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Dentomaxillofacial Radiology (2004) 33, 361–369 q 2004 The British Institute of Radiology http://dmfr.birjournals.org RESEARCH Effect of number of projections on image quality of local CT AN van Daatselaar*, PF van der Stelt and J Weenen Department of Oral Radiology, Academic Center for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands Objectives: To determine the image quality of the local CT imaging procedure, in terms of resolution, contrast, and noise as a function of the number of projections. Methods: The contrast and resolution of the images was determined with a phantom object consisting of three rods of different materials, as well as a phantom human head embedded in soft tissue equivalent material. In addition, slices reconstructed from computed sinograms were used for comparison. Results: Sharpness, contrast and noise were determined as a function of the number of projections. The number of projections was found to affect the contrast and the noise most, and had much less influence on resolution. Conclusions: Judging from the images of the phantom head and the numerical data, it seems that the minimum number of projections needed to obtain images of useful quality in the geometry used is about 33. Improved image quality (at any number of projections) can best be achieved through noise suppression. Dentomaxillofacial Radiology (2004) 33, 361–369. doi: 10.1259/dmfr/23496562 Keywords: tomography, X-ray computed; local CT; digital radiography; image reconstruction, image quality Introduction Computed tomography (CT) is a frequently used technique in medical radiology, providing detailed information by means of cross-sectional images and volume reconstruction. However, the radiation dose involved in conventional CT is relatively high for the diagnosis of non-lethal oral and maxillofacial pathology, although the advent of faster image acquisition schemes in conventional CT and the introduction of cone beam CT modalities have lowered the radiation dose significantly. Local CT1 – 3 is a variant of CT that aims to reduce the radiation dose to the patient by using a narrow X-ray beam that only covers the area of interest. As a consequence, the field of view is reduced in size as determined by the size of the detector and the width of the beam. A complicating factor in local CT is the influence of the structures surrounding the region of interest. These structures reduce contrast and the signal to noise ratio. A primary parameter of the imaging geometry is the number of projections used. Clearly, reducing the number *Correspondence to: AN van Daatselaar, Department of Oral Radiology, Academic Center for Dentistry Amsterdam (ACTA), Louwesweg 1, 1066EA Amsterdam, The Netherlands; E-mail: [email protected] Received 20 August 2003; revised 9 September 2004; accepted 10 September 2004 of projections used for the reconstruction can reduce the radiation dose to the patient. However, reducing the number of projections will also reduce image quality because of the sparser sampling of image data. The problem this study addresses is how many projections are necessary to obtain an adequate image quality for the diagnostic question at hand. The reduction of the number of basis projections is relevant not only for local CT, but also for other, related, imaging modalities. For instance, tuned aperture computed tomography (TACTw) also generates images from a number of basis projections and the diagnostic quality of the images has been investigated.4 Image quality can be objectively qualified by measuring noise, resolution and contrast.5,6 It is to be expected that a lower number of projections would result in a lower image quality. The objective of this study is to obtain insight into the effects of the number of projections on noise, resolution and contrast, related to an imaging geometry that is suitable for local CT in dental diagnosis. In addition, an attempt can be made to determine the minimum number of projections that is required for the detection of specific details in the volume of interest. Image quality of local CT van Daatselaar et al 362 Materials and methods Experimental set-up The experimental set-up used, outlined in Figure 1, is similar to that used in previous studies.3,7 It consists of a Heliodent X-ray source (Sirona, Bensheim, Germany), a lead diaphragm, a rotational stage (Micro-controle, Vitrysur-Seine, France), and the Sidexis charge-coupled device (CCD) detector (Sirona, Bensheim, Germany), all mounted on an optical bench. The object to be studied is mounted on the rotational stage. The diaphragm serves to intercept as much scattered radiation as possible and limits the beam to the size of the detector. The CCD has 872 rows and 664 columns of pixels, the size of which is 39 mm by 39 mm. The CCD has 12-bit resolution (it can discern 4096 levels of radiation intensity). Using 12 bit data (instead of the more standard 8 bit) improves contrast and increases the signal to noise ratio because the data are not rounded off to 8 bits, and because we make use of the larger dynamical range the 12 bit data provides. An 8-bit system will only register 256 to 1 intensity ratios, whereas a 12-bit system can register up to 4096 to 1 intensity ratios. This is especially important because of the fact that the object is imaged from all directions, some of them resulting in the X-ray beam traversing through thick layers of bone and others in which only a small amount of soft tissues is in the X-ray beam. The X-ray source is equipped with an internal 1.5 mm aluminium filter and has a 0.7 mm focal spot size. It was set at 70 kV and an exposure time of 0.64 s. The source – object distance was set at 123 cm, the object – detector distance was as small as possible for the free rotation of the object along the sensor. For the test object this was 1.5 cm and for the phantom head it was 9 cm, measured from the rotational axis to the detector. The CT series taken consisted of 180 projections through 1808. From these series other series with fewer projections were made by deleting projections. This was done in such a way that the remaining projections were still as much as possible equally spaced. data, before the window and level operation that transforms them to viewable 8 bit images. Therefore, these measurements were not influenced by the window and level operation, which is somewhat arbitrary in nature and which causes some round-off noise when the data are reduced to 8 bits. The contrast measurements were performed on windowed and levelled images because these measurements need a well defined background level and non-negative grey values. Test object To ascertain image quality, a test object was made consisting of three cylindrical posts mounted on a small plastic disk. The posts are 5 mm in diameter and are mounted 4.5 mm from the centre of the disk, in a symmetrical formation (Figure 2). The three posts are made of aluminium, Perspex and plaster. Because the sizes and positions of the posts are well known and because they are made from homogeneous materials, the expected crosssections are well defined. The cross-sections are well suited for measurements and comparison with theoretical cross-sections obtained from calculations. The reconstructed slices were 332 by 332 pixels in size. Five consecutive slices were averaged to reduce noise. The slice thickness was approximately 0.2 mm. No filtering other than the ramp-filtering inherent in filtered backprojection was used. Computed phantom The cross-section of the test object consists of three circles, equal in diameter and positioned on the vertices of an Reconstructions The cross-sectional slices were obtained by filtered backprojection,6,8,9 using software written by one of the authors.3 In the case of the head phantom, the filtered backprojection as described in van Daatselaar et al3 was combined with extrapolation of the projection data to counter artefacts caused by the cutoff of the projection data at the edges of the detector. The measurements on noise and resolution were done on the raw floating point image Figure 1 distances Schematic diagram of the experimental set-up with typical Dentomaxillofacial Radiology Figure 2 Schematic drawing of the test object Image quality of local CT van Daatselaar et al 363 equilateral triangle. The X-ray absorption through such an arrangement of circles (or, more generally, any arrangement of ellipses) can be easily computed. The well-known Shepp-Logan head phantom8,10 is an example of a phantom consisting of an arrangement of ellipses. We developed a virtual test object to compare with the real test object. The computed sinogram3,6 of this virtual test object is shown in Figure 3. This sinogram is geometrically exact, and contains no noise. The represented objects are purely homogeneous. In addition, the absorption is strictly according to Beer’s law (exponential attenuation), and is free of beam hardening, without scattering. However, the number of projections is finite and this will cause some artefacts. The reconstructed slices were 332 by 332 pixels in size. No slices were averaged. Because the object is mathematical, all cross-sections and therefore all slices are exactly equal, and averaging will produce no effect. No filtering other than ramp-filtering was used. regions are analysed by computing the average grey value and standard deviation. The signal is defined as the difference between the average value for the background and the average value for each post. The standard deviation of the pixel values in each post serves as a measure for noise. In the ideal case, all pixels should have the same value, as the posts are homogeneous. But electronic noise and reconstruction artefacts will cause variations that show up as noise. By comparing the standard deviation with the average value, a signal to noise ratio (SNR) can be computed using the following equation: signal ð1Þ SNR ¼ 10·log noise Head phantom The head phantom used is a custom made head phantom, a human skull embedded in soft tissue equivalent material. This material gives the phantom the shape of a normal human head. The material scatters and absorbs the radiation in the same way as human soft tissues. The images obtained from the phantom therefore are comparable in image quality with the images obtained from patients, although it does not include small errors caused by the difficulty to completely immobilize a real patient. The slices obtained were 400 by 400 pixels in size. For each image used, five consecutive slices were averaged, resulting in a slice thickness of approximately 0.2 mm. With BS the brightness of the object and B0 the brightness of the background. For this measurement images scaled to (viewable) 8 bit images were used, in order to have a well defined background level. This is necessary because Equation 2 requires positive values, and brightness values defined relative to zero (or black). The transition from post to background is measured by examining the pixels near the transition region. For each pixel the distance to the centre and its brightness are recorded. To this data a scaled error function is then fitted. This function has the form Measuring image quality For measuring the image quality of the slices of the test object a software tool was implemented that computes certain statistical properties of the image and produces graphs that can be used to assess contrast and noise. The image is divided into regions by means of six circles, two circular regions for each post (Figure 4). The radius and positions of the two circles for each post are chosen so that one falls slightly within the post, and one slightly outside the post. If the circles are chosen as in Figure 4, they divide the reconstruction into seven regions, of which four are used. The inner circle for each post defines the pixels belonging to the post, and all pixels outside the outer circles are defined as background pixels. The annular regions within the inner and outer circles are not used, as they constitute the transition region from post to background. The pixels in the four Figure 3 Contrast C can be defined5 as C¼ lBS 2 B0 l B0 ð2Þ yðxÞ ¼ a þ b erfðcx þ dÞ with erf(x) the error function. a and b determine the left and right limits, e.g. the object and background brightness. c and d determine the position of the point of inflexion, e.g. the edge of the object. c determines the width of the transition region, e.g. the width of the blurry transition from object to background. This non-linear four parameter model is fitted to the data using the Leverberg-Marquardt method.11 This method is an iterative algorithm for a leastsquares fit of a non-linear model to measured data. Nonlinear refers to the fact that the model depends non-linearly on its parameters. In the present case, the parameters c and d make the model non-linear. Results Reconstructions Reconstructions of the real test object are presented in Figure 5. Reconstructions using several different numbers Computed sinogram of the virtual test object Dentomaxillofacial Radiology Image quality of local CT van Daatselaar et al 364 Figure 4 A reconstructed slice of the test object, with regions indicated. The circles define the areas that are inside and outside the posts Figure 5 Six reconstructed CT slices through test object. Left: Perspex, top: aluminium, bottom: plaster. Figures 5a – f have been reconstructed with decreasing numbers of projections. a, 180 projections; b, 90; c, 60; d, 45; e, 30; f, 18 Dentomaxillofacial Radiology Image quality of local CT van Daatselaar et al of basis projections are shown. Reconstructions of the virtual test object are presented in Figure 6, using the same numbers of projections as in Figure 5. Reconstructions of the phantom head are shown in Figure 7. Signal to noise ratios Signal to noise ratios have been measured for the test object using Equation 1, and are visualized in Figure 8. The ratios have been plotted as a function of the number of projections. Each graph shows a plot for five averaged slices, for three averaged slices and for a slice with no averaging. In the case of Perspex, the material with the smallest absorption coefficient, it is clear that for low numbers of projections, the signal is completely lost in the noise because of the negative signal to noise values. Compare these graphs with the images in Figures 5 and 6. The signal to noise ratios measured for the computed phantom are presented in Figure 9. In the computed phantom, noise is primarily due to the finite number of projections. Resolution A graph showing measured profiles is shown in Figure 10. The graph shows three point clouds, representing the pixels near the edge of each of the three posts. The fitted error Figure 6 365 functions are plotted in white. Measurements of resolution are presented in Figure 11. Contrast Measurements of contrast according to Equation 2 have been made and are presented in Figure 12. For each material the contrast is plotted as a function of the number of projections. This has been repeated for 3 and 5 averaged slices. Discussion and conclusions It is clear that for all three materials of the real test object the SNR increases as the number of projections is increased (Figure 8). In addition, the materials with higher absorption coefficients have better signal to noise ratios. In the case of Perspex, the material with the smallest absorption coefficient, it is clear that for low numbers of projections, the signal is completely lost in the noise, that is, the contrast of the images is so poor that the object is not recognizable. The same conclusion can be drawn for the contrast: increasing the number of projections increases the contrast (Figure 12). In the images of the head phantom (Figure 7), Slices reconstructed from computed data. a, 180 projections; b, 90; c, 60; d, 45; e, 30; f, 18 Dentomaxillofacial Radiology Image quality of local CT van Daatselaar et al 366 Figure 7 Horizontal local CT cross-sections centred at the right first lower molar of the phantom head with soft tissue equivalent material. The number of projections used is indicated in the images which simulate clinical images, the lower limit for the number of projections seems to be approximately 30. With fewer projections, all relevant anatomy is rendered invisible. The contrast in the test object is about 0.8 for 30 projections. The sharpness of the images of the test object are surprisingly not very dependent on the number of projections, except for low numbers of projections, where the sharpness becomes meaningless because of the dominant artefacts (Figure 11). The sharpness does however depend on the material. The sharpnesses found are approximately 4.3 pixels (220 mm) for aluminium, 5.4 pixels (280 mm) for plaster and 6.3 pixels (324 mm) for Perspex. The graphs for the computed phantom (Figure 9) show the same trends. However, for the computed phantom the source of the noise is clear: noise and artefacts can only be caused by the limited number of projections. A perfect image will only be obtained for an infinite number of projections. Because the head phantom is not accessible for direct measurements, measuring noise, contrast and sharpness is difficult. However, the head phantom can be inspected visually. All anatomical details not on the microscopic level have been retained in the bone. Dentomaxillofacial Radiology The slices show the major anatomical structures of the teeth: root canals, lamina dura, and periodontal space are clearly seen, as well as the cortical and trabecular structure of the surrounding bone. Judging from the graphs and figures, it seems that the minimum number of projections needed to obtain images of useful quality is about 33. With fewer than 20 projections the contrast in the reconstructions is lost and with fewer than 33 projections the sharpness of the reconstruction is lost. This can be seen in Figure 11 where below 33 projections the constant resolution is overtaken by noise. In conclusion, the number of projections affects mostly the contrast and the noise, not the resolution. Improved image quality (at a certain number of projections) must therefore come from reduction of noise and improvement of contrast. Reduction of noise can be achieved either by using better hardware, e.g. CCD detectors with less noisy signals, or by software noise suppression. Acknowledgments Special settings making the raw 12 bit image data available from the system were supplied by Sirona. Image quality of local CT van Daatselaar et al Figure 8 Figure 9 367 Graphs of the signal to noise ratio for the three materials. (a) Aluminium; (b) Perspex; (c) plaster Noise measurements for the computed phantom Figure 10 Graph showing the profiles of the three posts. The highest is of aluminium, the middle graph of plaster, and the lower graph of Perspex. The slices are based on 180 projections. The white lines are the error functions fitted to the measured data Dentomaxillofacial Radiology Image quality of local CT van Daatselaar et al 368 Figure 11 Measurements of the resolution at the edges of the posts Figure 12 Measurements of the contrast in the reconstructions of the test object. Note the different scale for Perspex References 1. Lewitt RM. Processing of incomplete measurement data in computed tomography. Med Phys 1979; 6: 412 –417. 2. Smith K, Keinert F. Mathematical foundations of computed tomography. Applied Optics 1985; 24: 3950 –3957. Dentomaxillofacial Radiology 3. 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The Fourier reconstruction of a head section. IEEE Trans Nucl Sci 1974; NS-21: 21 –43. 11. Press WH, Flannery BP, Teukolsky SA. Vetterling WT. Modeling of data. In: Numerical recipes, the art of scientific computing. Cambridge: Cambridge University Press, 1990, pp 498 –546. Dentomaxillofacial Radiology