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A CBCT Head Scanner for Point-Of-Care Imaging of Intracranial Hemorrhage

J Xu

J Xu1*, A Sisniega1 , W Zbijewski1 , H Dang1 , J Stayman1 , X Wang2 , D Foos2 , N Aygun1 , V Koliatsos1 , J Siewerdsen1 , (1) Johns Hopkins University, Baltimore, MD, (2) Carestream Health, Rochester, New York


WE-AB-207A-3 (Wednesday, August 3, 2016) 7:30 AM - 9:30 AM Room: 207A

Purpose:This work reports the design, development, and first technical assessment of a cone-beam CT (CBCT) scanner developed specifically for imaging of acute intracranial hemorrhage (ICH) at the point of care, with target applications in diagnosis and monitoring of traumatic brain injury, stroke, and postsurgical hemorrhage.

Methods:System design employed a task-based image quality model to quantify the influence of factors such as additive noise and high-gain (HG) detector readout on ICH detectability. Three bowtie filters with varying bare-beam attenuation strength and curvature were designed to enable HG readout without detector saturation, and a polyenergetic gain correction was developed to minimize artifacts from bowtie flood-field calibration. Image reconstruction used an iterative penalized weighted least squares (PWLS) method with artifact correction including Monte Carlo scatter estimation, Joseph-Spital beam hardening correction, and spatiotemporal deconvolution of detector glare and lag. Radiation dose was characterized for half-scan and full-scan protocols at various kV, and imaging performance was assessed in a head phantom presenting simulated ICH with diameter ranging 2-12 mm.

Results:The image quality model guided system design and was validated by measurements on a CBCT imaging bench. Compared to low-gain readout without a bowtie filter, the combination of HG readout and a modest bowtie improved the contrast-to-noise ratio (CNR per unit square-root dose) by 20% in the center of the image but degraded noise performance near the periphery (20% reduction in CNR). Low-frequency bowtie artifacts (~100 HU magnitude) were corrected by the polyenergetic gain correction. Image reconstructions on the prototype scanner demonstrate clear visibility of the smallest ICH insert (2 mm diameter) in both HG readout (with a bowtie) and dual-gain readout (without bowtie).

Conclusion:Technical assessment of the prototype scanner suggests the capability for reliable visualization of small (2 mm), low-contrast (50 HU) ICH at <20 mGy dose and motivates translation to clinical studies, now underway.

Funding Support, Disclosures, and Conflict of Interest: Xiaohui Wang and David Foos (co-authors) are employees of Carestream Health. Research funding support from Carestream Health.

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