Accuracy of Noise Magnitude Measurements from Patient CT Images
Date
2023-07-23
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Abstract
Purpose Noise magnitude is a main CT image quality indicator. In vivo measurements emerged as a patient-specific methodology to assess and qualify CT noise, yet methods to do so vary. Current noise measurement methods in soft tissues and air surrounding the patient use distinct image segmentations, HU thresholds, and region-of-interests, resulting in noise estimation variations. In this study, we compared two noise magnitude calculation methods against the gold standard ensemble noise in two cohorts of virtually-generated patient images across 36 imaging conditions. Methods 1800 image datasets were generated using a virtual trial platform based on anthropomorphic phantoms (XCAT) and a validated, scanner-specific CT simulator (DukeSim). XCAT phantoms were repeatedly imaged 50 times using Chest and Abdominopelvic protocols, three dose levels, and three reconstruction kernels, using both FBP and IR algorithms. Noise magnitudes were calculated in the air surrounding the patient (An) and soft tissues (GNI) by applying HU<-900 and -300<HU<100 thresholds, respectively. Per each imaging condition, An and GNI were compared to the ensemble noise calculated in soft tissue (En) and to the ensemble noise calculated in the liver and in the lungs (On) for abdominopelvic and chest studies, respectively. Results Across the three kernels and dose levels, An largely underestimated En and On for both FBP (median differences: -46% and -49%) and IR (median differences: -49% and -51%); whereas the GNI showed closer values to the En and On for FBP (median differences: 4% and 3%) and IR (median differences: -3% and -8%). Conclusion Applying virtual imaging techniques enabled an unbiased comparison of different noise magnitude calculation methods in large and realistic populations simulating clinical conditions. The noise measured in the air surrounding the patient cannot represent noise magnitude in soft tissues. The results affirmed the validation of soft tissue-based noise measurements as a close surrogate to inform protocol design and technology assessment.
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Scholars@Duke
Francesco Ria
Dr. Francesco Ria is a medical physicist and he serves as an Assistant Professor in the Department of Radiology. Francesco has an extensive expertise in the assessment of procedure performances in radiology. In particular, his research activities focus on the simultaneous evaluation of radiation dose and image quality in vivo in computed tomography providing a comprehensive evaluation of radiological exams. Moreover, Francesco is developing and investigating novel mathematical models that, uniquely in the radiology field, can incorporate a comprehensive and quantitative risk-to-benefit assessment of the procedures; he is continuing to apply his expertise towards the definition of new patient specific risk metrics, and in the assessment of image quality in vivo also using state-of-the-art imaging technology, such as photon counting computed tomography scanners, and machine learning reconstruction algorithms.
Dr. Ria is a member of the American Association of Physicists in Medicine task group 392 (Investigation and Quality Control of Automatic Exposure Control System in CT), of the American Association of Physicists in Medicine Public Education working group (WGATE), and of the Italian Association of Medical Physics task group Dose Monitoring in Diagnostic Imaging.
Ehsan Abadi
Ehsan Abadi, PhD is an imaging scientist at Duke University. He serves as an Associate Professor in the departments of Radiology and Electrical & Computer Engineering, a faculty member in the Medical Physics Graduate Program and Carl E. Ravin Advanced Imaging Laboratories, and a co-Lead in the Center for Virtual Imaging Trials. Ehsan’s research focuses on quantitative imaging and optimization, computational human modeling, medical imaging simulation, and CT imaging in cardiothoracic and musculoskeletal applications. He is actively involved in developing computational anthropomorphic models with various diseases such as COPD, and scanner-specific simulation platforms (e.g., DukeSim) for imaging systems. Currently, his work is centered on identifying and optimizing imaging systems to ensure accurate and precise quantifications of lung and bone diseases.
Ehsan Samei
Dr. Ehsan Samei, PhD, DABR, FAAPM, FSPIE, FAIMBE, FIOMP, FACR is a Persian-American medical physicist. He is the Reed and Martha Rice Distinguished Professor of Radiology, and Professor of Medical Physics, Biomedical Engineering, Physics, and Electrical and Computer Engineering at Duke University. He serves as the Chief Imaging Physicist for Duke University Health System, the Director of the Carl E Ravin Advanced Imaging Laboratories and the Center for Virtual Imaging Trials (CVIT), and co-PI of one the five Centers of Excellence in Regulatory Science and Innovation (CERSI), Triangle CERSI. He is certified by the American Board of Radiology, recognized as a Distinguished Investigator by the Academy of Radiology Research, and awarded Fellow by five professional organization. He founded/co-founded the Duke Medical Physics Program, the Duke Imaging Physics Residency Program, the Duke Clinical Imaging Physics Group, the Center for Virtual Imaging Trials, and the Society of Directors of Academic Medical Physics Programs (SDAMPP). He has held senior leadership positions in the AAPM, SPIE, SDAMPP, and RSNA, including election to the presidency of the SEAAPM (2010-2011), SDAMPP (2011), and AAPM (2023).
Dr. Samei's scientific expertise include x-ray imaging, theoretical imaging models, simulation methods, and experimental techniques in medical image formation, quantification, and perception. His research aims to bridge the gap between scientific scholarship and clinical practice, in the meaningful realization of translational research, and in clinical processes that are informed by scientific evidence. He has advanced image quality and safety metrics and radiometrics that are clinically relevant and that can be used to design, optimize, and monitor interpretive and quantitative performance of imaging techniques. These have been implemented in advanced imaging performance characterization, procedural optimization, and clinical dose and quality analytics. His most recent research interests have been virtual clinical trial across a broad spectrum of oncologic, pulmonary, cardiac, and vascular diseases, and developing methodological advances that provide smart fusions of principle-informed and AI-based, data-informed approaches to scientific inquiry.
Dr. Samei has mentored over 140 trainees (graduate and postgraduate). He has more than 1400 scientific publications including more than 360 referred journal articles, 600 conference presentations, and 4 books. Citations to his work is reflected in an h-index of 74 and a Weighted Relative Citation Ratio of 613. His laboratory of over 20 researchers has been supported continuously over two decades by 44 extramural grants, culminating in a NIH Program Project grant in 2021 to establish the national Center for Virtual Imaging Trials (CVIT), joining a small number of prominent Biomedical Technology Research Centers across the nation. In 2023, he, along with 3 other PIs, was awarded to lead one of five national Centers of Excellence in Regulatory Science and Innovation (Triangle CERSI) by the FDA.
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