A novel low-dose ECG-gated helical scan method to investigate coronary artery diseases was developed. This method
uses a high pitch for scanning (based on the patient's heart rate) and X-rays are generated only during the optimal cardiac
phases. The dose reduction was obtained using a two-level approach: 1) To use a 64-slice CT scanner (Aquilion,
Toshiba, Otawara, Tochigi, Japan) with a scan speed of 0.35 s/rot. to helically scan the heart at a high pitch based on the
patient's heart rate. By changing the pitch from the conventional 0.175 to 0.271 for a heart rate of 60 bpm, the exposure
dose was reduced to 65%. 2) To employ tube current gating that predicts the timing of optimal cardiac phases from the
previous cardiac cycle and generates X-rays only during the required cardiac phases. The combination of high speed
scanning with a high pitch and appropriate X-ray generation only in the cardiac phases from 60% to 90% allows the
exposure dose to be reduced to 5.6 mSv for patients with a heart rate lower than 65 bpm. This is a dose reduction of
approximately 70% compared to the conventional scanning method recommended by the manufacturer when segmental
reconstruction is considered. This low-dose protocol seamlessly allows for wide scan ranges (e.g., aortic dissection) with
the benefits of ECG-gated helical scanning: smooth continuity for longitudinal direction and utilization of data from all
cardiac cycles.
With high-speed multislice helical CT, the time needed to select the optimal cardiac phase accounts for a large percentage of the coronary CT angiography examination time because the scan time is short. To reduce the phase selection time, we have developed an automatic cardiac phase selection algorithm and implemented it in the Aquilion 64 scanner. This algorithm calculates the absolute sum of the differences between two raw data sets for subsequent cardiac phases (e.g., 4% and 0%) and generates a velocity curve representing the magnitude of cardiac motion velocity for the entire heart volume. Normally, the velocity curve has two local minimum slow-motion phases corresponding to end-systole and mid-diastole. By applying these local minimum phases in reconstruction, stationary cardiac images can be reconstructed automatically. In this report, the algorithm for generating the velocity curve and the processing time for selecting the optimal cardiac phase are discussed. The accuracy of this method is compared with that of the conventional manual method. In the manual method, a sample plane containing all four cardiac chambers was selected, reconstruction was performed for all phases at 2% intervals, and images were visually evaluated. Optimal phase selection required about 5 min/exam. With automatic phase selection, optimal phase selection required only about 1 min/exam, and the cardiac phases were close to those selected using the manual method. Automatic phase selection substantially reduces the time needed to select the optimal phase and increases patient throughput. Moreover, the influence of operator skill in selecting the optimal phase is minimized.
Multislice CT with a larger number of detector rows has recently become the mainstream. As a result, scanning with
a thin slice thickness is more frequently performed. However, a large number of obvious raster-type artifacts occur
when X-ray absorption in the lateral direction is extremely high, such as in the shoulder and the pelvis. There are two
methods to solve this problem. In one method, X-ray output is modulated during rotation so that the exposure dose is
increased in regions with high X-ray absorption and reduced in regions with low X-ray absorption. In the other method,
regions that are responsible for artifacts are filter-processed using image processing to minimize artifacts.
From the viewpoints of image quality and exposure dose, we have evaluated a method we have developed that
combines X-ray modulation technology (X-ray Modulation) and artifact elimination processing (Boost3D). An acrylic
elliptical phantom was used for evaluation. Assuming a constant image SD level, it was found that the exposure dose
can be reduced by approximately 25% with the combined use of X-ray Modulation and Boost3D.
The dose efficiency index (DEI) is a dose independent measure that quantifies the low-contrast performance of CT scanners. The purpose of this paper is to compare the results of DEI analysis with those of ROC analysis. A custom-made phantom consisting of diluted contrast targets of various sizes and densities was scanned at 80 & 120 kV on a multislice CT scanner (Hispeed Advantage RP, GE). Eight radiographers reviewed the images and identified discernable targets. The likelihood of detection was measured as a function of the target size and scan conditions. The results of the DEI & ROC analyses showed that the low-contrast resolution was higher at 80kV than at 120kV. The p-value obtained by the paired-t test was 0.000 for both analyses, indicating that the difference was significant. Under the conditions used in this study, the DEI analysis was found to be an effective alternative to ROC analysis for characterizing the low-contrast performance of CT scanners. The evaluation time was about 1/6 compared with ROC analysis. It is much simpler to calculate than ROC and is useful in comparing scanners from different manufacturers or as part of ongoing quality assurance.
The purpose of this study is to develop an x-ray detector system for multislice CTs with 0.5 slice thickness and 0.5- second revolution, and to evaluate clinical advantages. The detector adopts a newly developed ceramic scintillator having a high light-output efficiency as well as a high light-transmittance. By employing high precision machining technology to fabricate the detector, it is not necessary to mask the gap from incident x-ray in the longitudinal direction between neighboring cells. The scintillator properties and the geometry of the detector provide a high x-ray-to-light conversion efficiency, and realize a good low-contrast detectability for CTs. The detector structure allows 0.5 mm slice thickness. The afterglow intensity of the scintaillator is less than 0.1 percent at 3 ms, facilitating 1800 views per second for 0.5-second revolution. This detector improves the performance of CT scanners.
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