Single-exposure, dual-energy x-ray angiography using photon-counting x-ray detectors is a potential alternative to kV-switching dual-energy angiography and digital subtraction angiography (DSA), but is unable to simultaneously suppress anatomic noise from soft tissue and bone. Triple-energy, photon-counting angiography that counts photons in three energy bins during a single x-ray exposure would overcome this limitation but high quantum noise levels compromise image quality. We extended anti-correlated noise reduction (ACNR) for dual-energy angiography to triple-energy photon-counting angiography and evaluated the resulting improvement in iodine signal-difference-to-noise ratio (SDNR). We implemented triple-energy photon-counting imaging of iodine using a cadmium-telluride, photon-counting x-ray detector with analog charge summing for charge-sharing correction. We imaged a phantom consisting of vessel-like structures with diameters of 3mm, 4mm and 5mm embedded in background clutter. The vessels were filled with an iodine solution containing 100mg/ml of iodine. We acquired images at 60kV, 80kV and 100kV using energy thresholds that theoretically maximized SDNR per root entrance air kerma without ACNR. For each tube voltage, we simulated three energy bins by acquiring two separate exposures using two different sets of energy thresholds. The triple-energy images with ACNR had SDNR that was approximately 7.5 times greater than those without. Further increases in ACNR are expected with optimization of tube voltage and energy thresholds in the presence of ACNR. Future work will focus on optimization and frequency-dependent image-quality assessment.
Xenon-enhanced, dual-energy x-ray radiography has been proposed for imaging of lung ventilation. It is important to assess the ability of dual-energy subtraction to suppress anatomic noise associated with lung parenchyma. Anatomic noise in thoracic radiography obeys an inverse power law and there exist imaging phantoms that mimic this power law. Such phantoms are based on a random, tight packing of solid acrylic spheres and are not suitable for lung ventilation studies. We developed a phantom based on randomly-packed, hollow acrylic cylinders with inner diameters of 1.59 cm, wall thicknesses of 0.16 cm and lengths of 1.59, 1.27, 0.95, 0.64 or 0.32 cm. The number of segments of each length was chosen to approximately match the volume of space occupied by each set of segments. Measurements of the effective density of the packed cylinders yielded ~0.26 g cm-3. A randomly-packed-sphere phantom was also constructed as a reference. Both phantoms were imaged using a flat-panel detector at tube voltages of 50 kV to 150 kV. A power-law model (NPS ∝ κ/|u|β) was fit to the anatomic noise power spectra. The β-value of the cylinder phantom was within 1/5 of that of the sphere phantom, although both phantoms yielded power-law parameters ranging from 2.0 to 2.4, which is lower than that reported in the literature. The κ-value of the cylinder phantom was ~1.1 times that of the sphere phantom. We conclude that the cylinder-based clutter phantom, with some modifications, can be used to simulate the anatomic noise power spectrum in thoracic radiography.
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