects are located in the field of view (FOV). Our novel method reduces metal artifacts by virtually replacing the metal objects with tissue objects of the same shape. First, the considered objects must be segmented in the original 2D projection data as well as in a reconstructed 3D volume. The attenuation coefficients of the segmented voxels are replaced with adequate attenuation coefficients of tissue (or water), then the required parts of the volume are projected onto the segmented 2D pixels, to replace the original information. This corrected 2D data can then be reconstructed with reduced artifacts, i. e. all metal objects virtually vanished. After the reconstruction, the segmented 3D metal objects were re-inserted into the corrected 3D volume. Our method was developed for mobile C-arm CBCTs; as it is necessary that they are of low weight, the C-arm results in unpredictable distortion. This misalignment between the original 2D data and the forward projection of the reconstructed 3D volume must be adjusted before the correction of the segmented 2D pixels. We applied this technique to clinical data and will now present the results.

3D C-arm as an alternative modality to CT in postmortem imaging: technical feasibility.

OBJECT: The aim of our study was to demonstrate the image quality of the new device using human cadavers, extending the horizon of available imaging modalities in forensic medicine. MATERIALS AND METHODS: Six human cadavers were examined, revealing C-arm data sets of the head, neck thorax, abdomen and pelvis. High-resolution mode was performed with 500 fluoroscopy shots during a 190 degrees orbital movement with a constant tube voltage of 100 kV and a current of 4.6 mA. Based on these data sets subsequent three-dimensional reconstructions were generated. RESULTS: Reconstructed data sets revealed high-resolution images of all skeletal structures in a near-CT quality. The same image quality was available in all reconstruction planes. Artefacts caused by restorative dental materials are less accentuated in CBCT data sets. The system configuration was not powerful enough to generate sufficient images of intracranial structures. CONCLUSION: After the here-demonstrated encouraging preliminary results, the forensic indications that would be suitable for imaging with a 3D C-arm have to be defined. Promising seems the visualization local limited region of interest as the cervical spine or the facial skeleton.

Cervical soft tissue imaging using a mobile CBCT scanner with a flat panel detector in comparison with corresponding CT and MRI data sets.

OBJECTIVE: The aim of this study was to evaluate soft tissue image quality of a mobile cone-beam computed tomography (CBCT) scanner with an integrated flat-panel detector. STUDY DESIGN: Eight fresh human cadavers were used in this study. For evaluation of soft tissue visualization, CBCT data sets and corresponding computed tomography (CT) and magnetic resonance imaging (MRI) data sets were acquired. Evaluation was performed with the help of 10 defined cervical anatomical structures. RESULTS: The statistical analysis of the scoring results of 3 examiners revealed the CBCT images to be of inferior quality regarding the visualization of most of the predefined structures. Visualization without a significant difference was found regarding the demarcation of the vertebral bodies and the pyramidal cartilages, the arteriosclerosis of the carotids (compared with CT), and the laryngeal skeleton (compared with MRI). Regarding arteriosclerosis of the carotids compared with MRI, CBCT proved to be superior. CONCLUSIONS: The integration of a flat-panel detector improves soft tissue visualization using a mobile CBCT scanner.

3D soft tissue imaging with a mobile C-arm.

We introduce a clinical prototype for 3D soft tissue imaging to support surgical or interventional procedures based on a mobile C-arm. An overview of required methods and materials is followed by first clinical images of animals and human patients including dosimetry. The mobility and flexibility of 3D C-arms gives free access to the patient and therefore avoids relocation of the patient between imaging and surgical intervention. Image fusion with diagnostic data (MRI, CT, PET) is demonstrated and promising applications for brachytherapy, RFTT and others are discussed.