C-arm based cone-beam CT (CBCT) has evolved into a routine clinical imaging modality to provide threedimensional tomographic image guidance before, during, and after an interventional procedure. It is often used to update the clinician to the state of the patient anatomy and interventional tool placement. Due to the repeatedly use of CBCT, the accumulated radiation dose in an interventional procedure has become a concern. There is a strong desire from both patients and health care providers to reduce the radiation exposure required for these exams. The overall objective of this work is to propose and validate a method to significantly reduce the total radiation dose used during a CBCT image guided intervention. The basic concept is that the first cone-beam CT scan acquired at the full dose will be used to constrain the reconstruction of the later CBCT scans acquired at a much lower radiation dose. A recently developed new image reconstruction algorithm, Prior Image Constrained Compressed Sensing (PICCS), was used to reconstruct subsequent CBCT images with lower dose. This application differs from other applications of the PICCS algorithm, such as time-resolved CT or fourdimensional CBCT (4DCBCT), because the patient position may be frequently changed from one CBCT scan to another during the procedure. Thus, an image registration step to account for the change in patient position is indispensable for use of the PICCS image reconstruction algorithm. In this paper, the image registration step is combined with the PICCS algorithm to enable radiation dose reduction in CBCT image guided interventions. Experimental results acquired from a clinical C-arm system using a human cadaver were used to validate the PICCS algorithm based radiation dose reduction scheme. Using the proposed method in this paper, it has been demonstrated that, instead of 300 view angles, this technique requires about 20 cone-beam view angles to reconstruct CBCT angiograms. This signals a radiation dose reduction by a factor of approximately fifteen for subsequent acquisitions.

Date Published: 10 March 2009
PDF: 12 pages
Proc. SPIE 7258, Medical Imaging 2009: Physics of Medical Imaging, 725803 (10 March 2009);

Published in SPIE Proceedings Vol. 7258:
Medical Imaging 2009: Physics of Medical Imaging
Ehsan Samei; Jiang Hsieh, Editor(s)