Academic Appointments

  • Professor (Research), Radiology
  • Member, Bio-X

Honors & Awards

  • Summer Research Scholarship, University of Technology, Sydney (1994)
  • Research Traineeship and Graduate Scholarship, Heart and Stroke Foundation of Canada - UWO (1995-1999)
  • Post-doctoral Fellowship, Medical Research Council, Canada (1999-2002)
  • First Place, Young Investigator’s Competition, The American Association of Physicists in Medicine (1999)
  • Fellowship Research Trainee Prize, Radiological Society of North America - Physics Subcommittee (2000)
  • Cum Laude Award, The Society of Computed Body Tomography and Magnetic Resonance (2001)
  • Faculty Scholar in Translational Research Award, The Baxter Foundation (2004)
  • Fellowship Research Trainee Prize (Zhu, PhD candidate), RSNA 2005 Physics Subcommittee, Radiological Society of North America (2005)
  • Greenfield award for best paper (non radiation dosimetry) published in Medical Physics in 2005, Medical Physics (2006)

Professional Education

  • Postdoc, Stanford University, Fellowship (2002)
  • Ph.D., University of Western Ontario, Medical Biophysics (1999)
  • M.S., University of Toronto, Medical Biophysics (1992)
  • B.S., University of Toronto, Physics (1989)

Research & Scholarship

Clinical Trials

  • Impact of C-arm CT in Patients With HCC Undergoing TACE: Optimal Imaging Guidance Not Recruiting

    Patients will be enrolled based on presence of HCC and eligibility for TACE. They will be randomized to one of two arms for imaging navigation to the optimal catheter location for chemotherapy injection to treat the first (possibly sole) tumor target. The two arms will be: TACE using F and DSA only, or TACE using F, DSA, and CACT. Navigation to subsequent treatment targets in all patients will be done with fluoroscopy, CACT, and DSA, as is standard of care at Stanford University Medical Center, and is not part of the study. Vascular complexity, which affects navigation difficulty and thus the need for imaging, will be assessed separately for use in data analysis by two radiologists on a four-point scale.

    Stanford is currently not accepting patients for this trial. For more information, please contact Kamil Unver, (650) 725 - 9810.

    View full details


2014-15 Courses


All Publications

  • Novel motor design for rotating anode x-ray tubes operating in the fringe field of a magnetic resonance imaging system MEDICAL PHYSICS Lillaney, P., Shin, M., Hinshaw, W., Bennett, N. R., Pelc, N., Fahrig, R. 2013; 40 (2)


    Using hybrid x-ray∕MR (XMR) systems for image guidance during interventional procedures could enhance the diagnosis and treatment of neurologic, oncologic, cardiovascular, and other disorders. The authors propose a close proximity hybrid system design in which a C-arm fluoroscopy unit is placed immediately adjacent to the solenoid magnet of a MR system with a minimum distance of 1.2 m between the x-ray and MR imaging fields of view. Existing rotating anode x-ray tube designs fail within MR fringe field environments because the magnetic fields alter the electron trajectories in the x-ray tube and act as a brake on the induction motor, reducing the rotation speed of the anode. In this study the authors propose a novel motor design that avoids the anode rotation speed reduction.The proposed design replaces the permanent magnet stator found in brushed dc motors with the radial component of the MR fringe field. The x-ray tube is oriented such that the radial component of the MR fringe field is orthogonal to the cathode-anode axis. Using a feedback position sensor and the support bearings as electrical slip rings, the authors use electrical commutation to eliminate the need for mechanical brushes and commutators. A vacuum compatible prototype of the proposed motor design was assembled, and its performance was evaluated at various operating conditions. The prototype consisted of a 3.1 in. diameter anode rated at 300 kHU with a ceramic rotor that was 5.6 in. in length and had a 2.9 in. diameter. The material chosen for all ceramic components was MACOR, a machineable glass ceramic developed by Corning Inc. The approximate weight of the entire assembly was 1750 g. The maximum rotation speed, angular acceleration, and acceleration time of the motor design were investigated, as well as the dependence of these parameters on rotor angular offset, magnetic field strength, and field orientation. The resonance properties of the authors' assembly were also evaluated to determine its stability during acceleration, and a pulse width modulation algorithm was implemented to control the rotation speed of the motor.At a magnetic flux density of 41 mT orthogonal to the axis of rotation (on the lower end of the expected flux density in the MR suite) the maximum speed of the motor was found to be 5150 revolutions per minute (rpm). The acceleration time necessary to reach 3000 rpm was found to be approximately 10 s at 59 mT. The resonance frequency of the assembly with the anode attached was 1310 rpm (21.8 Hz) which is far below the desired operating speeds. Pulse width modulation provides an effective method to control the speed of the motor with a resolution of 100 rpm.The proposed design can serve as a direct replacement to the conventional induction motor used in rotating anode x-ray tubes. It does not suffer from a reduced rotation speed when operating in a MR environment. The presence of chromic steel bearings in the prototype prevented testing at the higher field strengths, and future iterations of the design could eliminate this shortcoming. The prototype assembly demonstrates proof of concept of the authors' design and overcomes one of the major obstacles for a MR compatible rotating anode x-ray tube.

    View details for DOI 10.1118/1.4773313

    View details for Web of Science ID 000314727700045

    View details for PubMedID 23387764

  • In vitro evaluation of the imaging accuracy of C-arm conebeam CT in cerebral perfusion imaging MEDICAL PHYSICS Ganguly, A., Fieselmann, A., Boese, J., Rohkohl, C., Hornegger, J., Fahrig, R. 2012; 39 (11): 6652-6659


    The authors have developed a method to enable cerebral perfusion CT imaging using C-arm based conebeam CT (CBCT). This allows intraprocedural monitoring of brain perfusion during treatment of stroke. Briefly, the technique consists of acquiring multiple scans (each scan comprised of six sweeps) acquired at different time delays with respect to the start of the x-ray contrast agent injection. The projections are then reconstructed into angular blocks and interpolated at desired time points. The authors have previously demonstrated its feasibility in vivo using an animal model. In this paper, the authors describe an in vitro technique to evaluate the accuracy of their method for measuring the relevant temporal signals.The authors' evaluation method is based on the concept that any temporal signal can be represented by a Fourier series of weighted sinusoids. A sinusoidal phantom was developed by varying the concentration of iodine as successive steps of a sine wave. Each step corresponding to a different dilution of iodine contrast solution contained in partitions along a cylinder. By translating the phantom along the axis at different velocities, sinusoidal signals at different frequencies were generated. Using their image acquisition and reconstruction algorithm, these sinusoidal signals were imaged with a C-arm system and the 3D volumes were reconstructed. The average value in a slice was plotted as a function of time. The phantom was also imaged using a clinical CT system with 0.5 s rotation. C-arm CBCT results using 6, 3, 2, and 1 scan sequences were compared to those obtained using CT. Data were compared for linear velocities of the phantom ranging from 0.6 to 1 cm?s. This covers the temporal frequencies up to 0.16 Hz corresponding to a frequency range within which 99% of the spectral energy for all temporal signals in cerebral perfusion imaging is contained.The errors in measurement of temporal frequencies are mostly below 2% for all multiscan sequences. For single scan sequences, the errors increase sharply beyond 0.10 Hz. The amplitude errors increase with frequency and with decrease in the number of scans used.Our multiscan perfusion CT approach allows low errors in signal frequency measurement. Increasing the number of scans reduces the amplitude errors. A two-scan sequence appears to offer the best compromise between accuracy and the associated total x-ray and iodine dose.

    View details for DOI 10.1118/1.4757910

    View details for Web of Science ID 000310726300013

    View details for PubMedID 23127059

  • Fast simulation of x-ray projections of spline-based surfaces using an append buffer PHYSICS IN MEDICINE AND BIOLOGY Maier, A., Hofmann, H. G., Schwemmer, C., Hornegger, J., Keil, A., Fahrig, R. 2012; 57 (19): 6193-6210


    Many scientists in the field of x-ray imaging rely on the simulation of x-ray images. As the phantom models become more and more realistic, their projection requires high computational effort. Since x-ray images are based on transmission, many standard graphics acceleration algorithms cannot be applied to this task. However, if adapted properly, the simulation speed can be increased dramatically using state-of-the-art graphics hardware. A custom graphics pipeline that simulates transmission projections for tomographic reconstruction was implemented based on moving spline surface models. All steps from tessellation of the splines, projection onto the detector and drawing are implemented in OpenCL. We introduced a special append buffer for increased performance in order to store the intersections with the scene for every ray. Intersections are then sorted and resolved to materials. Lastly, an absorption model is evaluated to yield an absorption value for each projection pixel. Projection of a moving spline structure is fast and accurate. Projections of size 640 × 480 can be generated within 254 ms. Reconstructions using the projections show errors below 1 HU with a sharp reconstruction kernel. Traditional GPU-based acceleration schemes are not suitable for our reconstruction task. Even in the absence of noise, they result in errors up to 9 HU on average, although projection images appear to be correct under visual examination. Projections generated with our new method are suitable for the validation of novel CT reconstruction algorithms. For complex simulations, such as the evaluation of motion-compensated reconstruction algorithms, this kind of x-ray simulation will reduce the computation time dramatically.

    View details for DOI 10.1088/0031-9155/57/19/6193

    View details for Web of Science ID 000308915900020

    View details for PubMedID 22975431

  • A nonlinear lag correction algorithm for a-Si flat-panel x-ray detectors MEDICAL PHYSICS Starman, J., Star-Lack, J., Virshup, G., Shapiro, E., Fahrig, R. 2012; 39 (10): 6035-6047


    Detector lag, or residual signal, in a-Si flat-panel (FP) detectors can cause significant shading artifacts in cone-beam computed tomography reconstructions. To date, most correction models have assumed a linear, time-invariant (LTI) model and correct lag by deconvolution with an impulse response function (IRF). However, the lag correction is sensitive to both the exposure intensity and the technique used for determining the IRF. Even when the LTI correction that produces the minimum error is found, residual artifact remains. A new non-LTI method was developed to take into account the IRF measurement technique and exposure dependencies.First, a multiexponential (N = 4) LTI model was implemented for lag correction. Next, a non-LTI lag correction, known as the nonlinear consistent stored charge (NLCSC) method, was developed based on the LTI multiexponential method. It differs from other nonlinear lag correction algorithms in that it maintains a consistent estimate of the amount of charge stored in the FP and it does not require intimate knowledge of the semiconductor parameters specific to the FP. For the NLCSC method, all coefficients of the IRF are functions of exposure intensity. Another nonlinear lag correction method that only used an intensity weighting of the IRF was also compared. The correction algorithms were applied to step-response projection data and CT acquisitions of a large pelvic phantom and an acrylic head phantom. The authors collected rising and falling edge step-response data on a Varian 4030CB a-Si FP detector operating in dynamic gain mode at 15 fps at nine incident exposures (2.0%-92% of the detector saturation exposure). For projection data, 1st and 50th frame lag were measured before and after correction. For the CT reconstructions, five pairs of ROIs were defined and the maximum and mean signal differences within a pair were calculated for the different exposures and step-response edge techniques.The LTI corrections left residual 1st and 50th frame lag up to 1.4% and 0.48%, while the NLCSC lag correction reduced 1st and 50th frame residual lags to less than 0.29% and 0.0052%. For CT reconstructions, the NLCSC lag correction gave an average error of 11 HU for the pelvic phantom and 3 HU for the head phantom, compared to 14-19 HU and 2-11 HU for the LTI corrections and 15 HU and 9 HU for the intensity weighted non-LTI algorithm. The maximum ROI error was always smallest for the NLCSC correction. The NLCSC correction was also superior to the intensity weighting algorithm.The NLCSC lag algorithm corrected for the exposure dependence of lag, provided superior image improvement for the pelvic phantom reconstruction, and gave similar results to the best case LTI results for the head phantom. The blurred ring artifact that is left over in the LTI corrections was better removed by the NLCSC correction in all cases.

    View details for DOI 10.1118/1.4752087

    View details for Web of Science ID 000310101900025

    View details for PubMedID 23039642

  • Magnetostatic focal spot correction for x-ray tubes operating in strong magnetic fields using iterative optimization MEDICAL PHYSICS Lillaney, P., Shin, M., Conolly, S. M., Fahrig, R. 2012; 39 (9): 5567-5583


    Combining x-ray fluoroscopy and MR imaging systems for guidance of interventional procedures has become more commonplace. By designing an x-ray tube that is immune to the magnetic fields outside of the MR bore, the two systems can be placed in close proximity to each other. A major obstacle to robust x-ray tube design is correcting for the effects of the magnetic fields on the x-ray tube focal spot. A potential solution is to design active shielding that locally cancels the magnetic fields near the focal spot.An iterative optimization algorithm is implemented to design resistive active shielding coils that will be placed outside the x-ray tube insert. The optimization procedure attempts to minimize the power consumption of the shielding coils while satisfying magnetic field homogeneity constraints. The algorithm is composed of a linear programming step and a nonlinear programming step that are interleaved with each other. The coil results are verified using a finite element space charge simulation of the electron beam inside the x-ray tube. To alleviate heating concerns an optimized coil solution is derived that includes a neodymium permanent magnet. Any demagnetization of the permanent magnet is calculated prior to solving for the optimized coils. The temperature dynamics of the coil solutions are calculated using a lumped parameter model, which is used to estimate operation times of the coils before temperature failure.For a magnetic field strength of 88 mT, the algorithm solves for coils that consume 588 A?cm(2). This specific coil geometry can operate for 15 min continuously before reaching temperature failure. By including a neodymium magnet in the design the current density drops to 337 A?cm(2), which increases the operation time to 59 min. Space charge simulations verify that the coil designs are effective, but for oblique x-ray tube geometries there is still distortion of the focal spot shape along with deflections of approximately 3 mm in the radial and circumferential directions on the anode.Active shielding is an attractive solution for correcting the effects of magnetic fields on the x-ray focal spot. If extremely long fluoroscopic exposure times are required, longer operation times can be achieved by including a permanent magnet with the active shielding design.

    View details for DOI 10.1118/1.4742060

    View details for Web of Science ID 000309334500027

    View details for PubMedID 22957623

  • Interventional 4-D C-Arm CT Perfusion Imaging Using Interleaved Scanning and Partial Reconstruction Interpolation IEEE TRANSACTIONS ON MEDICAL IMAGING Fieselmann, A., Ganguly, A., Yu Deuerling-Zheng, D. Z., Zellerhoff, M., Rohkohl, C., Boese, J., Hornegger, J., Fahrig, R. 2012; 31 (4): 892-906


    Tissue perfusion measurement during catheter-guided stroke treatment in the interventional suite is currently not possible. In this work, we present a novel approach that uses a C-arm angiography system capable of computed tomography (CT)-like imaging (C-arm CT) for this purpose. With C-arm CT one reconstructed volume can be obtained every 4-6 s which makes it challenging to measure the flow of an injected contrast bolus. We have developed an interleaved scanning (IS) protocol that uses several scan sequences to increase temporal sampling. Using a dedicated 4-D reconstruction approach based on partial reconstruction interpolation (PRI) we can optimally process our data. We evaluated our combined approach (IS-PRI) with simulations and a study in five healthy pigs. In our simulations, the cerebral blood flow values (unit: ml/100 g/min) were 60 (healthy tissue) and 20 (pathological tissue). For one scan sequence the values were estimated with standard deviations of 14.3 and 2.9, respectively. For two interleaved sequences the standard deviations decreased to 3.6 and 1.5, respectively. We used perfusion CT to validate the in vivo results. With two interleaved sequences we achieved promising correlations ranging from r=0.63 to r=0.94. The results suggest that C-arm CT tissue perfusion imaging is feasible with two interleaved scan sequences.

    View details for DOI 10.1109/TMI.2011.2181531

    View details for Web of Science ID 000302547400005

    View details for PubMedID 22203707

  • Empirical Cupping Correction for CT Scanners with Primary Modulation (ECCP) MEDICAL PHYSICS Grimmer, R., Fahrig, R., Hinshaw, W., Gao, H., Kachelriess, M. 2012; 39 (2): 825-831


    X-ray CT measures the attenuation of polychromatic x-rays through an object. The raw data acquired, which are the negative logarithm of the relative x-ray intensity behind the patient, must undergo water precorrection to linearize the measurement and to convert them into line integrals that are ready for reconstruction. The function to linearize the measured projection data depends on the detected spectrum of the ray. This spectrum may vary as a function of the detector position, e.g., in cases where the heel effect becomes relevant, where a bow-tie filter introduces channel-dependent beam hardening, or where a primary modulator is used to modulate the primary intensity of the spectrum.The authors propose a new approach that allows to handle these effects in a highly convenient way. Their new empirical cupping correction for primary modulation (ECCP) corrects for artifacts, such as cupping artifacts or ring artifacts, which are induced by nonlinearities in the projection data due to spatially varying pre- or postfiltration of the x-rays. To do so, ECCP requires only a simple scan of a homogeneous phantom of nearly arbitrary shape. Based on this information, coefficients of a polynomial series are calculated and stored for later use.Physical measurements demonstrate the quality of the precorrection that can be achieved using ECCP to remove the cupping artifacts and to obtain well-calibrated CT values even in cases of strong primary modulation. A combination of ECCP with analytical techniques yielding a hybrid cupping correction method is possible and allows for channel-dependent correction functions.The proposed ECCP method is a very effective and easy to incorporate approach that compensates for even strong detector channel-dependent changes of the detected spectrum. © 2011 American Association of Physicists in Medicine.

    View details for DOI 10.1118/1.3676180

    View details for Web of Science ID 000300215800028

    View details for PubMedID 22320792

  • A forward bias method for lag correction of an a-Si flat panel detector MEDICAL PHYSICS Starman, J., Tognina, C., Partain, L., Fahrig, R. 2012; 39 (1): 18-27


    Digital a-Si flat panel (FP) x-ray detectors can exhibit detector lag, or residual signal, of several percent that can cause ghosting in projection images or severe shading artifacts, known as the radar artifact, in cone-beam computed tomography (CBCT) reconstructions. A major contributor to detector lag is believed to be defect states, or traps, in the a-Si layer of the FP. Software methods to characterize and correct for the detector lag exist, but they may make assumptions such as system linearity and time invariance, which may not be true. The purpose of this work is to investigate a new hardware based method to reduce lag in an a-Si FP and to evaluate its effectiveness at removing shading artifacts in CBCT reconstructions. The feasibility of a novel, partially hardware based solution is also examined.The proposed hardware solution for lag reduction requires only a minor change to the FP. For pulsed irradiation, the proposed method inserts a new operation step between the readout and data collection stages. During this new stage the photodiode is operated in a forward bias mode, which fills the defect states with charge. A Varian 4030CB panel was modified to allow for operation in the forward bias mode. The contrast of residual lag ghosts was measured for lag frames 2 and 100 after irradiation ceased for standard and forward bias modes. Detector step response, lag, SNR, modulation transfer function (MTF), and detective quantum efficiency (DQE) measurements were made with standard and forward bias firmware. CBCT data of pelvic and head phantoms were also collected.Overall, the 2nd and 100th detector lag frame residual signals were reduced 70%-88% using the new method. SNR, MTF, and DQE measurements show a small decrease in collected signal and a small increase in noise. The forward bias hardware successfully reduced the radar artifact in the CBCT reconstruction of the pelvic and head phantoms by 48%-81%.Overall, the forward bias method has been found to greatly reduce detector lag ghosts in projection data and the radar artifact in CBCT reconstructions. The method is limited to improvements of the a-Si photodiode response only. A future hybrid mode may overcome any limitations of this method.

    View details for DOI 10.1118/1.3664004

    View details for Web of Science ID 000298812200004

    View details for PubMedID 22225271

  • Imaging Guidance with C-arm CT: Prospective Evaluation of Its Impact on Patient Radiation Exposure during Transhepatic Arterial Chemoembolization JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY Kothary, N., Abdelmaksoud, M. H., Tognolini, A., Fahrig, R., Rosenberg, J., Hovsepian, D. M., Ganguly, A., Louie, J. D., Kuo, W. T., Hwang, G. L., Holzer, A., Sze, D. Y., Hofmann, L. V. 2011; 22 (11): 1535-1544


    To prospectively evaluate the impact of C-arm CT on radiation exposure to hepatocellular carcinoma (HCC) patients treated by chemoembolization.Patients with HCC (N = 87) underwent digital subtraction angiography (DSA; control group) or combined C-arm CT/DSA (test group) for chemoembolization. Dose-area product (DAP) and cumulative dose (CD) were measured for guidance and treatment verification. Contrast agent volume and C-arm CT utility were also measured.The marginal DAP increase in the test group was offset by a substantial (50%) decrease in CD from DSA. Use of C-arm CT allowed reduction of DAP and CD from DSA imaging (P = .007 and P = .017). Experienced operators were more efficient in substituting C-arm CT for DSA, resulting in a negligible increase (7.5%) in total DAP for guidance, compared with an increase of 34% for all operators (P = .03). For treatment verification, DAP from C-arm CT exceeded that from DSA, approaching that of conventional CT. The test group used less contrast medium (P = .001), and C-arm CT provided critical or supplemental information in 20% and 17% of patients, respectively.Routine use of C-arm CT can increase stochastic risk (DAP) but decrease deterministic risk (CD) from DSA. However, the increase in DAP is operator-dependent, thus, with experience, it can be reduced to under 10%. C-arm CT provides information not provided by DSA in 33% of patients, while decreasing the use of iodinated contrast medium. As with all radiation-emitting modalities, C-arm CT should be used judiciously.

    View details for DOI 10.1016/j.jvir.2011.07.008

    View details for Web of Science ID 000296661800008

    View details for PubMedID 21875814

  • Three-dimensional anisotropic adaptive filtering of projection data for noise reduction in cone beam CT MEDICAL PHYSICS Maier, A., Wigstrom, L., Hofmann, H. G., Hornegger, J., Zhu, L., Strobel, N., Fahrig, R. 2011; 38 (11): 5896-5909


    The combination of quickly rotating C-arm gantry with digital flat panel has enabled the acquisition of three-dimensional data (3D) in the interventional suite. However, image quality is still somewhat limited since the hardware has not been optimized for CT imaging. Adaptive anisotropic filtering has the ability to improve image quality by reducing the noise level and therewith the radiation dose without introducing noticeable blurring. By applying the filtering prior to 3D reconstruction, noise-induced streak artifacts are reduced as compared to processing in the image domain.3D anisotropic adaptive filtering was used to process an ensemble of 2D x-ray views acquired along a circular trajectory around an object. After arranging the input data into a 3D space (2D projections?+?angle), the orientation of structures was estimated using a set of differently oriented filters. The resulting tensor representation of local orientation was utilized to control the anisotropic filtering. Low-pass filtering is applied only along structures to maintain high spatial frequency components perpendicular to these. The evaluation of the proposed algorithm includes numerical simulations, phantom experiments, and in-vivo data which were acquired using an AXIOM Artis dTA C-arm system (Siemens AG, Healthcare Sector, Forchheim, Germany). Spatial resolution and noise levels were compared with and without adaptive filtering. A human observer study was carried out to evaluate low-contrast detectability.The adaptive anisotropic filtering algorithm was found to significantly improve low-contrast detectability by reducing the noise level by half (reduction of the standard deviation in certain areas from 74 to 30 HU). Virtually no degradation of high contrast spatial resolution was observed in the modulation transfer function (MTF) analysis. Although the algorithm is computationally intensive, hardware acceleration using Nvidia's CUDA Interface provided an 8.9-fold speed-up of the processing (from 1336 to 150 s).Adaptive anisotropic filtering has the potential to substantially improve image quality and/or reduce the radiation dose required for obtaining 3D image data using cone beam CT.

    View details for DOI 10.1118/1.3633901

    View details for Web of Science ID 000296534000010

    View details for PubMedID 22047354

  • Cerebral CT Perfusion Using an Interventional C-Arm Imaging System: Cerebral Blood Flow Measurements AMERICAN JOURNAL OF NEURORADIOLOGY Ganguly, A., Fieselmann, A., Marks, M., Rosenberg, J., Boese, J., Deuerling-Zheng, Y., Straka, M., Zaharchuk, G., Bammer, R., Fahrig, R. 2011; 32 (8): 1525-1531


    CTP imaging in the interventional suite could reduce delays to the start of image-guided interventions and help determine the treatment progress and end point. However, C-arms rotate slower than clinical CT scanners, making CTP challenging. We developed a cerebral CTP protocol for C-arm CBCT and evaluated it in an animal study.Five anesthetized swine were imaged by using C-arm CBCT and conventional CT. The C-arm rotates in 4.3 seconds plus a 1.25-second turnaround, compared with 0.5 seconds for clinical CT. Each C-arm scan had 6 continuous bidirectional sweeps. Multiple scans each with a different delay to the start of an aortic arch iodinated contrast injection and a novel image reconstruction algorithm were used to increase temporal resolution. Three different scan sets (consisting of 6, 3, or 2 scans) and 3 injection protocols (3-mL/s 100%, 3-mL/s 67%, and 6-mL/s 50% contrast concentration) were studied. CBF maps for each scan set and injection were generated. The concordance and Pearson correlation coefficients (? and r) were calculated to determine the injection providing the best match between the following: the left and right hemispheres, and CT and C-arm CBCT.The highest ? and r values (both 0.92) for the left and right hemispheres were obtained by using the 6-mL 50% iodinated contrast concentration injection. The same injection gave the best match for CT and C-arm CBCT for the 6-scan set (? = 0.77, r = 0.89). Some of the 3-scan and 2-scan protocols provided matches similar to those in CT.This study demonstrated that C-arm CBCT can produce CBF maps that correlate well with those from CTP.

    View details for DOI 10.3174/ajnr.A2518

    View details for Web of Science ID 000295706200027

    View details for PubMedID 21757522

  • A study of the effect of in-line and perpendicular magnetic fields on beam characteristics of electron guns in medical linear accelerators MEDICAL PHYSICS Constantin, D. E., Fahrig, R., Keall, P. J. 2011; 38 (7): 4174-4185


    Using magnetic resonance imaging (MRI) for real-time guidance during radiotherapy is an active area of research and development. One aspect of the problem is the influence of the MRI scanner, modeled here as an external magnetic field, on the medical linear accelerator (linac) components. The present work characterizes the behavior of two medical linac electron guns with external magnetic fields for in-line and perpendicular orientations of the linac with respect to the MRI scanner.Two electron guns, Litton L-2087 and Varian VTC6364, are considered as representative models for this study. Emphasis was placed on the in-line design approach in which case the MRI scanner and the linac axes of symmetry coincide and assumes no magnetic shielding of the linac. For the in-line case, the magnetic field from a 0.5 T open MRI (GE Signa SP) magnet with a 60 cm gap between its poles was computed and used in full three dimensional (3D) space charge simulations, whereas for the perpendicular case the magnetic field was constant.For the in-line configuration, it is shown that the electron beam is not deflected from the axis of symmetry of the gun and the primary beam current does not vanish even at very high values of the magnetic field, e.g., 0.16 T. As the field strength increases, the primary beam current has an initial plateau of constant value after which its value decreases to a minimum corresponding to a field strength of approximately 0.06 T. After the minimum is reached, the current starts to increase slowly. For the case when the beam current computation is performed at the beam waist position the initial plateau ends at 0.016 T for Litton L-2087 and at 0.012 T for Varian VTC6364. The minimum value of the primary beam current is 27.5% of the initial value for Litton L-2087 and 22.9% of the initial value for Varian VTC6364. The minimum current is reached at 0.06 and 0.062 T for Litton L-2087 and Varian VTC6364, respectively. At 0.16 T the beam current increases to 40.2 and 31.4% from the original value of the current for Litton L-2087 and Varian VTC6364, respectively. In contrast, for the case when the electron gun is perpendicular to the magnetic field, the electron beam is deflected from the axis of symmetry even at small values of the magnetic field. As the strength of the magnetic field increases, so does the beam deflection, leading to a sharp decrease of the primary beam current which vanishes at about 0.007 T for Litton L-2087 and at 0.006 T for Varian VTC6364, respectively. At zero external field, the beam rms emittance computed at beam waist is 1.54 and 1.29n-mm-mrad for Litton L-2087 and Varian VTC6364, respectively. For the inline configuration, there are two particular values of the external field where the beam rms emittance reaches a minimum. Litton L-2087 rms emittance reaches a minimum of 0.72n and 2.01 n-mm-mrad at 0.026 and 0.132 T, respectively. Varian VTC6364 rms emittance reaches a minimum of 0.34n and 0.35n-mm-mrad at 0.028 and 0.14 T, respectively. Beam radius dependence on the external field is shown for the in-line configuration for both electron guns.3D space charge simulation of two electron guns, Litton L-2087 and Varian VTC6364, were performed for in-line and perpendicular external magnetic fields. A consistent behavior of Pierce guns in external magnetic fields was proven. For the in-line configuration, the primary beam current does not vanish but a large reduction of beam current (up to 77.1%) is observed at higher field strengths; the beam directionality remains unchanged. It was shown that for a perpendicular configuration the current vanishes due to beam bending under the action of the Lorentz force. For in-line configuration it was determined that the rms beam emittance reaches two minima for relatively high values of the external magnetic field.

    View details for DOI 10.1118/1.3600695

    View details for Web of Science ID 000292521100034

    View details for PubMedID 21859019

  • Intraprocedure Visualization of the Esophagus Using Interventional C-arm CT as Guidance for Left Atrial Radiofrequency Ablation ACADEMIC RADIOLOGY Tognolini, A., Al-Ahmad, A., Wang, P. J., Hsia, H. H., Herfkens, R. J., Girard, E., Moore, T., Fahrig, R. 2011; 18 (7): 850-857


    During radiofrequency catheter ablation for atrial fibrillation, the esophagus is at risk for thermal injury. In this study, C-arm computed tomography (CT) was compared to clinical CT, without the administration of oral contrast, to visualize the esophagus and its relationship to the left atrium and the ostia of the pulmonary veins (PVs) during the radiofrequency ablation procedure.Sixteen subjects underwent both cardiac clinical CT and C-arm CT. Computed tomographic scans were performed on a multidetector scanner using a standard electrocardiographically gated protocol. C-arm computed tomographic scans were obtained using either a multisweep protocol with retrospective electrocardiographic gating or a non-gated single-sweep protocol. C-arm and clinical computed tomographic scans were analyzed in a random order and then compared for the following criteria: (1) visualization of the esophagus (yes or no), (2) relationship of esophageal position to the four PVs, and (3) direct contact or absence of a fat pad between the esophagus and the PV antrum.The esophagus was identified in all C-arm and clinical computed tomographic scans. In four cases, orthogonal planes were needed on C-arm CT (inferior PV level). In six patients, the esophageal location on C-arm CT was different from that on CT. Direct contact was reported in 19 of 64 of the segments (30%) examined on CT and in 26 of 64 (41%) on C-arm CT. In five of 64 segments (8%), C-arm CT overestimated a direct contact of the esophagus to the left atrium.C-arm computed tomographic image quality without the administration of oral contrast agents was shown to be sufficient for visualization of the esophagus location during a radiofrequency catheter ablation procedure for atrial fibrillation.

    View details for DOI 10.1016/j.acra.2011.01.023

    View details for Web of Science ID 000292066200010

    View details for PubMedID 21440465

  • A model for filtered backprojection reconstruction artifacts due to time-varying attenuation values in perfusion C-arm CT PHYSICS IN MEDICINE AND BIOLOGY Fieselmann, A., Dennerlein, F., Deuerling-Zheng, Y., Boese, J., Fahrig, R., Hornegger, J. 2011; 56 (12): 3701-3717


    Filtered backprojection is the basis for many CT reconstruction tasks. It assumes constant attenuation values of the object during the acquisition of the projection data. Reconstruction artifacts can arise if this assumption is violated. For example, contrast flow in perfusion imaging with C-arm CT systems, which have acquisition times of several seconds per C-arm rotation, can cause this violation. In this paper, we derived and validated a novel spatio-temporal model to describe these kinds of artifacts. The model separates the temporal dynamics due to contrast flow from the scan and reconstruction parameters. We introduced derivative-weighted point spread functions to describe the spatial spread of the artifacts. The model allows prediction of reconstruction artifacts for given temporal dynamics of the attenuation values. Furthermore, it can be used to systematically investigate the influence of different reconstruction parameters on the artifacts. We have shown that with optimized redundancy weighting function parameters the spatial spread of the artifacts around a typical arterial vessel can be reduced by about 70%. Finally, an inversion of our model could be used as the basis for novel dynamic reconstruction algorithms that further minimize these artifacts.

    View details for DOI 10.1088/0031-9155/56/12/016

    View details for Web of Science ID 000291095700017

    View details for PubMedID 21617289

  • Investigation into the optimal linear time-invariant lag correction for radar artifact removal MEDICAL PHYSICS Starman, J., Star-Lack, J., Virshup, G., Shapiro, E., Fahrig, R. 2011; 38 (5): 2398-2411


    Detector lag, or residual signal, in amorphous silicon (a-Si) flat-panel (FP) detectors can cause significant shading artifacts in cone-beam computed tomography (CBCT) reconstructions. To date, most correction models have assumed a linear, time-invariant (LTI) model and lag is corrected by deconvolution with an impulse response function (IRF). However, there are many ways to determine the IRF. The purpose of this work is to better understand detector lag in the Varian 4030CB FP and to identify the IRF measurement technique that best removes the CBCT shading artifact.We investigated the linearity of lag in a Varian 4030CB a-Si FP operating in dynamic gain mode at 15 frames per second by examining the rising step-response function (RSRF) followed by the falling step-response function (FSRF) at ten incident exposures (0.5%-84% of a-Si FP saturation exposure). We implemented a multiexponential (N = 4) LTI model for lag correction and investigated the effects of various techniques for determining the IRF such as RSRF versus FSRF, exposure intensity, length of exposure, and spatial position. The resulting IRFs were applied to (1) the step-response projection data and (2) CBCT acquisitions of a large pelvic phantom and acrylic head phantom. For projection data, 1st and 50th frame lags were measured pre- and postcorrection. For the CBCT reconstructions, four pairs of ROIs were defined and the maximum and mean errors within each pair were calculated for the different exposures and step-response edge techniques.A nonlinearity greater than 50% was observed in the FSRF data. A model calibrated with RSRF data resulted in overcorrection of FSRF data. Conversely, models calibrated with FSRF data applied to RSRF data resulted in undercorrection of the RSRF. Similar effects were seen when LTI models were applied to data collected at different incident exposures. Some spatial variation in lag was observed in the step-response data. For CBCT reconstructions, an average error range of 3-21 HU was observed when using IRFs from different techniques. For our phantoms and FP, the lowest average error occurred for the FSRF-based techniques at exposures of 1.6 or 3.4% a-Si FP saturation, depending on the phantom used.The choice of step-response edge (RSRF versus FSRF) and exposure intensity for IRF calibration could leave large residual lag in the step-response data. For the CBCT reconstructions, IRFs derived from FSRF data at low exposure intensities (1.6 and 3.4%) best removed the CBCT shading artifact. Which IRF to use for lag correction could be selected based on the object size.

    View details for DOI 10.1118/1.3574873

    View details for Web of Science ID 000290625700013

    View details for PubMedID 21776774

  • Contrast-Enhanced C-Arm CT Evaluation of Radiofrequency Ablation Lesions in the Left Ventricle JACC-CARDIOVASCULAR IMAGING Girard, E. E., Al-Ahmad, A., Rosenberg, J., Luong, R., Moore, T., Lauritsch, G., Boese, J., Fahrig, R. 2011; 4 (3): 259-268


    The purpose of this study was to evaluate use of cardiac C-arm computed tomography (CT) in the assessment of the dimensions and temporal characteristics of radiofrequency ablation (RFA) lesions. This imaging modality uses a standard C-arm fluoroscopy system rotating around the patient, providing CT-like images during the RFA procedure.Both cardiac magnetic resonance (CMR) and CT can be used to assess myocardial necrotic tissue. Several studies have reported visualizing cardiac RFA lesions with CMR; however, obtaining CMR images during interventional procedures is not common practice. Direct visualization of RFA lesions using C-arm CT during the procedure may improve outcomes and circumvent complications associated with cardiac ablation procedures.RFA lesions were created on the endocardial surface of the left ventricle of 9 swine using a 7-F RFA catheter. An electrocardiographically gated C-arm CT imaging protocol was used to acquire projection images during iodine contrast injection and after the injection every 5 min for up to 30 min, with no additional contrast. Reconstructed images were analyzed offline. The mean and SD of the signal intensity of the lesion and normal myocardium were measured in all images in each time series. Lesion dimensions and area were measured and compared in pathologic specimens and C-arm CT images.All ablation lesions (n = 29) were visualized and lesion dimensions, as measured on C-arm CT, correlated well with postmortem tissue measurements (linear dimensions: concordance correlation = 0.87; area: concordance correlation = 0.90. Lesions were visualized as a perfusion defect on first-pass C-arm CT images with a signal intensity of 95 HU lower than that of normal myocardium (95% confidence interval: -111 HU to -79 HU). Images acquired at 1 and 5 min exhibited an enhancing ring surrounding the perfusion defect in 24 lesions (83%).RFA lesion size, including transmurality, can be assessed using electrocardiographically gated cardiac C-arm CT in the interventional suite. Visualization of RFA lesions using cardiac C-arm CT may facilitate the assessment of adequate lesion delivery and provide valuable feedback during cardiac ablation procedures.

    View details for DOI 10.1016/j.jcmg.2010.11.019

    View details for Web of Science ID 000289083000008

    View details for PubMedID 21414574

  • In-vitro Imaging of Femoral Artery Nitinol Stents for Deformation Analysis JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY Ganguly, A., Simons, J., Schneider, A., Keck, B., Bennett, N. R., Fahrig, R. 2011; 22 (2): 236-243


    Femoral artery stents are prone to fracture, and studying their deformations could lead to a better understanding of the cause of breakage. The present study sought to develop a method of imaging and analyzing stent deformation in vitro with use of a calibrated test device.High-resolution (approximately 200 ?m) volumetric data were obtained with a flat-panel detector-based C-arm computed tomography system. A nitinol stent placed in a testing device was imaged with various loads that caused bending, axial tension, and torsion. Semiautomatic software was developed to calculate the bending, extension, and torsion from the stent images by measuring the changes in the radius of curvature, eccentricity, and angular distortions.For the axial tension case, there was generally good agreement between the physical measurements and the image-based measurements. The bending measurements had better agreement at bend angles lower than 30°. For stent torsion, the hysteresis between the loading and unloading curves were larger for the image-based results compared with physical measurements.An imaging and analysis framework has been set up for the analysis of stent deformations that shows fairly good agreement between physical and image-based measurements.

    View details for DOI 10.1016/j.jvir.2010.10.017

    View details for Web of Science ID 000287166600017

    View details for PubMedID 21276916

  • In-vivo Imaging of Femoral Artery Nitinol Stents for Deformation Analysis JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY Ganguly, A., Simons, J., Schneider, A., Keck, B., Bennett, N. R., Herfkens, R. J., Coogan, S. M., Fahrig, R. 2011; 22 (2): 244-249


    The authors have developed a direct method to study femoral artery stent deformations in vivo. A previously described imaging and analysis approach based on a calibrated phantom was used to examine stents in human volunteers treated for atherosclerotic disease. In this pilot study, forces on stents were evaluated under different in-vivo flexion conditions.The optimized imaging protocol for imaging with a C-arm computed tomography system was first verified in an in-vivo porcine stent model. Human data were obtained by imaging 13 consenting volunteers with stents in femoral vessels. The affected leg was imaged in straight and bent positions to observe stent deformations. Semiautomatic software was used to calculate the changes in bending, extension, and torsion on the stents for the two positions.For the human studies, tension and bending calculation were successful. Bending was found to compress stent lengths by 4% ± 3% (-14.2 to 1.5 mm), increase their average eccentricity by 10% ± 9% (0.12 to -0.16), and change their mean curvature by 27% ± 22% (0 to -0.005 mm(-1)). Stents with the greatest change in eccentricity and curvature were located behind the knee or in the pelvis. Torsion calculations were difficult because the stents were untethered and are symmetric. In addition, multiple locations in each stent underwent torsional deformations.The imaging and analysis approach developed based on calibrated in vitro measurements was extended to in-vivo data. Bending and tension forces were successfully evaluated in this pilot study.

    View details for DOI 10.1016/j.jvir.2010.10.019

    View details for Web of Science ID 000287166600018

    View details for PubMedID 21276917

  • Automatic measurement of contrast bolus distribution in carotid arteries using a C-arm angiography system to support interventional perfusion imaging MEDICAL IMAGING 2011: VISUALIZATION, IMAGE-GUIDED PROCEDURES, AND MODELING Fieselmann, A., Ganguly, A., Yu Deuerling-Zheng, D. Z., Boese, J., Hornegger, J., Fahrig, R. 2011; 7964

    View details for DOI 10.1117/12.877658

    View details for Web of Science ID 000294224900064

  • Modulator design for x-ray scatter correction using primary modulation: Material selection MEDICAL PHYSICS Gao, H., Zhu, L., Fahrig, R. 2010; 37 (8): 4029-4037


    An optimal material selection for primary modulator is proposed in order to minimize beam hardening of the modulator in x-ray cone-beam computed tomography (CBCT). Recently, a measurement-based scatter correction method using primary modulation has been developed and experimentally verified. In the practical implementation, beam hardening of the modulator blocker is a limiting factor because it causes inconsistency in the primary signal and therefore degrades the accuracy of scatter correction.This inconsistency can be purposely assigned to the effective transmission factor of the modulator whose variation as a function of object filtration represents the magnitude of beam hardening of the modulator. In this work, the authors show that the variation reaches a minimum when the K-edge of the modulator material is near the mean energy of the system spectrum. Accordingly, an optimal material selection can be carried out in three steps. First, estimate and evaluate the polychromatic spectrum for a given x-ray system including both source and detector; second, calculate the mean energy of the spectrum and decide the candidate materials whose K-edge energies are near the mean energy; third, select the optimal material from the candidates after considering both the magnitude of beam hardening and the physical and chemical properties.A tabletop x-ray CBCT system operated at 120 kVp is used to validate the material selection method in both simulations and experiments, from which the optimal material for this x-ray system is then chosen. With the transmission factor initially being 0.905 and 0.818, simulations show that erbium provides the least amount of variation as a function of object filtrations (maximum variations are 2.2% and 4.3%, respectively, only one-third of that for copper). With different combinations of aluminum and copper filtrations (simulating a range of object thicknesses), measured overall variations are 2.5%, 1.0%, and 8.6% for 25.4 microm of copper, erbium, and tungsten, respectively. With and without 300 microm of copper in the beam, the measured variations for 25.4 microm of copper, erbium, and tungsten, 1 mm of aluminum, as well as 406 microm of copper, are 1.8%, 0.2%, 5.5%, 1.9%, and 7.5%, respectively.The spatial variation in the effective transmission factor of the modulator blocker due to beam hardening caused by the modulator itself reaches a minimum when the K-edge of the modulator material is near the mean energy of the spectrum. An optimal modulator material selection using the K-edge discontinuity is therefore proposed.

    View details for DOI 10.1118/1.3457472

    View details for Web of Science ID 000281112900013

    View details for PubMedID 20879564

  • Dose and detectability for a cone-beam C-arm CT system revisited MEDICAL PHYSICS Ganguly, A., Yoon, S., Fahrig, R. 2010; 37 (5): 2264-2268


    The authors had previously published measurements of the detectability of disk-shaped contrast objects in images obtained from a C-arm CT system. A simple approach based on Rose's criterion was used to scale the date, assuming the threshold for the smallest diameter detected should be inversely proportional to (dose)1/2. A more detailed analysis based on recent theoretical modeling of C-arm CT images is presented in this work.The signal and noise propagations in a C-arm based CT system have been formulated by other authors using cascaded systems analysis. They established a relationship between detectability and the noise equivalent quanta. Based on this model, the authors obtained a relation between x-ray dose and the diameter of the smallest disks detected. A closed form solution was established by assuming no rebinning and no resampling of data, with low additive noise and using a ramp filter. For the case when no such assumptions were made, a numerically calculated solution using previously reported imaging and reconstruction parameters was obtained. The detection probabilities for a range of dose and kVp values had been measured previously. These probabilities were normalized to a single dose of 56.6 mGy using the Rose-criteria-based relation to obtain a universal curve. Normalizations based on the new numerically calculated relationship were compared to the measured results.The theoretical and numerical calculations have similar results and predict the detected diameter size to be inversely proportional to (dose)1/3 and (dose)1/2.8, respectively. The normalized experimental curves and the associated universal plot using the new relation were not significantly different from those obtained using the Rose-criterion-based normalization.From numerical simulations, the authors found that the diameter of detected disks depends inversely on the cube root of the dose. For observer studies for disks larger than 4 mm, the cube root as well as square root relations appear to give similar results when used for normalization.

    View details for DOI 10.1118/1.3397465

    View details for Web of Science ID 000277242800034

    View details for PubMedID 20527560

  • Simultaneous segmentation and reconstruction: A level set method approach for limited view computed tomography MEDICAL PHYSICS Yoon, S., Pineda, A. R., Fahrig, R. 2010; 37 (5): 2329-2340


    An iterative tomographic reconstruction algorithm that simultaneously segments and reconstructs the reconstruction domain is proposed and applied to tomographic reconstructions from a sparse number of projection images.The proposed algorithm uses a two-phase level set method segmentation in conjunction with an iterative tomographic reconstruction to achieve simultaneous segmentation and reconstruction. The simultaneous segmentation and reconstruction is achieved by alternating between level set function evolutions and per-region intensity value updates. To deal with the limited number of projections, a priori information about the reconstruction is enforced via penalized likelihood function. Specifically, smooth function within each region (piecewise smooth function) and bounded function intensity values for each region are assumed. Such a priori information is formulated into a quadratic objective function with linear bound constraints. The level set function evolutions are achieved by artificially time evolving the level set function in the negative gradient direction; the intensity value updates are achieved by using the gradient projection conjugate gradient algorithm.The proposed simultaneous segmentation and reconstruction results were compared to "conventional" iterative reconstruction (with no segmentation), iterative reconstruction followed by segmentation, and filtered backprojection. Improvements of 6%-13% in the normalized root mean square error were observed when the proposed algorithm was applied to simulated projections of a numerical phantom and to real fan-beam projections of the Catphan phantom, both of which did not satisfy the a priori assumptions.The proposed simultaneous segmentation and reconstruction resulted in improved reconstruction image quality. The algorithm correctly segments the reconstruction space into regions, preserves sharp edges between different regions, and smoothes the noise within each region. The proposed algorithm framework has the flexibility to be adapted to different a priori constraints while maintaining the benefits achieved by the simultaneous segmentation and reconstruction.

    View details for DOI 10.1118/1.3397463

    View details for Web of Science ID 000277242800041

    View details for PubMedID 20527567

  • A Patient Set-up Protocol Based on Partially Blocked Cone-beam CT TECHNOLOGY IN CANCER RESEARCH & TREATMENT Zhu, L., Wang, J., Xie, Y., Starman, J., Fahrig, R., Xing, L. 2010; 9 (2): 191-198


    Three-dimensional x-ray cone-beam CT (CBCT) is being increasingly used in radiation therapy. Since the whole treatment course typically lasts several weeks, the repetitive x-ray imaging results in large radiation dose delivered on the patient. In the current radiation therapy treatment, CBCT is mainly used for patient set-up, and a rigid transformation of the CBCT data from the planning CT data is also assumed. For an accurate rigid registration, it is not necessary to acquire a full 3D image. In this paper, we propose a patient set-up protocol based on partially blocked CBCT. A sheet of lead strips is inserted between the x-ray source and the scanned patient. From the incomplete projection data, only several axial slices are reconstructed and used in the image registration for patient set-up. Since the radiation is partially blocked, the dose delivered onto the patient is significantly reduced, with an additional benefit of reduced scatter signals. The proposed approach is validated using experiments on two anthropomorphic phantoms. As x-ray beam blocking ratio increases, more dose reduction is achieved, while the patient set-up error also increases. To investigate this tradeoff, two lead sheets with different strip widths are implemented, which correspond to radiation dose reduction of approximately 6 and approximately 11, respectively. We compare the registration results using the partially blocked CBCT with those using the regular CBCT. Both lead sheets achieve high patient set-up accuracies. It is seen that, using the lead sheet with radiation dose reduction by a factor of approximately 11, the patient set-up error is still less than 1mm in translation and less than 0.2 degrees in rotation. The comparison of the reconstructed images also shows that the image quality of the illuminated slices in the partially blocked CBCT is much improved over that in the regular CBCT.

    View details for Web of Science ID 000276135400008

    View details for PubMedID 20218741

  • Scatter correction method for x-ray CT using primary modulation: Phantom studies MEDICAL PHYSICS Gao, H., Fahrig, R., Bennett, N. R., Sun, M., Star-Lack, J., Zhu, L. 2010; 37 (2): 934-946


    Scatter correction is a major challenge in x-ray imaging using large area detectors. Recently, the authors proposed a promising scatter correction method for x-ray computed tomography (CT) using primary modulation. Proof of concept was previously illustrated by Monte Carlo simulations and physical experiments on a small phantom with a simple geometry. In this work, the authors provide a quantitative evaluation of the primary modulation technique and demonstrate its performance in applications where scatter correction is more challenging.The authors first analyze the potential errors of the estimated scatter in the primary modulation method. On two tabletop CT systems, the method is investigated using three phantoms: A Catphan 600 phantom, an anthropomorphic chest phantom, and the Catphan 600 phantom with two annuli. Two different primary modulators are also designed to show the impact of the modulator parameters on the scatter correction efficiency. The first is an aluminum modulator with a weak modulation and a low modulation frequency, and the second is a copper modulator with a strong modulation and a high modulation frequency.On the Catphan 600 phantom in the first study, the method reduces the error of the CT number in the selected regions of interest (ROIs) from 371.4 to 21.9 Hounsfield units (HU); the contrast to noise ratio also increases from 10.9 to 19.2. On the anthropomorphic chest phantom in the second study, which represents a more difficult case due to the high scatter signals and object heterogeneity, the method reduces the error of the CT number from 327 to 19 HU in the selected ROIs and from 31.4% to 5.7% on the overall average. The third study is to investigate the impact of object size on the efficiency of our method. The scatter-to-primary ratio estimation error on the Catphan 600 phantom without any annulus (20 cm in diameter) is at the level of 0.04, it rises to 0.07 and 0.1 on the phantom with an elliptical annulus (30 cm in the minor axis and 38 cm in the major axis) and with a circular annulus (38 cm in diameter).On the three phantom studies, good scatter correction performance of the proposed method has been demonstrated using both image comparisons and quantitative analysis. The theory and experiments demonstrate that a strong primary modulation that possesses a low transmission factor and a high modulation frequency is preferred for high scatter correction accuracy.

    View details for DOI 10.1118/1.3298014

    View details for Web of Science ID 000274075600054

    View details for PubMedID 20229902

  • Evaluating the Feasibility of C-arm CT for Brain Perfusion Imaging: An in vitro Study MEDICAL IMAGING 2010: VISUALIZATION, IMAGE-GUIDED PROCEDURES, AND MODELING GANGULY, A., Fieselmann, A., Boese, J., Rohkohl, C., Hornegger, J., Fahrig, R. 2010; 7625

    View details for DOI 10.1117/12.845386

    View details for Web of Science ID 000285047500019

  • A Filter Model to Analyze Reconstruction Artifacts in Perfusion C-arm CT 2010 IEEE NUCLEAR SCIENCE SYMPOSIUM CONFERENCE RECORD (NSS/MIC) Fieselmann, A., Dennerlein, F., Deuerling-Zheng, Y., Boese, J., Fahrig, R., Hornegger, J. 2010: 2239-2242
  • Cardiac C-Arm CT: A Unified Framework for Motion Estimation and Dynamic CT IEEE TRANSACTIONS ON MEDICAL IMAGING Pruemmer, M., Hornegger, J., Lauritsch, G., Wigstroem, L., Girard-Hughes, E., Fahrig, R. 2009; 28 (11): 1836-1849


    Generating 3-D images of the heart during interventional procedures is a significant challenge. In addition to real time fluoroscopy, angiographic C-arm systems can also now be used to generate 3-D/4-D CT images on the same system. One protocol for cardiac CT uses ECG triggered multisweep scans. A 3-D volume of the heart at a particular cardiac phase is then reconstructed by applying Feldkamp (FDK) reconstruction to the projection images with retrospective ECG gating. In this work we introduce a unified framework for heart motion estimation and dynamic cone-beam reconstruction using motion corrections. The benefits of motion correction are 1) increased temporal and spatial resolution by removing cardiac motion which may still exist in the ECG gated data sets and 2) increased signal-to-noise ratio (SNR) by using more projection data than is used in standard ECG gated methods. Three signal-enhanced reconstruction methods are introduced that make use of all of the acquired projection data to generate a 3-D reconstruction of the desired cardiac phase. The first averages all motion corrected back-projections; the second and third perform a weighted averaging according to 1) intensity variations and 2) temporal distance relative to a time resolved and motion corrected reference FDK reconstruction. In a comparison study seven methods are compared: nongated FDK, ECG-gated FDK, ECG-gated, and motion corrected FDK, the three signal-enhanced approaches, and temporally aligned and averaged ECG-gated FDK reconstructions. The quality measures used for comparison are spatial resolution and SNR. Evaluation is performed using phantom data and animal models. We show that data driven and subject-specific motion estimation combined with motion correction can decrease motion-related blurring substantially. Furthermore, SNR can be increased by up to 70% while maintaining spatial resolution at the same level as is provided by the ECG-gated FDK. The presented framework provides excellent image quality for cardiac C-arm CT.

    View details for DOI 10.1109/TMI.2009.2025499

    View details for Web of Science ID 000271437600018

    View details for PubMedID 19884068

  • Simulations of Virtual PET/CT 3-D Bronchoscopy Imaging Using a Physical Porcine Lung-Heart Phantom MOLECULAR IMAGING AND BIOLOGY Yerushalmi, D., Mullick, R., Quon, A., Fahrig, R., Pelc, N. J., Fann, J. I., Gambhir, S. S. 2009; 11 (4): 275-282


    We present a systematic approach for studying positron emission tomography-computed tomography (PET/CT) 3-D virtual fly-through endoscopy and for assessing the accuracy of this technology for visualizing and detecting endobronchial lesions as a function of focal lesion morphology and activity.Capsules designed to simulate endobronchial lesions were filled with activity and introduced into a porcine lung-heart phantom. PET/CT images were acquired, reconstructed, and volume rendered as 3-D fly-through and fly-around visualizations. Anatomical positioning of lesions seen on the 3-D-volume-rendered PET/CT images was compared to the actual position of the capsules.Lesion size was observed to be highly sensitive to PET threshold parameter settings and careful opacity and color transfer function parameter assignment.We have demonstrated a phantom model for studies of PET/CT 3-D virtual fly-through bronchoscopy and have applied this model for understanding the effect of PET thresholding on the visualization and detection of lesions.

    View details for DOI 10.1007/s11307-009-0201-8

    View details for Web of Science ID 000266830700010

    View details for PubMedID 19434462

  • Closed bore XMR (CBXMR) systems for aortic valve replacement: Active magnetic shielding of x-ray tubes MEDICAL PHYSICS Bracken, J. A., DeCrescenzo, G., Komljenovic, P., Lillaney, P. V., Fahrig, R., Rowlands, J. A. 2009; 36 (5): 1717-1726


    Hybrid closed bore x-ray/MRI systems are being developed to improve the safety and efficacy of percutaneous aortic valve replacement procedures by harnessing the complementary strengths of the x-ray and MRI modalities in a single interventional suite without requiring patient transfer between two rooms. These systems are composed of an x-ray C-arm in close proximity (approximately 1 m) to an MRI scanner. The MRI magnetic fringe field can cause the electron beam in the x-ray tube to deflect. The deflection causes the x-ray field of view to shift position on the detector receptacle. This could result in unnecessary radiation exposure to the patient and the staff in the cardiac catheterization laboratory. Therefore, the electron beam deflection must be corrected. The authors developed an active magnetic shielding system that can correct for electron beam deflection to within an accuracy of 5% without truncating the field of view or increasing exposure to the patient. This system was able to automatically adjust to different field strengths as the external magnetic field acting on the x-ray tube was changed. Although a small torque was observed on the shielding coils of the active shielding system when they were placed in a magnetic field, this torque will not impact their performance if they are securely mounted on the x-ray tube and the C-arm. The heating of the coils of the shielding system for use in the clinic caused by electric current was found to be slow enough not to require a dedicated cooling system for one percutaneous aortic valve replacement procedure. However, a cooling system will be required if multiple procedures are performed in one session.

    View details for DOI 10.1118/1.3116363

    View details for Web of Science ID 000265526800030

    View details for PubMedID 19544789

  • MR Voiding Cystography for Evaluation of Vesicoureteral Reflux AMERICAN JOURNAL OF ROENTGENOLOGY Vasanawala, S. S., Kennedy, W. A., Ganguly, A., Fahrig, R., Rieke, V., Daniel, B., Barth, R. A. 2009; 192 (5): W206-W211


    The purpose of our study is to present a real-time interactive continuous fluoroscopy MRI technique for vesicoureteral reflux (VUR) diagnosis.MR voiding cystography with a real-time interactive MR fluoroscopic technique on an open MRI magnet is feasible for the evaluation of VUR in children.

    View details for DOI 10.2214/AJR.08.1251

    View details for Web of Science ID 000265387300045

    View details for PubMedID 19380524

  • Closed-bore XMR (CBXMR) systems for aortic valve replacement: X-ray tube imaging performance MEDICAL PHYSICS Bracken, J. A., Komljenovic, P., Lillaney, P. V., Fahrig, R., Rowlands, J. A. 2009; 36 (4): 1086-1097


    A hybrid closed-bore x-ray/MRI system (CBXMR) is proposed to improve the safety and efficacy of percutaneous aortic valve replacement procedures. In this system, an x-ray C-arm will be positioned about 1 m from the entrance of a 1.5 T MRI scanner. The CBXMR system will harness the complementary strengths of both modalities to guide and deploy a bioprosthetic valve into the aortic annulus of the heart without coronary artery obstruction. A major challenge in constructing this system is ensuring proper operation of a rotating-anode x-ray tube in the MRI magnetic fringe field environment. The electron beam in the x-ray tube responsible for producing x rays can be deflected by the fringe field. However, the clinical impact of electron beam deflection in a magnetic field has not yet been studied. Here, the authors investigated changes in focal spot resolving power, field of view shift, and field of view truncation in x-ray images as a result of electron beam deflection. The authors found that in the fringe field acting on the x-ray tube at the clinical location for the x-ray C-arm (4 mT), focal spot size increased by only 2%, so the fringe field did not limit the resolving power of the x-ray system. The magnetic field also caused the field of view to shift by 3 mm. This shift must be corrected to avoid unnecessary primary radiation exposure to the patient and the staff in the cardiac catheterization laboratory. The fringe field was too weak to cause field of view truncation.

    View details for DOI 10.1118/1.3086188

    View details for Web of Science ID 000264733800006

    View details for PubMedID 19472613

  • Characterization of a novel anthropomorphic plastinated lung phantom MEDICAL PHYSICS Yoon, S., Henry, R. W., Bouley, D. M., Bennett, N. R., Fahrig, R. 2008; 35 (12): 5934-5943


    Phantoms are widely used during the development of new imaging systems and algorithms. For development and optimization of new imaging systems such as tomosynthesis, where conventional image quality metrics may not be applicable, a realistic phantom that can be used across imaging systems is desirable. A novel anthropomorphic lung phantom was developed by plastination of an actual pig lung. The plastinated phantom is characterized and compared with reference to in vivo images of the same tissue prior to plastination using high resolution 3D CT. The phantom is stable over time and preserves the anatomical features and relative locations of the in vivo sample. The volumes for different tissue types in the phantom are comparable to the in vivo counterparts, and CT numbers for different tissue types fall within a clinically useful range. Based on the measured CT numbers, the phantom cardiac tissue experienced a 92% decrease in bulk density and the phantom pulmonary tissue experienced a 78% decrease in bulk density compared to their in vivo counterparts. By-products in the phantom from the room temperature vulcanizing silicone and plastination process are also identified. A second generation phantom, which eliminates most of the by-products, is presented. Such anthropomorphic phantoms can be used to evaluate a wide range of novel imaging systems.

    View details for DOI 10.1118/1.3016524

    View details for Web of Science ID 000261210000070

    View details for PubMedID 19175148

  • Shimming with permanent magnets for the x-ray detector in a hybrid x-ray/MR system MEDICAL PHYSICS Wen, Z., Fahrig, R., Williams, S. T., Pelc, N. J. 2008; 35 (9): 3895-3902


    In this x-ray/MR hybrid system an x-ray flat panel detector is placed under the patient cradle, close to the MR volume of interest (VOI), where the magnetic field strength is approximately 0.5 T. Immersed in this strong field, several electronic components inside the detector become magnetized and create an additional magnetic field that is superimposed on the original field of the MR scanner. Even after linear shimming, the field homogeneity of the MR scanner remains disrupted by the detector. The authors characterize the field due to the detector with the field of two magnetic dipoles and further show that two sets of permanent magnets (NdFeB) can withstand the main magnetic field and compensate for the nonlinear components of the additional field. The ideal number of magnets and their locations are calculated based on a field map measured with the detector in place. Experimental results demonstrate great promise for this technique, which may be useful in many settings where devices with magnetic components need to be placed inside or close to an MR scanner.

    View details for DOI 10.1118/1.2963994

    View details for Web of Science ID 000258773000009

    View details for PubMedID 18841840

  • Closed bore XMR (CBXMR) systems for aortic valve replacement: Investigation of rotating-anode x-ray tube heat loadability MEDICAL PHYSICS Bracken, J. A., Lillaney, P. V., Fahrig, R., Rowlands, J. A. 2008; 35 (9): 4049-4062


    In order to improve the safety and efficacy of percutaneous aortic valve replacement procedures, a closed bore hybrid x-ray/MRI (CBXMR) system is proposed in which an x-ray C-arm will be positioned with its isocenter approximately =1 m from the entrance of a clinical MRI scanner. This system will harness the complementary strengths of both modalities to improve clinical outcome. A key component of the CBXMR system will be a rotating anode x-ray tube to produce high-quality x-ray images. There are challenges in positioning an x-ray tube in the magnetic fringe field of the MRI magnet. Here, the effects of an external magnetic field on x-ray tube induction motors of radiography x-ray tubes and the corresponding reduction of x-ray tube heat loadability are investigated. Anode rotation frequency f(aode) was unaffected when the external magnetic field Bb was parallel to the axis of rotation of the anode but decreased when Bb was perpendicular to the axis of rotation. The experimental f(anode) values agreed with predicted values to within +/-3% over a Bb range of 0-30 mT. The MRI fringe field at the proposed location of the x-ray tube mounted on the C-arm (approximately =4 mT) reduced f(anode) by only 1%, so x-ray tube heat loadability will not be compromised when using CBXMR systems for percutaneous aortic valve replacement procedures. Eddy current heating power in the rotor due to an MRI fringe field was found to be two orders of magnitude weaker than the heating power produced on the anode due to a fluoroscopic exposure, so eddy current heating had no effect on x-ray tube heat loadability.

    View details for DOI 10.1118/1.2968337

    View details for Web of Science ID 000258773000026

    View details for PubMedID 18841857

  • Time-resolved three-dimensional imaging of the left atrium and pulmonary veins in the interventional suite - A comparison between muttisweep gated rotational three-dimensional reconstructed fluoroscopy and multislice computed tomography HEART RHYTHM Al-Ahmad, A., Wigstroem, L., Sandner-Porkristl, D., Wang, P. J., Zei, P. C., Boese, J., Lauritsch, G., Moore, T., Chan, F., Fahrig, R. 2008; 5 (4): 513-519


    Cardiac computed tomography (CT) is commonly used to visualize left atrial (LA) anatomy for ablation of atrial fibrillation. We have developed a new imaging technique that allows acquisition and visualization of three-dimensional (3D) cardiac images in the catheter lab.We sought to compare LA and pulmonary vein (PV) dimensions acquired using gated multisweep rotational fluoroscopy (C-arm CT) system and multislice computed tomography (MSCT) in an in vivo porcine model.A Siemens AXIOM Artis dTA C-arm system (Siemens AG, Medical Solutions) was modified to allow acquisition of four bidirectional sweeps during synchronized acquisition of the electrocardiogram signal to allow retrospective gating. C-arm CT image volumes were then reconstructed. Gated MSCT (SOMATOM Sensation 16 and 64, Siemens AG, Medical Solutions) and C-arm CT images were acquired in six animals. The two main PV diameters were measured in orthogonal axes. LA volumes were calculated. C-arm CT measurements were compared with the MSCT measurements.The average PV diameters using the C-arm CT were 2.24 x 1.35 cm, versus 2.27 x 1.38 cm for CT. The average difference was 0.034 cm (1.9%) between the C-arm CT and standard CT. The average LA volume using MSCT was 49.1 +/- 12.7 cm(3), as compared with 51.0 +/- 8.7 cm(3) obtained by the C-arm CT. The average difference between the C-arm CT and the MSCT was 1.9 cm(3) (3.7%). There were no significant differences in either the PV or LA measurements.Visualization of 3D cardiac anatomy during ablation procedures is possible and highly accurate. The 3D cardiac reconstructions acquired during ablation procedures will be valuable for procedural planning and guidance.

    View details for DOI 10.1016/j.hrthm.2007.12.027

    View details for Web of Science ID 000254596600003

    View details for PubMedID 18362018

  • Experimental study of intracranial hematoma detection with flat panel detector C-arm CT AMERICAN JOURNAL OF NEURORADIOLOGY Arakawa, H., Marks, M. P., Do, H. M., Bouley, D. M., Strobel, N., Moore, T., Fahrig, R. 2008; 29 (4): 766-772


    Intracranial hemorrhage is a commonly acknowledged complication of interventional neuroradiology procedures, and the ability to image hemorrhage at the time of the procedure would be very beneficial. A new C-arm system with 3D functionality extends the capability of C-arm imaging to include soft-tissue applications by facilitating the detection of low-contrast objects. We evaluated its ability to detect small intracranial hematomas in a swine model.Intracranial hematomas were created in 7 swine by autologous blood injection of various hematocrits (19%-37%) and volumes (1.5-5 mL). Four animals received intravascular contrast before obtaining autologous blood (group 1), and 3 did not (group 2). We scanned each animal by using the C-arm CT system, acquiring more than 500 images during a 20-second rotation through more than 200 degrees . Multiplanar reformatted images with isotropic resolution were reconstructed on the workstation by using product truncation, scatter, beam-hardening, and ring-artifact correction algorithms. The brains were harvested and sliced for hematoma measurement and compared with imaging findings.Five intracranial hematomas were created in group 1 animals, and all were visualized. Six were created in group 2, and 3 were visualized. One nonvisualized hematoma was not confirmed at necropsy. All the others in both groups were confirmed. In group 1 (with contrast), small hematomas were detectable even when the hematocrit was 19%-20%. In group 2 (without contrast) C-arm CT was able to detect small hematomas (<1.0 cm(2)) created with hematocrits of 29%-37%. The area of hematoma measured from the C-arm CT data was, on average, within 15% of the area measured from harvested brain.The image quality obtained with this implementation of C-arm CT was sufficient to detect experimentally created small intracranial hematomas. This capability should provide earlier detection of hemorrhagic complications that may occur during neurointerventional procedures.

    View details for DOI 10.3174/ajnr.A0898

    View details for Web of Science ID 000255129700029

    View details for PubMedID 18202240

  • Design, performance, and applications of a hybrid X-Ray/MR system for interventional guidance PROCEEDINGS OF THE IEEE Fahrig, R., Ganguly, A., Lillaney, P., Bracken, J., Rowlands, J. A., Wen, Z., Yu, H., Rieke, V., Santos, J. M., Pauly, K. B., Sze, D. Y., Frisoli, J. K., Daniel, B. L., Pelc, N. J. 2008; 96 (3): 468-480
  • A hybrid radiography/MRI system for combining hysterosalpingography and MRI in infertility patients: Initial experience AMERICAN JOURNAL OF ROENTGENOLOGY Freeman-Walsh, C. B., Fahrig, R., Ganguly, A., Rieke, V., Daniel, B. L. 2008; 190 (2): W157-W160


    We evaluated the feasibility of a prototype hybrid radiography/MRI system in evaluating infertility patients. Pelvic MRI was followed by hysterosalpingography (HSG) without moving the patient. This system allowed evaluation of tubal patency and cross-sectional imaging with one examination.Our hybrid radiography/MRI system provided good-quality HSG and MR images. We were able to assess tubal anatomy and patency and uterine anatomy and to detect pelvic abnormalities, including fibroids and adenomyosis. Furthermore, MR images and radiographs were superimposed to clarify HSG findings.

    View details for DOI 10.2214/AJR.07.2282

    View details for Web of Science ID 000252932100049

    View details for PubMedID 18212200

  • An efficient estimation method for reducing the axial intensity drop in circular cone-beam CT. International journal of biomedical imaging Zhu, L., Starman, J., Fahrig, R. 2008; 2008: 242841-?


    Reconstruction algorithms for circular cone-beam (CB) scans have been extensively studied in the literature. Since insufficient data are measured, an exact reconstruction is impossible for such a geometry. If the reconstruction algorithm assumes zeros for the missing data, such as the standard FDK algorithm, a major type of resulting CB artifacts is the intensity drop along the axial direction. Many algorithms have been proposed to improve image quality when faced with this problem of data missing; however, development of an effective and computationally efficient algorithm remains a major challenge. In this work, we propose a novel method for estimating the unmeasured data and reducing the intensity drop artifacts. Each CB projection is analyzed in the Radon space via Grangeat's first derivative. Assuming the CB projection is taken from a parallel beam geometry, we extract those data that reside in the unmeasured region of the Radon space. These data are then used as in a parallel beam geometry to calculate a correction term, which is added together with Hu's correction term to the FDK result to form a final reconstruction. More approximations are then made on the calculation of the additional term, and the final formula is implemented very efficiently. The algorithm performance is evaluated using computer simulations on analytical phantoms. The reconstruction comparison with results using other existing algorithms shows that the proposed algorithm achieves a superior performance on the reduction of axial intensity drop artifacts with a high computation efficiency.

    View details for DOI 10.1155/2008/242841

    View details for PubMedID 18923681

  • Parameter investigation and first results from a digital flat panel detector with forward bias capability MEDICAL IMAGING 2008: PHYSICS OF MEDICAL IMAGING, PTS 1-3 Starman, J., Tognina, C., Virshup, G., Star-Lack, J., Mollov, I., Fahrig, R. 2008; 6913

    View details for DOI 10.1117/12.772356

    View details for Web of Science ID 000256660300019

  • Cardiac C-arm CT: Image-based gating MEDICAL IMAGING 2008: PHYSICS OF MEDICAL IMAGING, PTS 1-3 Rohkohl, C., Pruemmer, A., Fahrig, R., Lauritsch, G., Hornegger, J. 2008; 6913

    View details for DOI 10.1117/12.770124

    View details for Web of Science ID 000256660300048

  • Design, Performance, and Applications of a Hybrid X-Ray/MR System for Interventional Guidance Proceedings of the IEEE Fahrig R, Ganguly A, Lillaney P, Bracken J, Rowlands J A, Wen Z, Yu H, Rieke V, Santos J M, Pauly K B, Sze D Y, Frisoli J K, Daniel B L, Pelc N J 2008; 96 (3): 469-480
  • A short-scan reconstruction for cone-beam CT Using shift-invariant FBP and equal weighting MEDICAL PHYSICS Zhu, L., Yoon, S., Fahrig, R. 2007; 34 (11): 4422-4438


    A 3D reconstruction formula has been derived for a circular cone-beam (CB) short scan using ID shift-invariant filtering, CB backprojection, and equal weighting. By first converting the divergent projections to parallel projections, we analyze the circular CB data using the classic central slice theorem. The sampling density in Fourier space is investigated and 1D shift-invariant filtering before backprojection can be used to compensate for the nonuniformity. The final formula consists of a conventional FDK reconstruction and a correction term using differential backprojection and the 1D Hilbert transform in the image domain. On a full scan, the approach reduces to the FDK algorithm, while for a short scan, the CB artifacts are suppressed by the second term. This algorithm outperforms the modified FDK algorithm with Parker's weighting, as illustrated by computer simulations and experimental results. Due to its shift-invariant filtered-backprojection structure, the proposed algorithm is implemented efficiently, and requires a simple adaptation of the FDK algorithm.

    View details for DOI 10.1118/1.2789405

    View details for Web of Science ID 000251145900035

    View details for PubMedID 18072507

  • Investigation of electron trajectories of an x-ray tube in magnetic fields of MR scanners MEDICAL PHYSICS Wen, Z., Fahrig, R., Conolly, S., Pelc, N. J. 2007; 34 (6): 2048-2058


    A hybrid x-ray/MR system combining an x-ray fluoroscopic system and an open-bore magnetic resonance (MR) system offers advantages from both powerful imaging modalities and thus can benefit numerous image-guided interventional procedures. In our hybrid system configurations, the x-ray tube and detector are placed in the MR magnet and therefore experience a strong magnetic field. The electron beam inside the x-ray tube can be deflected by a misaligned magnetic field, which may damage the tube. Understanding the deflection process is crucial to predicting the electron beam deflection and avoiding potential damage to the x-ray tube. For this purpose, the motion of an electron in combined electric (E) and magnetic (B) fields was analyzed theoretically to provide general solutions that can be applied to different geometries. For two specific cases, a slightly misaligned strong field and a perpendicular weak field, computer simulations were performed with a finite-element method program. In addition, experiments were conducted using an open MRI magnet and an inserted electromagnet to quantitatively verify the relationship between the deflections and the field misalignment. In a strong (B > E/c; c: speed of light) and slightly misaligned magnetic field, the deflection in the plane of E and B caused by electrons following the magnetic field lines is the dominant component compared to the deflection in the E X B direction due to the drift of electrons. In a weak magnetic field (B < or = E/c), the main deflection is in the E x B direction and is caused by the perpendicular component of the magnetic field.

    View details for DOI 10.1118/1.2733798

    View details for Web of Science ID 000247479600022

    View details for PubMedID 17654908

  • Quantitative evaluation of the relaxivity effects of iodine on Gd-DTPA enhanced MR arthrography JOURNAL OF MAGNETIC RESONANCE IMAGING Ganguly, A., Gold, G. E., Pauly, K. B., Mayer, D., Moseley, M. M., Pelc, N. J., Fahrig, R. 2007; 25 (6): 1219-1225


    To quantify the effect of iodine on the gadolinium (Gd) contrast-enhanced signal in MR arthrography.Saline solutions of Gd contrast agent (0-1 mmol/liter) were mixed with iodinated contrast agent (0-185 mmol/liter). The T1 and T2 relaxation constants of these solutions were measured at 1.5T. Different types of commonly used iodinated contrast agents as well as sodium iodide (NaI) solutions were also analyzed.Iodine caused significant T2 shortening and some T1 shortening in Gd contrast solutions. Both contrast agents independently obeyed the standard relaxation relation, and their mixture obeyed a modified version of this relation. The side chains in various iodine molecules and their viscosities affected the relaxation properties differently. For various spin-echo (SE) sequences, the signal from synovial fluid containing different concentrations of the two contrast agents was calculated. The T2-weighted signal appeared to be most affected by the increase in iodine concentrations. In the absence of Gd contrast, all SE sequences showed an initial increase in signal from iodine contrast.A generalized relation for the relaxivities of Gd contrast in the presence of iodine was established. The side chains of iodine contrast were found to alter the relaxivities of Gd contrast. Imaging with proton density (PD)-weighted SE with only iodine contrast agent was found to be feasible.

    View details for DOI 10.1002/jmri.20934

    View details for Web of Science ID 000246824100017

    View details for PubMedID 17520728

  • Determination of 3-dimensional zonal renal volumes using contrast-enhanced computed tomography JOURNAL OF COMPUTER ASSISTED TOMOGRAPHY Sommer, G., Bouley, D., Frisoli, J., Pierce, L., Sandner-Porkristl, D., Fahrig, R. 2007; 31 (2): 209-213


    To determine the accuracy with which total and cortical renal volumes may be measured in vivo with contrast-enhanced computed tomography (CT) in an animal model.Seven female Yorkshire pigs were scanned in vivo using both a 64-channel multidetector row computed tomography (MDCT) scanner (Siemens Medical Solutions, Erlangen, Germany) and a C-arm CT scanner (Siemens AXIOM). Kidneys were scanned in corticomedullary and nephrographic phases after contrast injection. Three-dimensional volumetric analysis of CT data was performed to determine renal cortical and overall renal volumes, and renal lengths. We measured renal weights, water displacement volumes, and overall and cortical renal volumes of resected kidneys.Overall and cortical renal volumes by CT showed excellent correlation (R2 values varying from 0.77 to 0.92) with anatomic measurements of renal volume. There was poor correlation of anatomic renal volumes with renal lengths by CT.Three-dimensional analysis of contrast-enhanced CT provides accurate measurement of overall and cortical renal volumes in vivo.

    View details for Web of Science ID 000245456700009

    View details for PubMedID 17414755

  • Study of increased radiation when an x-ray tube is placed in a strong magnetic field MEDICAL PHYSICS Wen, Z., Pelc, N. J., Nelson, W. R., Fahrig, R. 2007; 34 (2): 408-418


    When a fixed anode x-ray tube is placed in a magnetic field (B) that is parallel to the anode-cathode axis, the x-ray exposure increases with increasing B. It was hypothesized that the increase was caused by backscattered electrons which were constrained by B and reaccelerated by the electric field onto the x-ray tube target. We performed computer simulations and physical experiments to study the behavior of the backscattered electrons in a magnetic field, and their effects on the radiation output, x-ray spectrum, and off-focal radiation. A Monte Carlo program (EGS4) was used to generate the combined energy and angular distribution of the backscattered electrons. The electron trajectories were traced and their landing locations back on the anode were calculated. Radiation emission from each point was modeled with published data (IPEM Report 78), and thus the exposure rate and x-ray spectrum with the contribution of backscattered electrons could be predicted. The point spread function for a pencil beam of electrons was generated and then convolved with the density map of primary electrons incident on the anode as simulated with a finite element program (Opera-3d, Vector Fields, UK). The total spatial distribution of x-ray emission could then be calculated. Simulations showed that for an x-ray tube working at 65 kV, about 54% of the electrons incident on the target were backscattered. In a magnetic field of 0.5 T, although the exposure would be increased by 33%, only a small fraction of the backscattered electrons landed within the focal spot area. The x-ray spectrum was slightly shifted to lower energies and the half value layer (HVL) was reduced by about 6%. Measurements of the exposure rate, half value layer and focal spot distribution were acquired as functions of B. Good agreement was observed between experimental data and simulation results. The wide spatial distribution of secondary x-ray emission can degrade the MTF of the x-ray system at low spatial frequencies for B < 0.5 T.

    View details for DOI 10.1118/1.2404618

    View details for Web of Science ID 000244424200005

    View details for PubMedID 17388157

  • Cardiac C-arm CT: 4D non-model based heart motion estimation and its application MEDICAL IMAGING 2007: PHYSICS OF MEDICAL IMAGING, PTS 1-3 Pruemmer, M., Fahrig, R., Wigstroem, L., Boese, J., Lauritsch, G., Strobel, N., Hornegger, J. 2007; 6510

    View details for DOI 10.1117/12.708151

    View details for Web of Science ID 000247292100039

  • Dose and image quality for a cone-beam C-arm CT system MEDICAL PHYSICS Fahrig, R., Dixon, R., Payne, T., Morin, R. L., Ganguly, A., Strobel, N. 2006; 33 (12): 4541-4550


    We assess dose and image quality of a state-of-the-art angiographic C-arm system (Axiom Artis dTA, Siemens Medical Solutions, Forchheim, Germany) for three-dimensional neuro-imaging at various dose levels and tube voltages and an associated measurement method. Unlike conventional CT, the beam length covers the entire phantom, hence, the concept of computed tomography dose index (CTDI) is not the metric of choice, and one can revert to conventional dosimetry methods by directly measuring the dose at various points using a small ion chamber. This method allows us to define and compute a new dose metric that is appropriate for a direct comparison with the familiar CTDIw of conventional CT. A perception study involving the CATPHAN 600 indicates that one can expect to see at least the 9 mm inset with 0.5% nominal contrast at the recommended head-scan dose (60 mGy) when using tube voltages ranging from 70 kVp to 125 kVp. When analyzing the impact of tube voltage on image quality at a fixed dose, we found that lower tube voltages gave improved low contrast detectability for small-diameter objects. The relationships between kVp, image noise, dose, and contrast perception are discussed.

    View details for DOI 10.1118/1.2370508

    View details for Web of Science ID 000243137600010

    View details for PubMedID 17278805

  • Scatter correction method for X-ray CT using primary modulation: Theory and preliminary results IEEE TRANSACTIONS ON MEDICAL IMAGING Zhu, L., Bennett, N. R., Fahrig, R. 2006; 25 (12): 1573-1587


    An X-ray system with a large area detector has high scatter-to-primary ratios (SPRs), which result in severe artifacts in reconstructed computed tomography (CT) images. A scatter correction algorithm is introduced that provides effective scatter correction but does not require additional patient exposure. The key hypothesis of the algorithm is that the high-frequency components of the X-ray spatial distribution do not result in strong high-frequency signals in the scatter. A calibration sheet with a checkerboard pattern of semitransparent blockers (a "primary modulator") is inserted between the X-ray source and the object. The primary distribution is partially modulated by a high-frequency function, while the scatter distribution still has dominant low-frequency components, based on the hypothesis. Filtering and demodulation techniques suffice to extract the low-frequency components of the primary and hence obtain the scatter estimation. The hypothesis was validated using Monte Carlo (MC) simulation, and the algorithm was evaluated by both MC simulations and physical experiments. Reconstructions of a software humanoid phantom suggested system parameters in the physical implementation and showed that the proposed method reduced the relative mean square error of the reconstructed image in the central region of interest from 74.2% to below 1%. In preliminary physical experiments on the standard evaluation phantom, this error was reduced from 31.8% to 2.3%, and it was also demonstrated that the algorithm has no noticeable impact on the resolution of the reconstructed image in spite of the filter-based approach. Although the proposed scatter correction technique was implemented for X-ray CT, it can also be used in other X-ray imaging applications, as long as a primary modulator can be inserted between the X-ray source and the imaged object.

    View details for DOI 10.1109/TMI.2006.884636

    View details for Web of Science ID 000242650400005

    View details for PubMedID 17167993

  • Compatibility of interventional x-ray and magnetic resonance imaging: Feasibility of a closed bore XMR (CBXMR) system MEDICAL PHYSICS Brzozowski, L., Ganguly, A., Pop, M., Wen, Z., Bennett, R., Fahrig, R., Rowlands, J. A. 2006; 33 (8): 3033-3045


    A next-generation interventional guidance system is proposed that will enable intraprocedural access to both x-ray and magnetic resonance imaging (MRI) modalities. This closed bore XMR (CBXMR) system is comprised of a conventional radiographic rotating anode x-ray tube and a direct conversion flat panel detector on a rotating gantry positioned adjacent to the bore of a 1.5 T MRI. To assess the feasibility of such a system, we have investigated the degree of compatibility between the x-ray components and the MRI. For /-->B(ext)/ < 200 G the effect on the radiographic tube motor was negligible regardless of the orientation of -->B(ext) with respect to the motor axis of rotation--the frequency of anode rotation remained within 6% of the 3400 rpm frequency measured at 0 G. For /-->B(ext)/ >2400 G the anode slowed down to below 2400 rpm at all orientations. At intermediate B(ext), the frequency of rotation varied between 2400 and 3200 rpm, showing a strong dependence on orientation, with -->B(ext) perpendicular to the tube axis having a much stronger effect on the rotation frequency than -->B(ext) parallel to the tube axis. In contrast to the effect of -->B(ext) on the induction motor, parallel -->B(ext) had a stronger detrimental effect on the cathode-anode electron beam, whose path was at 16 degrees to the tube axis, than the perpendicular -->B(ext). Parallel -->B(ext) of several hundred Gauss had a defocusing effect on the x-ray focal spot. -->B(ext) perpendicular to the electron beam shifted the beam without significant defocusing. We have determined that the direct conversion flat panel detector (FPD) technology is not intrinsically sensitive to -->B(ext), and that the modifications required to make the proposed FPDs MRI compatible are minimal. The homogeneity of the MRI signal in the normal field of view was not significantly degraded by the presence of these x-ray components in the vicinity of the MRI bore entrance.

    View details for DOI 10.1118/1.2219328

    View details for Web of Science ID 000239852800039

    View details for PubMedID 16964881

  • Towards cardiac C-arm computed tomography IEEE TRANSACTIONS ON MEDICAL IMAGING Lauritsch, G., Boese, J., Wigstroem, L., Kemeth, H., Fahrig, R. 2006; 25 (7): 922-934


    Cardiac interventional procedures would benefit tremendously from sophisticated three-dimensional image guidance. Such procedures are typically performed with C-arm angiography systems, and tomographic imaging is currently available only by using preprocedural computed tomography (CT) or magnetic resonance imaging (MRI) scans. Recent developments in C-arm CT (Angiographic CT) allow three-dimensional (3-D) imaging of low contrast details with angiography imaging systems for noncardiac applications. We propose a new approach for cardiac imaging that takes advantage of this improved contrast resolution and is based on intravenous contrast injection. The method is an analogue to multisegment reconstruction in cardiac CT adapted to the much slower rotational speed of C-arm CT. Motion of the heart is considered in the reconstruction process by retrospective electrocardiogram (ECG)-gating, using only projections acquired at a similar heart phase. A series of N almost identical rotational acquisitions is performed at different heart phases to obtain a complete data set at a minimum temporal resolution of 1/N of the heart cycle time. First results in simulation, using an experimental phantom, and in preclinical in vivo studies showed that excellent image quality can be achieved.

    View details for DOI 10.1109/TMI.2006.876166

    View details for Web of Science ID 000238781100010

    View details for PubMedID 16827492

  • A prototype table-top inverse-geometry volumetric CT system MEDICAL PHYSICS Schmidt, T. G., Star-Lack, J., Bennett, N. R., Mazin, S. R., Solomon, E. G., Fahrig, R., Pelc, N. J. 2006; 33 (6): 1867-1878


    A table-top volumetric CT system has been implemented that is able to image a 5-cm-thick volume in one circular scan with no cone-beam artifacts. The prototype inverse-geometry CT (IGCT) scanner consists of a large-area, scanned x-ray source and a detector array that is smaller in the transverse direction. The IGCT geometry provides sufficient volumetric sampling because the source and detector have the same axial, or slice direction, extent. This paper describes the implementation of the table-top IGCT scanner, which is based on the NexRay Scanning-Beam Digital X-ray system (NexRay, Inc., Los Gatos, CA) and an investigation of the system performance. The alignment and flat-field calibration procedures are described, along with a summary of the reconstruction algorithm. The resolution and noise performance of the prototype IGCT system are studied through experiments and further supported by analytical predictions and simulations. To study the presence of cone-beam artifacts, a "Defrise" phantom was scanned on both the prototype IGCT scanner and a micro CT system with a +/-5 cone angle for a 4.5-cm volume thickness. Images of inner ear specimens are presented and compared to those from clinical CT systems. Results showed that the prototype IGCT system has a 0.25-mm isotropic resolution and that noise comparable to that from a clinical scanner with equivalent spatial resolution is achievable. The measured MTF and noise values agreed reasonably well with theoretical predictions and computer simulations. The IGCT system was able to faithfully reconstruct the laminated pattern of the Defrise phantom while the micro CT system suffered severe cone-beam artifacts for the same object. The inner ear acquisition verified that the IGCT system can image a complex anatomical object, and the resulting images exhibited more high-resolution details than the clinical CT acquisition. Overall, the successful implementation of the prototype system supports the IGCT concept for single-rotation volumetric scanning free from cone-beam artifacts.

    View details for DOI 10.1118/1.2192887

    View details for Web of Science ID 000238688500036

    View details for PubMedID 16872094

  • Optimization of a tomosynthesis system for the detection of lung nodules MEDICAL PHYSICS Pineda, A. R., Yoon, S., Paik, D. S., Fahrig, R. 2006; 33 (5): 1372-1379


    Mathematical observers that track human performance can be used to reduce the number of human observer studies needed to optimize imaging systems. The performance of human observers for the detection of a 3.6 mm lung nodule in anatomical backgrounds was measured as a function of varying tomosynthetic angle and compared with mathematical observers. The human observer results showed a dramatic increase in the percent of correct responses, from 80% in the projection images to 96% in the projection images with a tomosynthetic angle of just 3 degrees. This result suggests the potential usefulness of the scanned beam digital x-ray system for this application. Given the small number of images (40) used per tomosynthetic angle and the highly nonstationary statistical nature of the backgrounds, the nonprewhitening eye observer achieved a higher performance than the channelized Hotelling observer using a Laguerre-Gauss basis. The channelized Hotelling observer with internal noise and the eye filter matched to the projection data were shown to track human performance as the tomosynthetic angle changed. The validation of these mathematical observers extends their applicability to the optimization of tomosynthesis systems.

    View details for DOI 10.1118/1.2190329

    View details for Web of Science ID 000237673600021

    View details for PubMedID 16752573

  • Transjugular intrahepatic portosystemic shunt creation in a polycystic liver facilitated by hybrid cross-sectional/angiographic imaging JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY Sze, D. Y., Strobel, N., Fahrig, R., Moore, T., Busque, S., Frisoli, J. K. 2006; 17 (4): 711-715


    Polycystic liver disease (PCLD) has long been considered to represent a contraindication to transjugular intrahepatic portosystemic shunt (TIPS) creation, primarily because of the risk of hemorrhage. Three-dimensional (3D) navigation within the enlarged and potentially disorienting parenchyma can now be performed during the procedure with the development of C-arm cone-beam computed tomography, which relies on the same equipment already used for angiography. Such a hybrid 3D reconstruction-enabled angiography system was used for safe image guidance of a TIPS procedure in a patient with PCLD. This technology has the potential to expedite any image-guided procedure that requires 3D navigation.

    View details for DOI 10.1097/01.RVI.0000208984.17697.58

    View details for Web of Science ID 000236836700015

    View details for PubMedID 16614155

  • Cardiac C-arm CT: Efficient Motion Correction for 4D-FBP 2006 IEEE NUCLEAR SCIENCE SYMPOSIUM CONFERENCE RECORD, VOL 1-6 Pruemmer, M., Wigstroem, L., Hornegger, J., Boese, J., Lauritsch, G., Strobel, N., Fahrig, R. 2006: 2620-2628
  • A three-dimensional reconstruction algorithm for an inverse-geometry volumetric CT system MEDICAL PHYSICS Schmidt, T. G., Fahrig, R., Pelc, N. J. 2005; 32 (11): 3234-3245


    An inverse-geometry volumetric computed tomography (IGCT) system has been proposed capable of rapidly acquiring sufficient data to reconstruct a thick volume in one circular scan. The system uses a large-area scanned source opposite a smaller detector. The source and detector have the same extent in the axial, or slice, direction, thus providing sufficient volumetric sampling and avoiding cone-beam artifacts. This paper describes a reconstruction algorithm for the IGCT system. The algorithm first rebins the acquired data into two-dimensional (2D) parallel-ray projections at multiple tilt and azimuthal angles, followed by a 3D filtered backprojection. The rebinning step is performed by gridding the data onto a Cartesian grid in a 4D projection space. We present a new method for correcting the gridding error caused by the finite and asymmetric sampling in the neighborhood of each output grid point in the projection space. The reconstruction algorithm was implemented and tested on simulated IGCT data. Results show that the gridding correction reduces the gridding errors to below one Hounsfield unit. With this correction, the reconstruction algorithm does not introduce significant artifacts or blurring when compared to images reconstructed from simulated 2D parallel-ray projections. We also present an investigation of the noise behavior of the method which verifies that the proposed reconstruction algorithm utilizes cross-plane rays as efficiently as in-plane rays and can provide noise comparable to an in-plane parallel-ray geometry for the same number of photons. Simulations of a resolution test pattern and the modulation transfer function demonstrate that the IGCT system, using the proposed algorithm, is capable of 0.4 mm isotropic resolution. The successful implementation of the reconstruction algorithm is an important step in establishing feasibility of the IGCT system.

    View details for DOI 10.1118/1.2064827

    View details for Web of Science ID 000233385800002

    View details for PubMedID 16370414

  • Truly hybrid x-ray/MR imaging: Toward a streamlined clinical system ACADEMIC RADIOLOGY Ganguly, A., Wen, Z. F., Daniel, B. L., Butts, K., Kee, S. T., Rieke, V., Do, H. M., Pelc, N. J., Alley, M. T., Fahrig, R. 2005; 12 (9): 1167-1177


    We have installed an improved X-ray/MR (XMR) truly hybrid system with higher imaging signal-to-noise ratio (SNR) and versatility than our first prototype. In our XMR design, a fixed anode X-ray fluoroscopy system is positioned between the two donut-shaped magnetic poles of a 0.5T GE Signa-SP magnet (SP-XMR). This paper describes the methods for increased compatibility between the upgraded x-ray and MR systems that have helped improve patient management.A GE OEC 9800 system (GE OEC Salt Lake City, UT) was specially reconfigured for permitting X-ray fluoroscopy inside the interventional magnet. A higher power X-ray tube, a new permanent tube mounting system, automatic exposure control (AEC), remote controlled collimators, choice of multiple frame rates, DICOM image compatibility, magnetically shimmed X-ray detector, X-ray compatible MR coil, and better RF shielding are the highlights of the new system. A total of 23 clinical procedures have been conducted with SP-XMR guidance of which five were performed using the new system.The 70% increased power for fluoroscopy, and a new 6 times higher power single frame imaging mode, has improved imaging capability. The choice of multiple imaging frame rates, AEC, and collimator control allow reduction in X-ray exposure to the patient. The DICOM formatting has permitted easy transfer of clinical images over the hospital PACS network. The increased MR compatibility of the detector and the X-ray transparent MR coil has enabled faster switching between X-ray and MR imaging modes.The improvements introduced in our SP-XMR system have further streamlined X-ray/MR hybrid imaging. Additional clinical procedures could benefit from the new SP-XMR imaging.

    View details for DOI 10.1016/j.acra.2005.03.076

    View details for Web of Science ID 000231463500014

    View details for PubMedID 16099685

  • Co-registration of x-ray and MR fields of view in a hybrid XMR system JOURNAL OF MAGNETIC RESONANCE IMAGING Yu, H. Z., Fahrig, R., Pelc, N. J. 2005; 22 (2): 291-301


    To validate one possible function of a real-time x-ray/MR (XMR) interface in a hybrid XMR system using x-ray images as "scouts" to prescribe the MR slices.The registration process consists of two steps: 1) calibration, in which the system's geometric parameters are found from fiducial-based registration; and 2) application, in which the x-ray image of a target structure and the estimated geometric parameters are used to prescribe an MR slice to observe the target structure. Errors from the noise in the location of the fiducial markers, and MR gradient nonlinearity were studied. Computer simulations were used to provide guidelines for fiducial marker placement and tolerable error estimation. A least-squares-based correction method was developed to reduce errors from gradient nonlinearity.In simulations with both sources of errors and the correction for gradient nonlinearity, the use of 16 fiducial markers yielded a mean error of about 0.4 mm over a 7200 cm(3) volume. Phantom scans showed that the prescribed target slice hit most of the target line, and that the length visualized was improved with the least-squares correction.The use of 16 fiducial markers to co-register XMR FOVs can offer satisfactory accuracy in both simulations and experiments.

    View details for DOI 10.1002/jmri.20376

    View details for Web of Science ID 000230812900017

    View details for PubMedID 16028248

  • Robust x-ray tubes for use within magnetic fields of MR scanners MEDICAL PHYSICS Wen, Z. F., Fahrig, R., Pelc, N. J. 2005; 32 (7): 2327-2336


    A hybrid system that combines an x-ray fluoroscopic system and a magnetic resonance (MR) system can provide physicians with the synergy of exquisite soft tissue contrast (from MR) and high temporal and spatial resolutions (from x ray), which may significantly benefit a number of image-guided interventional procedures. However, the system configuration may require the x-ray tube to be placed in a magnetic field, which can hinder the proper functioning of the x-ray tube by deflecting its electron beam. From knowledge of how the magnetic field affects the electron trajectories, we propose creating another magnetic field along the cathode-anode axis using either solenoids or permanent magnets to reduce the deflection of the electron beam for two cases: a strong and slightly misaligned field or a weak field that is arbitrary in direction. Theoretical analysis is presented and the electron beam is simulated in various external magnetic fields with a finite element modeling program. Results show that both correction schemes enhance the robustness of the x-ray tube operation in an externally applied magnetic field.

    View details for DOI 10.1118/1.1944267

    View details for Web of Science ID 000230542600018

    View details for PubMedID 16121589

  • Performance of a static-anode/flat-panel x-ray fluoroscopy system in a diagnostic strength magnetic field: A truly hybrid x-ray/MR imaging system MEDICAL PHYSICS Fahrig, R., Wen, Z., GANGULY, A., DECRESCENZO, G., Rowlands, J. A., Stevens, G. M., Saunders, R. F., Pelc, N. J. 2005; 32 (6): 1775-1784


    Minimally invasive procedures are increasing in variety and frequency, facilitated by advances in imaging technology. Our hybrid imaging system (GE Apollo flat panel, custom Brand x-ray static anode x-ray tube, GE Lunar high-frequency power supply and 0.5 T Signa SP) provides both x-ray and MR imaging capability to guide complex procedures without requiring motion of the patient between two distant gantries. The performance of the x-ray tube in this closely integrated system was evaluated by modeling and measuring both the response of the filament to an externally applied field and the behavior of the electron beam for field strengths and geometries of interest. The performance of the detector was assessed by measuring the slanted-edge modulation transfer function (MTF) and when placed at zero field and at 0.5 T. Measured resonant frequencies of filaments can be approximated using a modified vibrating beam model, and were at frequencies well below the 25 kHz frequency of our generator for our filament geometry. The amplitude of vibration was not sufficient to cause shorting of the filament during operation within the magnetic field. A simple model of electrons in uniform electric and magnetic fields can be used to estimate the deflection of the electron beam on the anode for the fields of interest between 0.2 and 0.5 T. The MTF measured at the detector and the DQE showed no significant difference inside and outside of the magnetic field. With the proper modifications, an x-ray system can be fully integrated with a MR system, with minimal loss of image quality. Any x-ray tube can be assessed for compatibility when placed at a particular location within the field using the models. We have also concluded that a-Si electronics are robust against magnetic fields. Detailed knowledge of the x-ray system installation is required to provide estimates of system operation.

    View details for DOI 10.1118/1.1915016

    View details for Web of Science ID 000229908600036

    View details for PubMedID 16013735

  • X-ray compatible radiofrequency coil for magnetic resonance imaging MAGNETIC RESONANCE IN MEDICINE Rieke, V., GANGULY, A., Daniel, B. L., Scott, G., Pauly, J. M., Fahrig, R., Pelc, N. J., Butts, K. 2005; 53 (6): 1409-1414


    The range of RF coils that can be used in combined X-ray/MR (XMR) systems is limited because many conventional coils contain highly X-ray attenuating materials that are visible in the X-ray images and potentially obscure patient anatomy. In this study, an X-ray compatible coil design that has minimal X-ray attenuation in the field of view (FOV) of the X-ray image is presented. In this design, aluminum is used for the loop conductor and discrete elements of the coil are eliminated from the X-ray FOV. A surface coil and an abdominal phased array coil were built using the X-ray compatible design. X-ray attenuation and MR imaging properties of the coils were evaluated and compared to conventional coils. The X-ray compatible phased array coil was used to image patients during two interventional procedures in the XMR system. The X-ray compatible coils allowed for fluoroscopic X-ray image acquisition, without degradation by the coil, while maintaining excellent MR imaging qualities.

    View details for DOI 10.1002/mrm.20494

    View details for Web of Science ID 000229468200022

    View details for PubMedID 15906285

  • MR-guided transjugular intrahepatic portosystemic shunt creation with use of a hybrid radiography/MR system JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY Kee, S. T., GANGULY, A., Daniel, B. L., Wen, Z. F., Butts, K., Shimikawa, A., Pelc, N. J., Fahrig, R., Dake, M. D. 2005; 16 (2): 227-234


    To evaluate the performance of a combined hybrid radiography/magnetic resonance (MR) unit to guide portal vein (PV) puncture during human transjugular intrahepatic portosystemic shunt (TIPS) creation.Fourteen patients undergoing TIPS creation were studied during standard clinical applications. Patients were anesthetized and then positioned in an open MR unit containing a flat-panel radiographic fluoroscopic unit. With use of a combination of fluoroscopy and MR imaging, the PV was accessed and the TIPS procedure was performed. A noncovered nitinol stent or a covered stent-graft was placed in the TIPS tract. Number of punctures required, total procedure time, fluoroscopy time, procedural success rate, complications, and ultrasonographic and clinical follow-up were recorded.Clinical success was obtained in 13 of 14 patients. In one patient, extrahepatic puncture of the PV occurred, resulting in hemorrhage and requiring placement of a covered stent to control the bleeding. The mean number of punctures required to access the PV was 2.6 +/- 1.7, and the total procedure time was 2.5 hours +/- 0.6. Mean fluoroscopy time was 22.3 minutes +/- 5.5. Results of clinical and ultrasonographic follow-up compare favorably to previously published reports.TIPS creation with a combination hybrid radiography/MR unit is feasible and may reduce the number of needle passes required and radiation exposure, with similar overall outcomes compared with studies reported in the literature.

    View details for DOI 10.1097/01.RVI.0000143766.08029.6E

    View details for Web of Science ID 000227710000009

    View details for PubMedID 15713923

  • Estimating 0(th) and 1(th) moments in C-arm CT data for extrapolating truncated projections MEDICAL IMAGING 2005: IMAGE PROCESSING, PT 1-3 Starman, J., Pelc, N., Strobel, N., Fahrig, R. 2005; 5747: 378-387

    View details for DOI 10.1117/12.596041

    View details for Web of Science ID 000230109600039

  • Correction of XRII geometric distortion using a liquid-filled grid and image subtraction MEDICAL PHYSICS Holdsworth, D. W., Pollmann, S. I., Nikolov, H. N., Fahrig, R. 2005; 32 (1): 55-64


    X-ray image intensifier (XRII) geometric distortion reduces the accuracy of image-guided procedures and quantitative image reconstructions. Due to the dependence of this error on the earth's magnetic field, the required correction is angle dependent, and calibration data should ideally be acquired simultaneously with clinical image data, at a specific orientation. We describe a technique to correct XRII geometric image distortion at any angular position during a stereotactic procedure. This approach uses a machined plastic grid, which contains channels that can be filled with iodinated contrast agent and subsequently flushed with water, providing contrast and mask images, respectively, of a geometric calibration grid. The standard image subtraction capabilities of conventional digital subtraction angiography devices can then be used to create a subtraction image of the iodine-filled channels, without any confounding anatomical structure. Grid-line intersection points are used to determine the control points that are required for a global polynomial correction algorithm, creating a correction map that is specific to the current angular position and XRII field of view (FOV). Tests with a clinical C-arm based XRII show that control points can be obtained with a precision of +/-0.053 mm, resulting in geometric correction accuracy of +/-0.152 mm, at a nominal FOV of 40 cm. While the precision and accuracy are both poorer than that achieved with a high-contrast steel-bead grid, the fact that the liquid grid can remain rigidly attached to the XRII during an entire procedure results in the establishment of an absolute detector coordinate system (referenced to the liquid-filled correction grid). The design of the liquid-filled channels allows the required control points to be introduced into the image or removed in about 30 s, avoiding the appearance of obscuring or confounding markers during clinical image acquisition, with a concurrent increase in patient dose of about 8% in the current design. Applications for this technique include stereotactic surgery, radiosurgery, x-ray stereogrammetry, and other image-guided procedures.

    View details for DOI 10.1118/1.1827751

    View details for Web of Science ID 000226595600009

    View details for PubMedID 15719955

  • An inverse-geometry volumetric CT system with a large-area scanned source: A feasibility study MEDICAL PHYSICS Schmidt, T. G., Fahrig, R., Pelc, N. J., Solomon, E. G. 2004; 31 (9): 2623-2627


    We propose an inverse-geometry volumetric CT system for acquiring a 15-cm volume in one rotation with negligible cone-beam artifacts. The system uses a large-area scanned source and a smaller detector array. This note describes two feasibility investigations. The first examines data sufficiency in the transverse planes. The second predicts the signal-to-noise ratio (SNR) compared to a conventional scanner. Results showed sufficient sampling of the full volume in less than 0.5 s and, when compared to a conventional scanner operating at 24 kW with a 0.5-s voxel illumination time (e.g., 0.5-s gantry rotation and pitch of one), predicted a relative SNR of 76%.

    View details for DOI 10.1118/1.1786171

    View details for Web of Science ID 000224117400031

    View details for PubMedID 15487745

  • First use of a truly-hybrid X-ray/MR imaging system for guidance of brain biopsy ACTA NEUROCHIRURGICA Fahrig, R., Heit, G., Wen, Z., Daniel, B. L., Butts, K., Pelc, N. J. 2003; 145 (11): 995-997


    The use of a new hybrid imaging system for guidance of a brain biopsy is described. The system combines the strengths of MRI (soft-tissue contrast, arbitrary plane selection) with those of x-ray fluoroscopy (high-resolution real-time projection images, clear portrayal of bony structures) and allows switching between the imaging modalities without moving the patient. The biopsy was carried out using x-ray guidance for direction of the needle through the foramen ovale and MR guidance to target the soft-tissue lesion. Appropriate samples were acquired. The system could be particularly effective for guidance of those cases where motion, swelling, resection and other intra-operative anatomical changes cannot be accounted for using traditional stereotactic-based imaging approaches.

    View details for DOI 10.1007/s00701-003-0138-7

    View details for Web of Science ID 000186686300020

    View details for PubMedID 14628205

  • Pair of resonant fiducial markers for localization of endovascular catheters at all catheter orientations JOURNAL OF MAGNETIC RESONANCE IMAGING Kuehne, T., Fahrig, R., Butts, K. 2003; 17 (5): 620-624


    To test wireless resonance circuits (RC) to be used as fiducial marker of endovascular catheters during MR-guided interventions. Current markers loose their signal enhancement for certain catheter orientations. The purpose of this study was to test a marker setup which overcomes this orientation problem.The markers were constructed from a pair of two RCs. The RCs were individually tuned and the coil axes were oriented perpendicular to each other in order to decouple the two RCs. The markers were mounted on the tip of endovascular catheters and tested in vitro and in one porcine in vivo experiment.An intense MR signal at similar signal levels was noted at all catheter orientations. In the in vivo experiment the markers allowed for fast and reliable MR guidance of the catheters.A pair of two individually tuned and decoupled RCs is well suited for MR guidance of endovascular catheters.

    View details for DOI 10.1002/jmri.10307

    View details for Web of Science ID 000182630800015

    View details for PubMedID 12720274

  • Truly hybrid interventional MR/x-ray system: Investigation of in vivo applications ACADEMIC RADIOLOGY Fahrig, R., Butts, K., Wen, Z. F., Saunders, R., Kee, S. T., Sze, D. Y., Daniel, B. L., Laerum, F., Pelc, N. J. 2001; 8 (12): 1200-1207


    The purpose of this study was to provide in vivo demonstrations of the functionality of a truly hybrid interventional x-ray/magnetic resonance (MR) system.A digital flat-panel x-ray system (1,024(2) array of 200 microm pixels, 30 frames per second) was integrated into an interventional 0.5-T magnet. The hybrid system is capable of MR and x-ray imaging of the same field of view without patient movement. Two intravascular procedures were performed in a 22-kg porcine model: placement of a transjugular intrahepatic portosystemic shunt (TIPS) (x-ray-guided catheterization of the hepatic vein, MR fluoroscopy-guided portal puncture, and x-ray-guided stent placement) and mock chemoembolization (x-ray-guided subselective catheterization of a renal artery branch and MR evaluation of perfused volume).The resolution and frame rate of the x-ray fluoroscopy images were sufficient to visualize and place devices, including nitinol guidewires (0.016-0.035-inch diameter) and stents and a 2.3-F catheter. Fifth-order branches of the renal artery could be seen. The quality of both real-time (3.5 frames per second) and standard MR images was not affected by the x-ray system. During MR-guided TIPS placement, the trocar and the portal vein could be easily visualized, allowing successful puncture from hepatic to portal vein.Switching back and forth between x-ray and MR imaging modalities without requiring movement of the patient was demonstrated. The integrated nature of the system could be especially beneficial when x-ray and MR image guidance are used iteratively.

    View details for Web of Science ID 000172759200002

    View details for PubMedID 11770916

  • Filtered backprojection for modifying the impulse response of circular tomosynthesis MEDICAL PHYSICS Stevens, G. M., Fahrig, R., Pelc, N. J. 2001; 28 (3): 372-380


    A filtering technique has been developed to modify the three-dimensional impulse response of circular motion tomosynthesis to allow the generation of images whose appearance is like those of some other imaging geometries. In particular, this technique can reconstruct images with a blurring function which is more homogeneous for off-focal plane objects than that from circular tomosynthesis. In this paper, we describe the filtering process, and demonstrate the ability to alter the impulse response in circular motion tomosynthesis from a ring to a disk. This filtering may be desirable because the blurred out-of-plane objects appear less structured.

    View details for Web of Science ID 000167593100012

    View details for PubMedID 11318319

  • A truly hybrid interventional MR/X-ray system: Feasibility demonstration Fahrig, R., Butts, K., Rowlands, J. A., Saunders, R., Stanton, J., Stevens, G. M., Daniel, B. L., Wen, Z. F., Ergun, D. L., Pelc, N. J. JOHN WILEY & SONS INC. 2001: 294-300


    A system enabling both x-ray fluoroscopy and MRI in a single exam, without requiring patient repositioning, would be a powerful tool for image-guided interventions. We studied the technical issues related to acquisition of x-ray images inside an open MRI system (GE Signa SP). The system includes a flat-panel x-ray detector (GE Medical Systems) placed under the patient bed, a fixed-anode x-ray tube overhead with the anode-cathode axis aligned with the main magnetic field and a high-frequency x-ray generator (Lunar Corp.). New challenges investigated related to: 1) deflection and defocusing of the electron beam of the x-ray tube; 2) proper functioning of the flat panel; 3) effects on B0 field homogeneity; and 4) additional RF noise in the MR images. We have acquired high-quality x-ray and MR images without repositioning the object using our hybrid system, which demonstrates the feasibility of this new configuration. Further work is required to ensure that the highest possible image quality is achieved with both MR and x-ray modalities.

    View details for Web of Science ID 000171295900018

    View details for PubMedID 11169837

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