All Publications

  • Characterization and Potential Applications of a Dual-Layer Flat-Panel Detector. Medical physics Shi, L., Lu, M., Bennett, N. R., Shapiro, E., Zhang, J., Colbeth, R., Star-Lack, J., Wang, A. S. 2020


    PURPOSE: Dual energy (DE) x-ray imaging has many clinical applications in radiography, fluoroscopy, and CT. This work characterizes a prototype dual layer (DL) flat panel detector (FPD) and investigates its DE imaging capabilities for applications in 2D radiography/fluoroscopy and quantitative 3D cone-beam CT. Unlike other DE methods like kV switching, a DL FPD obtains DE images from a single exposure, making it robust against patient and system motion.METHODS: The DL FPD consists of a top layer with a 200 m-thick CsI scintillator coupled to an amorphous silicon (aSi) FPD of 150 m pixel size and a bottom layer with a 550 m thick CsI scintillator coupled to an identical aSi FPD. The two layers are separated by a 1 mm Cu filter to increase spectral separation. Images (43*43 cm2 active area) can be read out in 2*2 binning mode (300 m pixels) at up to 15 frames per second. Detector performance was first characterized by measuring the MTF, NPS, and DQE for the top and bottom layers. For 2D applications, a qualitative study was conducted using an anthropomorphic thorax phantom containing a porcine heart with barium-filled coronary arteries (similar to iodine). Additionally, fluoroscopic lung tumor tracking was investigated by superimposing a moving tumor phantom on the thorax phantom. Tracking accuracies of single energy (SE) and DE fluoroscopy were compared against the ground truth motion of the tumor. For 3D quantitative imaging, a phantom containing water, iodine, and calcium inserts was used to evaluate overall DE material decomposition capabilities. Virtual monoenergetic (VM) images ranging from 40 to 100 keV were generated, and the optimal VM image energy which achieved the highest image uniformity and maximum contrast-to-noise ratio (CNR) was determined.RESULTS: The spatial resolution of the top layer was substantially higher than that of the bottom layer (top layer 50% MTF = 2.2 mm-1 , bottom layer = 1.2 mm-1 ). A substantial increase in NNPS and reduction in DQE was observed for the bottom layer mainly due to photon loss within the top layer and Cu filter. For 2D radiographic and fluoroscopic applications, the DL FPD was capable of generating high-quality material-specific images separating soft tissue from bone and barium. For lung tumor tracking, DE fluoroscopy yielded more accurate results than SE fluoroscopy, with an average reduction in the root-mean-square error (RMSE) of over 10*. For the DE CBCT studies, accurate basis material decompositions were obtained. The estimated material densities were 294.68 ± 17.41 and 92.14 ± 15.61 mg/ml for the 300 and 100 mg/ml calcium inserts respectively, and 8.93 ± 1.45, 4.72 ± 1.44, and 2.11 ± 1.32 mg/ml for the 10, 5, and 2 mg/ml iodine inserts respectively, with an average error of less than 5%. The optimal VM image energy was found to be 60 keV.CONCLUSIONS: We characterized a prototype DL FPD and demonstrated its ability to perform accurate single-exposure DE radiography/fluoroscopy and DE-CBCT. The merits of the dual layer detector approach include superior spatial and temporal registration between its constituent images, and less complicated acquisition sequences.

    View details for DOI 10.1002/mp.14211

    View details for PubMedID 32347561

  • Dedicated cone-beam breast CT using laterally-shifted detector geometry: Quantitative analysis of feasibility for clinical translation. Journal of X-ray science and technology Vedantham, S., Tseng, H., Konate, S., Shi, L., Karellas, A. 2020


    BACKGROUND: High-resolution, low-noise detectors with minimal dead-space at chest-wall could improve posterior coverage and microcalcification visibility in the dedicated cone-beam breast CT (CBBCT). However, the smaller field-of-view necessitates laterally-shifted detector geometry to enable optimizing the air-gap for x-ray scatter rejection.OBJECTIVE: To evaluate laterally-shifted detector geometry for CBBCT with clinical projection datasets that provide for anatomical structures and lesions.METHODS: CBBCT projection datasets (n = 17 breasts) acquired with a 40*30 cm detector (1024*768-pixels, 0.388-mm pixels) were truncated along the fan-angle to emulate 20.3*30 cm, 22.2*30 cm and 24.1*30 cm detector formats and correspond to 20, 120, 220 pixels overlap in conjugate views, respectively. Feldkamp-Davis-Kress (FDK) algorithm with 3 different weighting schemes were used for reconstruction. Visual analysis for artifacts and quantitative analysis of root-mean-squared-error (RMSE), absolute difference between truncated and 40*30 cm reconstructions (Diff), and its power spectrum (PSDiff) were performed.RESULTS: Artifacts were observed for 20.3*30 cm, but not for other formats. The 24.1*30 cm provided the best quantitative results with RMSE and Diff (both in units of mu, cm-1) of 4.39*10-3±1.98*10-3 and 4.95*10-4±1.34*10-4, respectively. The PSDiff (>0.3 cycles/mm) was in the order of 10-14mu2mm3 and was spatial-frequency independent.CONCLUSIONS: Laterally-shifted detector CBBCT with at least 220 pixels overlap in conjugate views (24.1*30 cm detector format) provides quantitatively accurate and artifact-free image reconstruction.

    View details for DOI 10.3233/XST-200651

    View details for PubMedID 32333575

  • Dedicated cone -beam breast CT using laterally -shifted detector geometry: Quantitative analysis of feasibility for clinical translation JOURNAL OF X-RAY SCIENCE AND TECHNOLOGY Vedantham, S., Tseng, H., Konate, S., Shi, L., Karellasa, A. 2020; 28 (3): 405–26
  • Fast shading correction for cone-beam CT via partitioned tissue classification PHYSICS IN MEDICINE AND BIOLOGY Shi, L., Wang, A., Wei, J., Zhu, L. 2019; 64 (6)
  • Fast shading correction for cone-beam CT via partitioned tissue classification. Physics in medicine and biology Shi, L., Wang, A. S., Wei, J., Zhu, L. 2019


    The quantitative use of cone beam computed tomography (CBCT) in radiation therapy is limited by severe shading artifacts, even with system embedded correction. We recently proposed effective shading correction methods, using planning CT (pCT) as prior information to estimate low-frequency errors in either the projection domain or the image domain. In this work, we further improve the clinical practicality of our previous methods by removing the requirement of prior pCT images. Clinical CBCT images are typically composed of a limited number of tissue types. By utilizing the low-frequency characteristic of shading distribution, we first generate a "shading-free" template image by enforcing uniformity on CBCT voxels of the same tissue type via a technique named partitioned tissue classification. Only a small subset of voxels on the template image is used to generate sparse samples of shading errors. Local filtration, a Fourier transform based algorithm, is employed to efficiently process the sparse errors to compute a full-field distribution of shading errors for CBCT correction. We evaluate the method performance on an anthropomorphic pelvis phantom and 6 pelvis patients. The proposed method improves the image quality of CBCT on both phantom and patients to a level matching that of pCT. On phantom, the signal non-uniformity (SNU) is reduced from 12.11 to 3.11% and 8.40 to 2.21% on fat and muscle, respectively. The maximum CT number error is reduced from 70 to 10 HU and 73 to 11 HU on fat and muscle, respectively. On patients, the average SNU is reduced from 9.22% to 1.06% and 11.41% to 1.67% on fat and muscle, respectively. The maximum CT number error is reduced from 95 to 9 HU and 88 to 8 HU on fat and muscle, respectively. The typical processing time for one CBCT dataset is about 45 seconds on a standard PC. .

    View details for PubMedID 30721886

  • Breast dispersion imaging using undersampled rapid dynamic contrast-enhanced MRI Shi, L., Srinivasan, S., Hargreaves, B., Daniel, B., Mori, K., Hahn, H. K. SPIE-INT SOC OPTICAL ENGINEERING. 2019

    View details for DOI 10.1117/12.2513059

    View details for Web of Science ID 000491309500085

  • Toward quantitative short-scan cone beam CT using shift-invariant filtered-backprojection with equal weighting and image domain shading correction Shi, L., Zhu, L., Wang, A., Matej, S., Metzler, S. D. SPIE-INT SOC OPTICAL ENGINEERING. 2019

    View details for DOI 10.1117/12.2534900

    View details for Web of Science ID 000535354300068

  • Fast Intensity Non-Uniformity Correction for MR Images Using Sparse Samples Shi, L., Perkins, S., Moran, C., Hargreaves, B., Daniel, B. WILEY. 2018: E360
  • Fast Shading Correction of Cone Beam CT in Radiation Therapy Via Tissue Sparsity Shi, L., Zhu, L., Wei, J. WILEY. 2018: E403–E404
  • Internal Breast Tumor Heterogeneity On T2-Weighted Imaging: Double Echo Steady State(DESS) Versus 3D Fast Spin Echo (CUBE) Shi, L., Alley, M., Hargreaves, B., Daniel, B., Moran, C. WILEY. 2018: E192
  • The Effect of Off-Focus Radiation in Scatter Correction for Cone Beam CT Shi, L., Zhu, L. WILEY. 2018: E459
  • The role of off-focus radiation in scatter correction for dedicated cone beam breast CT MEDICAL PHYSICS Shi, L., Vedantham, S., Karellas, A., Zhu, L. 2018; 45 (1): 191–201


    Dedicated cone beam breast CT (CBBCT) suffers from x-ray scatter contamination. We aim to identify the source of the significant difference between the scatter distributions estimated by two recent methods proposed by our group and to investigate its effect on CBBCT image quality.We recently proposed two novel methods of scatter correction for CBBCT, using a library based (LB) technique and a forward projection (FP) model. Despite similar enhancement on CBBCT image qualities, these two methods obtain very different scatter distributions. We hypothesize that the off-focus radiation (OFR) is the contributor and results in nontrivial signals in x-ray projections, which is ignored in the scatter estimation via the LB method. Experiments using a thin wire test tool are designed to study the effect of OFR on CBBCT spatial resolution by measuring the point spread function (PSF) and the modulation transfer function (MTF). A narrow collimator setting is used to suppress the OFR-induced signals. In addition, "PSFs" and "MTFs" are measured on clinical CBBCT images obtained by the LB and FP methods using small calcifications as point sources. The improvement of spatial resolution achieved by suppressing OFR in the wire experiment as well as in the clinical study is quantified by the improvement ratios of PSFs and spatial frequencies at different MTF values. Our hypothesis that OFR causes the imaging difference between the FP and LB methods is verified if these ratios obtained from experimental and clinical data are consistent.In the wire experiment, the results show that suppression of OFR increases the maximum signal of the PSF by about 14% and reduces the full-width-at-half-maximum (FWHM) by about 12.0%. Similar improvement on spatial resolution is achieved by the FP method compared with the LB method in the patient study. The improvement ratios of spatial frequencies at different MTF values without OFR match very well in both studies at a level of around 16%, with an average root-mean-square difference of 0.47%.The results of the wire experiment and the clinical study indicate that the main difference between the LB and FP methods is whether the OFR-induced signals are included after scatter correction. Our study further shows that OFR significantly affects the image spatial resolution of CBBCT, indicating that the visualization of micro-calcifications is susceptible to OFR contamination. Our finding is therefore important in further improvement of diagnostic performance of CBBCT.

    View details for PubMedID 29159941

    View details for PubMedCentralID PMC5985236

  • X-ray scatter correction for dedicated cone beam breast CT using a forward-projection model MEDICAL PHYSICS Shi, L., Vedantham, S., Karellas, A., Zhu, L. 2017; 44 (6): 2312–20


    The quality of dedicated cone-beam breast CT (CBBCT) imaging is fundamentally limited by x-ray scatter contamination due to the large irradiation volume. In this paper, we propose a scatter correction method for CBBCT using a novel forward-projection model with high correction efficacy and reliability.We first coarsely segment the uncorrected, first-pass, reconstructed CBBCT images into binary-object maps and assign the segmented fibroglandular and adipose tissue with the correct attenuation coefficients based on the mean x-ray energy. The modified CBBCT are treated as the prior images toward scatter correction. Primary signals are first estimated via forward projection on the modified CBBCT. To avoid errors caused by inaccurate segmentation, only sparse samples of estimated primary are selected for scatter estimation. A Fourier-Transform based algorithm, herein referred to as local filtration hereafter, is developed to efficiently estimate the global scatter distribution on the detector. The scatter-corrected images are obtained by removing the estimated scatter distribution from measured projection data.We evaluate the method performance on six patients with different breast sizes and shapes representing the general population. The results show that the proposed method effectively reduces the image spatial non-uniformity from 8.27 to 1.91% for coronal views and from 6.50 to 3.00% for sagittal views. The contrast-to-deviation ratio is improved by an average factor of 1.41. Comparisons on the image details reveal that the proposed scatter correction successfully preserves fine structures of fibroglandular tissues that are lost in the segmentation process.We propose a highly practical and efficient scatter correction algorithm for CBBCT via a forward-projection model. The method is attractive in clinical CBBCT imaging as it is readily implementable on a clinical system without modifications in current imaging protocols or system hardware.

    View details for PubMedID 28295375

    View details for PubMedCentralID PMC5994348

  • Shading Correction for Cone Beam CT in Radiation Therapy Via Sparse Sampling On Planning CT Shi, L., Tsui, T., Wei, J., Zhu, L. WILEY. 2017: 3012
  • Fast shading correction for cone beam CT in radiation therapy via sparse sampling on planning CT MEDICAL PHYSICS Shi, L., Tsui, T., Wei, J., Zhu, L. 2017; 44 (5): 1796–1808


    The image quality of cone beam computed tomography (CBCT) is limited by severe shading artifacts, hindering its quantitative applications in radiation therapy. In this work, we propose an image-domain shading correction method using planning CT (pCT) as prior information which is highly adaptive to clinical environment.We propose to perform shading correction via sparse sampling on pCT. The method starts with a coarse mapping between the first-pass CBCT images obtained from the Varian TrueBeam system and the pCT. The scatter correction method embedded in the Varian commercial software removes some image errors but the CBCT images still contain severe shading artifacts. The difference images between the mapped pCT and the CBCT are considered as shading errors, but only sparse shading samples are selected for correction using empirical constraints to avoid carrying over false information from pCT. A Fourier-Transform-based technique, referred to as local filtration, is proposed to efficiently process the sparse data for effective shading correction. The performance of the proposed method is evaluated on one anthropomorphic pelvis phantom and 17 patients, who were scheduled for radiation therapy. (The codes of the proposed method and sample data can be downloaded from RESULTS: The proposed shading correction substantially improves the CBCT image quality on both the phantom and the patients to a level close to that of the pCT images. On the phantom, the spatial nonuniformity (SNU) difference between CBCT and pCT is reduced from 74 to 1 HU. The root of mean square difference of SNU between CBCT and pCT is reduced from 83 to 10 HU on the pelvis patients, and from 101 to 12 HU on the thorax patients. The robustness of the proposed shading correction is fully investigated with simulated registration errors between CBCT and pCT on the phantom and mis-registration on patients. The sparse sampling scheme of our method successfully avoids false structures in the corrected CBCT even when the maximum registration error is as high as 8 mm.We develop an effective shading correction algorithm for CBCT readily implementable on clinical data as a software plug-in without modifications of current imaging hardware and protocol. The algorithm is directly applied on the output images from a commercial CBCT scanner with high computational efficiency and negligible memory burden.

    View details for PubMedID 28261827

  • Scintillator performance considerations for dedicated breast computed tomography Vedantham, S., Shi, L., Karellas, A., Grim, G. P., Furenlid, L. R., Barber, H. B. SPIE-INT SOC OPTICAL ENGINEERING. 2017

    View details for DOI 10.1117/12.2279225

    View details for Web of Science ID 000435128400016

  • Effects of breast density and compression on normal breast tissue hemodynamics through breast tomosynthesis guided near-infrared spectral tomography JOURNAL OF BIOMEDICAL OPTICS Michaelsen, K. E., Krishnaswamy, V., Shi, L., Vedantham, S., Karellas, A., Pogue, B. W., Paulsen, K. D., Poplack, S. P. 2016; 21 (9): 91316


    Optically derived tissue properties across a range of breast densities and the effects of breast compression on estimates of hemoglobin, oxygen metabolism, and water and lipid concentrations were obtained from a coregistered imaging system that integrates near-infrared spectral tomography (NIRST) with digital breast tomosynthesis (DBT). Image data were analyzed from 27 women who underwent four IRB approved NIRST/DBT exams that included fully and mildly compressed breast acquisitions in two projections—craniocaudal (CC) and mediolateral-oblique (MLO)—and generated four data sets per patient (full and moderate compression in CC and MLO views). Breast density was correlated with HbT (r=0.64, p=0.001), water (r=0.62, p=0.003), and lipid concentrations (r=?0.74, p<0.001), but not oxygen saturation. CC and MLO views were correlated for individual subjects and demonstrated no statistically significant differences in grouped analysis. Comparison of compressed and uncompressed imaging demonstrated a significant decrease in oxygen saturation under compression (58% versus 50%, p=0.04). Mammographic breast density categorization was correlated with measured optically derived properties.

    View details for PubMedID 27677170

    View details for PubMedCentralID PMC5038925

  • Library based x-ray scatter correction for dedicated cone beam breast CT MEDICAL PHYSICS Shi, L., Vedantham, S., Karellas, A., Zhu, L. 2016; 43 (8): 4529–44


    The image quality of dedicated cone beam breast CT (CBBCT) is limited by substantial scatter contamination, resulting in cupping artifacts and contrast-loss in reconstructed images. Such effects obscure the visibility of soft-tissue lesions and calcifications, which hinders breast cancer detection and diagnosis. In this work, we propose a library-based software approach to suppress scatter on CBBCT images with high efficiency, accuracy, and reliability.The authors precompute a scatter library on simplified breast models with different sizes using the geant4-based Monte Carlo (MC) toolkit. The breast is approximated as a semiellipsoid with homogeneous glandular/adipose tissue mixture. For scatter correction on real clinical data, the authors estimate the breast size from a first-pass breast CT reconstruction and then select the corresponding scatter distribution from the library. The selected scatter distribution from simplified breast models is spatially translated to match the projection data from the clinical scan and is subtracted from the measured projection for effective scatter correction. The method performance was evaluated using 15 sets of patient data, with a wide range of breast sizes representing about 95% of general population. Spatial nonuniformity (SNU) and contrast to signal deviation ratio (CDR) were used as metrics for evaluation.Since the time-consuming MC simulation for library generation is precomputed, the authors' method efficiently corrects for scatter with minimal processing time. Furthermore, the authors find that a scatter library on a simple breast model with only one input parameter, i.e., the breast diameter, sufficiently guarantees improvements in SNU and CDR. For the 15 clinical datasets, the authors' method reduces the average SNU from 7.14% to 2.47% in coronal views and from 10.14% to 3.02% in sagittal views. On average, the CDR is improved by a factor of 1.49 in coronal views and 2.12 in sagittal views.The library-based scatter correction does not require increase in radiation dose or hardware modifications, and it improves over the existing methods on implementation simplicity and computational efficiency. As demonstrated through patient studies, the authors' approach is effective and stable, and is therefore clinically attractive for CBBCT imaging.

    View details for PubMedID 27487870

    View details for PubMedCentralID PMC4947049

  • Library-Based X-Ray Scatter Correction for Dedicated Cone-Beam Breast CT: Clinical Validation Shi, L., Vedantham, S., Karellas, A., Zhu, L. WILEY. 2016: 3819

    View details for DOI 10.1118/1.4957870

    View details for Web of Science ID 000402375400054

  • Task-Specific Optimization of Scintillator Thickness for CMOS-Detector Based Cone-Beam Breast CT Vedantham, S., Shrestha, S., Shi, L., Vijayaraghavan, G., Karellas, A. WILEY. 2016: 3346

    View details for DOI 10.1118/1.4955660

    View details for Web of Science ID 000402425500036

  • Scatter Correction for Dedicated Cone Beam Breast CT Based On a Forward Projection Model Shi, L., Vedantham, S., Karellas, A., Zhu, L. WILEY. 2016: 3820

    View details for DOI 10.1118/1.4957872

    View details for Web of Science ID 000402375400055

  • Photon-counting hexagonal pixel array CdTe detector: Spatial resolution characteristics for image-guided interventional applications MEDICAL PHYSICS Vedantham, S., Shrestha, S., Karellas, A., Shi, L., Gounis, M. J., Bellazzini, R., Spandre, G., Brez, A., Minuti, M. 2016; 43 (5): 2118–30


    High-resolution, photon-counting, energy-resolved detector with fast-framing capability can facilitate simultaneous acquisition of precontrast and postcontrast images for subtraction angiography without pixel registration artifacts and can facilitate high-resolution real-time imaging during image-guided interventions. Hence, this study was conducted to determine the spatial resolution characteristics of a hexagonal pixel array photon-counting cadmium telluride (CdTe) detector.A 650 μm thick CdTe Schottky photon-counting detector capable of concurrently acquiring up to two energy-windowed images was operated in a single energy-window mode to include photons of 10 keV or higher. The detector had hexagonal pixels with apothem of 30 μm resulting in pixel pitch of 60 and 51.96 μm along the two orthogonal directions. The detector was characterized at IEC-RQA5 spectral conditions. Linear response of the detector was determined over the air kerma rate relevant to image-guided interventional procedures ranging from 1.3 nGy/frame to 91.4 μGy/frame. Presampled modulation transfer was determined using a tungsten edge test device. The edge-spread function and the finely sampled line spread function accounted for hexagonal sampling, from which the presampled modulation transfer function (MTF) was determined. Since detectors with hexagonal pixels require resampling to square pixels for distortion-free display, the optimal square pixel size was determined by minimizing the root-mean-squared-error of the aperture functions for the square and hexagonal pixels up to the Nyquist limit.At Nyquist frequencies of 8.33 and 9.62 cycles/mm along the apothem and orthogonal to the apothem directions, the modulation factors were 0.397 and 0.228, respectively. For the corresponding axis, the limiting resolution defined as 10% MTF occurred at 13.3 and 12 cycles/mm, respectively. Evaluation of the aperture functions yielded an optimal square pixel size of 54 μm. After resampling to 54 μm square pixels using trilinear interpolation, the presampled MTF at Nyquist frequency of 9.26 cycles/mm was 0.29 and 0.24 along the orthogonal directions and the limiting resolution (10% MTF) occurred at approximately 12 cycles/mm. Visual analysis of a bar pattern image showed the ability to resolve close to 12 line-pairs/mm and qualitative evaluation of a neurovascular nitinol-stent showed the ability to visualize its struts at clinically relevant conditions.Hexagonal pixel array photon-counting CdTe detector provides high spatial resolution in single-photon counting mode. After resampling to optimal square pixel size for distortion-free display, the spatial resolution is preserved. The dual-energy capabilities of the detector could allow for artifact-free subtraction angiography and basis material decomposition. The proposed high-resolution photon-counting detector with energy-resolving capability can be of importance for several image-guided interventional procedures as well as for pediatric applications.

    View details for PubMedID 27147324

    View details for PubMedCentralID PMC4826388

  • Library-based scatter correction for dedicated cone beam breast CT: a feasibility study Shi, L., Vedantham, S., Karellas, A., Zhu, L., Kontos, D., Flohr, T. G., Lo, J. Y. SPIE-INT SOC OPTICAL ENGINEERING. 2016

    View details for DOI 10.1117/12.2217327

    View details for Web of Science ID 000378352900102

  • Calibration and optimization of 3D digital breast tomosynthesis guided near infrared spectral tomography BIOMEDICAL OPTICS EXPRESS Michaelsen, K. E., Krishnaswamy, V., Shi, L., Vedantham, S., Poplack, S. P., Karellas, A., Pogue, B. W., Paulsen, K. D. 2015; 6 (12): 4981–91


    Calibration of a three-dimensional multimodal digital breast tomosynthesis (DBT) x-ray and non-fiber based near infrared spectral tomography (NIRST) system is challenging but essential for clinical studies. Phantom imaging results yielded linear contrast recovery of total hemoglobin (HbT) concentration for cylindrical inclusions of 15 mm, 10 mm and 7 mm with a 3.5% decrease in the HbT estimate for each 1 cm increase in inclusion depth. A clinical exam of a patient's breast containing both benign and malignant lesions was successfully imaged, with greater HbT was found in the malignancy relative to the benign abnormality and fibroglandular regions (11 μM vs. 9.5 μM). Tools developed improved imaging system characterization and optimization of signal quality, which will ultimately improve patient selection and subsequent clinical trial results.

    View details for PubMedID 26713210

  • Accuracy of Radiologists Interpretation of Mammographic Breast Density Vedantham, S., Shi, L., Karellas, A., O'Connell, A. AMER ASSOC PHYSICISTS MEDICINE AMER INST PHYSICS. 2015: 3574–75

    View details for DOI 10.1118/1.4925452

    View details for Web of Science ID 000356998302695

  • Dedicated Cone-Beam Breast CT: Design of a 3-D Beam-Shaping Filter Vedantham, S., Shi, L., Karellas, A. AMER ASSOC PHYSICISTS MEDICINE AMER INST PHYSICS. 2015: 3612

    View details for DOI 10.1118/1.4925629

    View details for Web of Science ID 000356998303096

  • Dedicated Cone-Beam Breast CT with Laterally-Shifted Detector: Monte Carlo Evaluation of X-Ray Scatter Distribution and Scatter-To-Primary Ratio Shi, L., Vedantham, S., Karellas, A. AMER ASSOC PHYSICISTS MEDICINE AMER INST PHYSICS. 2015: 3682

    View details for DOI 10.1118/1.4926013

    View details for Web of Science ID 000356998303330

  • Large-angle x-ray scatter in Talbot-Lau interferometry for breast imaging PHYSICS IN MEDICINE AND BIOLOGY Vedantham, S., Shi, L., Karellas, A. 2014; 59 (21): 6387–6400


    Monte Carlo simulations were used to investigate large-angle x-ray scatter at design energy of 25 keV during small field of view (9.6 cm × 5 cm) differential phase contrast imaging of the breast using Talbot-Lau interferometry. Homogenous, adipose and fibroglandular breasts of uniform thickness ranging from 2 to 8 cm encompassing the field of view were modeled. Theoretically determined transmission efficiencies of the gratings were used to validate the Monte Carlo simulations, followed by simulations to determine the x-ray scatter reaching the detector. The recorded x-ray scatter was classified into x-ray photons that underwent at least one Compton interaction (incoherent scatter) and Rayleigh interaction alone (coherent scatter) for further analysis. Monte Carlo based estimates of transmission efficiencies showed good correspondence [Formula: see text] with theoretical estimates. Scatter-to-primary ratio increased with increasing breast thickness, ranging from 0.11 to 0.22 for 2-8 cm thick adipose breasts and from 0.12 to 0.28 for 2-8 cm thick fibroglandular breasts. The analyzer grating reduced incoherent scatter by ~18% for 2 cm thick adipose breast and by ~35% for 8 cm thick fibroglandular breast. Coherent scatter was the dominant contributor to the total scatter. Coherent-to-incoherent scatter ratio ranged from 2.2 to 3.1 for 2-8 cm thick adipose breasts and from 2.7 to 3.4 for 2-8 cm thick fibroglandular breasts.

    View details for PubMedID 25295630

    View details for PubMedCentralID PMC4208689

  • Dedicated Breast CT: Feasibility for Monitoring Neoadjuvant Chemotherapy Treatment JOURNAL OF CLINICAL IMAGING SCIENCE Vedantham, S., O'Connell, A. M., Shi, L., Karellas, A., Huston, A. J., Skinner, K. A. 2014; 4: 64


    In this prospective pilot study, the feasibility of non-contrast dedicated breast computed tomography (bCT) to determine primary tumor volume and monitor its changes during neoadjuvant chemotherapy (NAC) treatment was investigated.Eleven women who underwent NAC were imaged with a clinical prototype dedicated bCT system at three time points - pre-, mid-, and post-treatment. The study radiologist marked the boundary of the primary tumor from which the tumor volume was quantified. An automated algorithm was developed to quantify the primary tumor volume for comparison with radiologist's segmentation. The correlation between pre-treatment tumor volumes from bCT and MRI, and the correlation and concordance in tumor size between post-treatment bCT and pathology were determined.Tumor volumes from automated and radiologist's segmentations were correlated (Pearson's r = 0.935, P < 0.001) and were not different over all time points [P = 0.808, repeated measures analysis of variance (ANOVA)]. Pre-treatment tumor volumes from MRI and bCT were correlated (r = 0.905, P < 0.001). Tumor size from post-treatment bCT was correlated with pathology (r = 0.987, P = 0.002) for invasive ductal carcinoma larger than 5 mm and the maximum difference in tumor size was 0.57 cm. The presence of biopsy clip (3 mm) limited the ability to accurately measure tumors smaller than 5 mm. All study participants were pathologically assessed to be responders, with three subjects experiencing complete pathologic response for invasive cancer and the reminder experiencing partial response. Compared to pre-treatment tumor volume, there was a statistically significant (P = 0.0003, paired t-test) reduction in tumor volume at mid-treatment observed with bCT, with an average tumor volume reduction of 47%.This pilot study suggests that dedicated non-contrast bCT has the potential to serve as an expedient imaging tool for monitoring tumor volume changes during NAC. Larger studies are needed in future.

    View details for PubMedID 25558431

    View details for PubMedCentralID PMC4278089

  • Volumetric Breast Density: Comparison of Estimates From Tomosynthesis Reconstructions with Mammography Shi, L., Vedantham, S., Michaelsen, K., Krishnaswamy, V., Shenoy, A., Pogue, B., Karellas, A., Paulsen, K. WILEY. 2014

    View details for DOI 10.1118/1.4888004

    View details for Web of Science ID 000439383100039

  • Personalized estimates of radiation dose from dedicated breast CT in a diagnostic population and comparison with diagnostic mammography PHYSICS IN MEDICINE AND BIOLOGY Vedantham, S., Shi, L., Karellas, A., O'Connell, A. M., Conover, D. L. 2013; 58 (22): 7921–36


    This study retrospectively analyzed the mean glandular dose (MGD) to 133 breasts from 132 subjects, all women, who participated in a clinical trial evaluating dedicated breast CT in a diagnostic population. The clinical trial was conducted in adherence to a protocol approved by institutional review boards and the study participants provided written informed consent. Individual estimates of MGD to each breast from dedicated breast CT was obtained by combining x-ray beam characteristics with estimates of breast dimensions and fibroglandular fraction from volumetric breast CT images, and using normalized glandular dose coefficients. For each study participant and for the breast corresponding to that imaged with breast CT, an estimate of the MGD from diagnostic mammography (including supplemental views) was obtained from the DICOM image headers for comparison. This estimate uses normalized glandular dose coefficients corresponding to a breast with 50% fibroglandular weight fraction. The median fibroglandular weight fraction for the study cohort determined from volumetric breast CT images was 15%. Hence, the MGD from diagnostic mammography was corrected to be representative of the study cohort. Individualized estimates of MGD from breast CT ranged from 5.7 to 27.8 mGy. Corresponding to the breasts imaged with breast CT, the MGD from diagnostic mammography ranged from 2.6 to 31.6 mGy. The mean (± inter-breast SD) and the median MGD (mGy) from dedicated breast CT exam were 13.9 ± 4.6 and 12.6, respectively. For the corresponding breasts, the mean (± inter-breast SD) and the median MGD (mGy) from diagnostic mammography were 12.4 ± 6.3 and 11.1, respectively. Statistical analysis indicated that at the 0.05 level, the distributions of MGD from dedicated breast CT and diagnostic mammography were significantly different (Wilcoxon signed ranks test, p = 0.007). While the interquartile range and the range (maximum-minimum) of MGD from dedicated breast CT was lower than diagnostic mammography, the median MGD from dedicated breast CT was approximately 13.5% higher than that from diagnostic mammography. The MGD for breast CT is based on a 1.45 mm skin layer and that for diagnostic mammography is based on a 4 mm skin layer; thus, favoring a lower estimate for MGD from diagnostic mammography. The median MGD from dedicated breast CT corresponds to the median MGD from four to five diagnostic mammography views. In comparison, for the same 133 breasts, the mean and the median number of views per breast during diagnostic mammography were 4.53 and 4, respectively. Paired analysis showed that there was approximately equal likelihood of receiving lower MGD from either breast CT or diagnostic mammography. Future work will investigate methods to reduce and optimize radiation dose from dedicated breast CT.

    View details for PubMedID 24165162

    View details for PubMedCentralID PMC3872967

  • X-Ray Scatter in Differential Phase-Contrast Breast Imaging Using Gratings-Based Interferometer Vedantham, S., Shi, L., Karellas, A. AMER ASSOC PHYSICISTS MEDICINE AMER INST PHYSICS. 2013

    View details for DOI 10.1118/1.4815664

    View details for Web of Science ID 000336849900081

  • Radiation Dose Reduction and Image Quality Evaluation of Coronal Truncated Projections in Cone-Beam Dedicated Breast CT Konate, S., Vedantham, S., Shi, L., Karellas, A. AMER ASSOC PHYSICISTS MEDICINE AMER INST PHYSICS. 2013

    View details for DOI 10.1118/1.4814101

    View details for Web of Science ID 000336849902391

  • Technical Note: Skin thickness measurements using high-resolution flat-panel cone-beam dedicated breast CT MEDICAL PHYSICS Shi, L., Vedantham, S., Karellas, A., O'Connell, A. M. 2013; 40 (3): 031913


    To determine the mean and range of location-averaged breast skin thickness using high-resolution dedicated breast CT for use in Monte Carlo-based estimation of normalized glandular dose coefficients.This study retrospectively analyzed image data from a clinical study investigating dedicated breast CT. An algorithm similar to that described by Huang et al. ["The effect of skin thickness determined using breast CT on mammographic dosimetry," Med. Phys. 35(4), 1199-1206 (2008)] was used to determine the skin thickness in 137 dedicated breast CT volumes from 136 women. The location-averaged mean breast skin thickness for each breast was estimated and the study population mean and range were determined. Pathology results were available for 132 women, and were used to investigate if the distribution of location-averaged mean breast skin thickness varied with pathology. The effect of surface fitting to account for breast curvature was also studied.The study mean (± interbreast SD) for breast skin thickness was 1.44 ± 0.25 mm (range: 0.87-2.34 mm), which was in excellent agreement with Huang et al. Based on pathology, pair-wise statistical analysis (Mann-Whitney test) indicated that at the 0.05 significance level, there were no significant difference in the location-averaged mean breast skin thickness distributions between the groups: benign vs malignant (p = 0.223), benign vs hyperplasia (p = 0.651), hyperplasia vs malignant (p = 0.229), and malignant vs nonmalignant (p = 0.172).Considering this study used a different clinical prototype system, and the study participants were from a different geographical location, the observed agreement between the two studies suggests that the choice of 1.45 mm thick skin layer comprising the epidermis and the dermis for breast dosimetry is appropriate. While some benign and malignant conditions could cause skin thickening, in this study cohort the location-averaged mean breast skin thickness distributions did not differ significantly with pathology. The study also underscored the importance of considering breast curvature in estimating breast skin thickness.

    View details for PubMedID 23464328

  • Scaling-law for the energy dependence of anatomic power spectrum in dedicated breast CT MEDICAL PHYSICS Vedantham, S., Shi, L., Glick, S. J., Karellas, A. 2013; 40 (1): 011901


    To determine the x-ray photon energy dependence of the anatomic power spectrum of the breast when imaged with dedicated breast computed tomography (CT).A theoretical framework for scaling the empirically determined anatomic power spectrum at one x-ray photon energy to that at any given x-ray photon energy when imaged with dedicated breast CT was developed. Theory predicted that when the anatomic power spectrum is fitted with a power curve of the form k f(-β), where k and β are fit coefficients and f is spatial frequency, the exponent β would be independent of x-ray photon energy (E), and the amplitude k scales with the square of the difference in energy-dependent linear attenuation coefficients of fibroglandular and adipose tissues. Twenty mastectomy specimens based numerical phantoms that were previously imaged with a benchtop flat-panel cone-beam CT system were converted to 3D distribution of glandular weight fraction (f(g)) and were used to verify the theoretical findings. The 3D power spectrum was computed in terms of f(g) and after converting to linear attenuation coefficients at monoenergetic x-ray photon energies of 20-80 keV in 5 keV intervals. The 1D power spectra along the axes were extracted and fitted with a power curve of the form k f(-β). The energy dependence of k and β were analyzed.For the 20 mastectomy specimen based numerical phantoms used in the study, the exponent β was found to be in the range of 2.34-2.42, depending on the axis of measurement. Numerical simulations agreed with the theoretical predictions that for a power-law anatomic spectrum of the form k f(-β), β was independent of E and k(E) = k(1)[μ(g)(E) - μ(a)(E)](2), where k(1) is a constant, and μ(g)(E) and μ(a)(E) represent the energy-dependent linear attenuation coefficients of fibroglandular and adipose tissues, respectively.Numerical simulations confirmed the theoretical predictions that in dedicated breast CT, the spatial frequency dependence of the anatomic power spectrum will be independent of x-ray photon energy, and the amplitude of the anatomic power spectrum scales by the square of difference in linear attenuation coefficients of fibroglandular and adipose tissues.

    View details for PubMedID 23298092

  • Dedicated breast CT: Fibroglandular volume measurements in a diagnostic population MEDICAL PHYSICS Vedantham, S., Shi, L., Karellas, A., O'Connell, A. M. 2012; 39 (12): 7317–28


    To determine the mean and range of volumetric glandular fraction (VGF) of the breast in a diagnostic population using a high-resolution flat-panel cone-beam dedicated breast CT system. This information is important for Monte Carlo-based estimation of normalized glandular dose coefficients and for investigating the dependence of VGF on breast dimensions, race, and pathology.Image data from a clinical trial investigating the role of dedicated breast CT that enrolled 150 women were retrospectively analyzed to determine the VGF. The study was conducted in adherence to a protocol approved by the institutional human subjects review boards and written informed consent was obtained from all study participants. All participants in the study were assigned BI-RADS(®) 4 or 5 as per the American College of Radiology assessment categories after standard diagnostic work-up and underwent dedicated breast CT exam prior to biopsy. A Gaussian-kernel based fuzzy c-means algorithm was used to partition the breast CT images into adipose and fibroglandular tissue after segmenting the skin. Upon determination of the accuracy of the algorithm with a phantom, it was applied to 137 breast CT volumes from 136 women. VGF was determined for each breast and the mean and range were determined. Pathology results with classification as benign, malignant, and hyperplasia were available for 132 women, and were used to investigate if the distributions of VGF varied with pathology.The algorithm was accurate to within ±1.9% in determining the volume of an irregular shaped phantom. The study mean (± inter-breast SD) for the VGF was 0.172 ± 0.142 (range: 0.012-0.719). VGF was found to be negatively correlated with age, breast dimensions (chest-wall to nipple length, pectoralis to nipple length, and effective diameter at chest-wall), and total breast volume, and positively correlated with fibroglandular volume. Based on pathology, pairwise statistical analysis (Mann-Whitney test) indicated that at the 0.05 significance level, there was no significant difference in distributions of VGF without adjustment for age between malignant and nonmalignant breasts (p = 0.41). Pairwise comparisons of the distributions of VGF in increasing order of mammographic breast density indicated all comparisons were statistically significant (p < 0.002).This study used a different clinical prototype breast CT system than that in previous studies to image subjects from a different geographical region, and used a different algorithm for analysis of image data. The mean VGF estimated from this study is within the range reported in previous studies, indicating that the choice of 50% glandular weight fraction to represent an average breast for Monte Carlo-based estimation of normalized glandular dose coefficients in mammography needs revising. In the study, the distributions of VGF did not differ significantly with pathology.

    View details for PubMedID 23231281

  • Dedicated breast CT: radiation dose for circle-plus-line trajectory MEDICAL PHYSICS Vedantham, S., Shi, L., Karellas, A., Noo, F. 2012; 39 (3): 1530–41


    Dedicated breast CT prototypes used in clinical investigations utilize single circular source trajectory and cone-beam geometry with flat-panel detectors that do not satisfy data-sufficiency conditions and could lead to cone beam artifacts. Hence, this work investigated the glandular dose characteristics of a circle-plus-line trajectory that fulfills data-sufficiency conditions for image reconstruction in dedicated breast CT.Monte Carlo-based computer simulations were performed using the GEANT4 toolkit and was validated with previously reported normalized glandular dose coefficients for one prototype breast CT system. Upon validation, Monte Carlo simulations were performed to determine the normalized glandular dose coefficients as a function of x-ray source position along the line scan. The source-to-axis of rotation distance and the source-to-detector distance were maintained constant at 65 and 100 cm, respectively, in all simulations. The ratio of the normalized glandular dose coefficient at each source position along the line scan to that for the circular scan, defined as relative normalized glandular dose coefficient (RD(g)N), was studied by varying the diameter of the breast at the chest wall, chest-wall to nipple distance, skin thickness, x-ray beam energy, and glandular fraction of the breast.The RD(g)N metric when stated as a function of source position along the line scan, relative to the maximum length of line scan needed for data sufficiency, was found to be minimally dependent on breast diameter, chest-wall to nipple distance, skin thickness, glandular fraction, and x-ray photon energy. This observation facilitates easy estimation of the average glandular dose of the line scan. Polynomial fit equations for computing the RD(g)N and hence the average glandular dose are provided.For a breast CT system that acquires 300-500 projections over 2π for the circular scan, the addition of a line trajectory with equal source spacing and constant x-ray beam quality (kVp and HVL) and mAs matched to the circular scan, will result in less than 0.18% increase in average glandular dose to the breast per projection along the line scan.

    View details for PubMedID 22380385

  • Cone-Beam Artifacts in Dedicated Breast CT Vedantham, S., Shi, L., Noo, F., Glick, S., Karellas, A. WILEY. 2011

    View details for DOI 10.1118/1.3611724

    View details for Web of Science ID 000411558900029

  • Semi-automated Segmentation and Classification of Digital Breast Tomosynthesis Reconstructed Images Vedantham, S., Shi, L., Karellas, A., Michaelsen, K. E., Krishnaswamy, V., Pogue, B. W., Paulsen, K. D., IEEE IEEE. 2011: 6188–91


    Digital breast tomosynthesis (DBT) is a limited-angle tomographic x-ray imaging technique that reduces the effect of tissue superposition observed in planar mammography. An integrated imaging platform that combines DBT with near infrared spectroscopy (NIRS) to provide co-registered anatomical and functional imaging is under development. Incorporation of anatomic priors can benefit NIRS reconstruction. In this work, we provide a segmentation and classification method to extract potential lesions, as well as adipose, fibroglandular, muscle and skin tissue in reconstructed DBT images that serve as anatomic priors during NIRS reconstruction. The method may also be adaptable for estimating tumor volume, breast glandular content, and for extracting lesion features for potential application to computer aided detection and diagnosis.

    View details for PubMedID 22255752

    View details for PubMedCentralID PMC3548319

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