The field of the invention is angiography, and particularly the production of angiograms using an x-ray CT system. Medical diagnostic imaging, is generally provided by CT, ultrasound, and MR systems, as well as those using positron emission tomography (PET), and other techniques. One particularly desirable use for such systems is the imaging of blood vessels in a patient, i.e. vascular imaging. Vascular imaging methods include two-dimensional (2D) techniques, as well as reconstruction of three-dimensional (3D) images from 2D image data acquired from such diagnostic imaging systems. In CT medical diagnosis, for example, 3D reconstruction of computed tomograms is particularly useful for visualizing blood vessels.
Conventional digital subtraction angiography (DSA) is considered the most accurate technique for medical diagnosis of vascular structures and remains the standard against which other methods are compared. However, conventional angiography is an invasive technique in which arterial catheterization and injection of a contrast agent presents a certain amount of risk. Accurate evaluation of the vascular system with noninvasive techniques remains an important goal. Thus, duplex ultrasound is often used for evaluation of blood flow in carotid arteries. Magnetic resonance angiography is also used for detailed evaluation of the vascular system. However, both of these techniques have limitations and alternative noninvasive approaches continue to be investigated.
Spiral computed tomography (CT) is a relatively new approach to CT that allows continuous data collection while a subject is advanced through the CT gantry. This provides an uninterrupted volume of x-ray attenuation data. From this data, multiple contiguous or overlapping slices of arbitrary thickness can be reconstructed. Spiral CT permits acquisition of a large volume of data in seconds. With spiral CT angiography (CTA), vascular structures can be selectively visualized by choosing an appropriate delay after IV injection of a contrast material. This gives excellent visualization of vessel lumina, stenoses, and lesions. The acquired data can then be displayed using 3D visualization techniques (e.g., volume-rendering, maximum intensity projection (MIP), and shaded surface display) to give an image of the vasculature. In contrast to conventional angiography, CTA is three-dimensional, thus giving the viewer more freedom to see the vasculature from different viewpoints.
There are a number of disadvantages of CTA as compared to DSA. First, when metal objects such as aneurysm clips or coils are in the field of view troublesome metal artifacts are produced in the image by the tomographic reconstruction process. Also, DSA (1024×1024 pixels) has four times the resolution of CT systems (512×512 pixels) allowing tiny abnormalities to be obscured when using CTA.
The present invention is a method for producing an angiogram with an x-ray CT system which is not obscured by metal artifacts and which can rival the resolution of a DSA image. More particularly: a data set is acquired with a CT system which includes a plurality of slices disposed along an axis in which each slice data subset includes a plurality of projections acquired at a corresponding plurality of gantry angles; a topographic plane data set is formed at a selected gantry angle by selecting from each slice data subset the projection corresponding to the selected gantry angle; and a 2D topographic image is produced by displaying the selected projections in the topographic plane data set at their corresponding slice locations along the axis. An angiogram is produced by acquiring one data set before contrast injection, acquiring the same data set after contrast injection and then subtracting the corresponding projections in each data set.
Another aspect of the present invention is to produce a CT image in which metal artifacts are significantly suppressed. More particularly: a first data set is acquired before injection of a contrast agent which includes a series of projections acquired at a succession of gantry angles and a succession of locations along an axis; a second data set is acquired after contrast injection which includes a series of projections acquired at the same succession of gantry angles and succession of locations along the axis as the first data set; a difference data set is produced by subtracting projections in the first data set from the corresponding projections in the second data set; and a tomographic image is produced by tomographically reconstructing the image from the difference data set. Signals caused by metal objects in the field of view are suppressed by subtracting projections from the two acquired data sets before they have an opportunity to affect the tomographic image reconstruction process.
Referring to
Rotation of gantry 12 and the operation of x-ray source 14 are governed by a control mechanism 26 of CT system 10. Control mechanism 26 includes an x-ray controller 28 that provides power and timing signals to x-ray source 14 and a gantry motor controller 30 that controls the rotational speed and position of gantry 12. A data acquisition system (DAS) 32 in control mechanism 26 samples analog data from detector elements 20 and converts the data to digital signals for subsequent processing. An image reconstructor 34 receives sampled and digitized x-ray data from DAS 32 and performs high speed image reconstruction. The reconstructed image is applied as an input to a computer 36 which stores the image in a mass storage device 38.
Computer 36 also receives commands and scanning parameters from an operator via console 40 that has a keyboard. An associated cathode ray tube display 42 allows the operator to observe the reconstructed image and other data from computer 36. The operator supplied commands and parameters are used by computer 36 to provide control signals and information to DAS 32, x-ray controller 28 and gantry motor controller 30. In addition, computer 36 operates a table motor controller 44 which controls a motorized table 46 to position patient 22 in gantry 12. Particularly, table 46 moves portions of patient 22 through gantry opening 48.
Rotation of the gantry assembly 212 around the subject 222 results in x-ray data being acquired by detector elements 220 for a range of view angles θ. A typical detector array 218 may comprise several hundred individual detector elements 220, such as 888 individual elements 220. The array 218 is positioned on the gantry 212 at a distance of, for example, 0.949 meter (m) from the x-ray source 214. The circular path of source 214 has a radius of, for example, 0.541 m. Particular values of these parameters are not critical to the present invention and may be varied according to well-known principles of CT system design.
One complete gantry rotation for the gantry 212 may comprise, for example, 984 view angles. Source 214 is thereby positioned to illuminate the subject 222 successively from 984 different directions θ and the detector array 218 generates x-ray data at each view angle θ, from which projection data for 984 separate projection views are acquired.
In the fan beam case, the data acquisition cycle is sometimes called an axial scan. The projection data for an axial scan is comprised of a set of projection views all acquired at the same axial position z0. As shown in
A sinogram obtained from an axial scan is a collection of projection views of the subject at the position z0. Here the term “projection view” means such a row of projection data corresponding to a given view angle θ and representing the imaged subject at a single axial position z0. Well known tomographic image reconstruction procedures utilize as their principal inputs a complete set of such projection views (discretized in θ, but all consisting of data values for the same axial position z0). The projection views are processed by such tomographic techniques to reconstruct a slice image depicting the internal features of the subject in a slice located at the position z0.
Tomographic image data for a three-dimensional representation may comprise image data for several slice images at a succession of axial positions (so-called “stacked 2-D slices” or “stacked slice images”). One way to obtain these multiple slice images is to acquire corresponding sinogram data sets slice by slice using, for example, a fan beam CT imaging system (such as the system of
Helical scanning relaxes the requirement of axial scanning systems that fix the axial position of the gantry at a single z-axis point throughout the data collection cycle. Instead, the entire gantry (source and detector array) translates axially (in the z direction) relative to the patient while the gantry is being rotated. A single scanning operation (i.e., continuous rotation of the gantry) can thereby cover the entire organ or structure under study. The projection views thus acquired may be processed to form a plurality of sinogram data sets at discrete slice locations along the z-axis. Such processing is well known in the art as exemplified by the method disclosed in U.S. Pat. No. 5,270,923 issued on Dec. 14, 1993 and entitled “Computed Tomographic Image Reconstruction Method For Helical Scanning Using Interpolation Of Partial Scans For Image Construction” which is incorporated herein by reference.
The assembly 710 of
In both fan beam and cone beam helical scanning the x-ray source follows a helical path given by
θ(0)=ωt
Z(0)=(pΔd/2π)ωt
where θ(0) is the view angle, Z(0) is the axial position of the source, ω is the rate of gantry rotation, and p (for “pitch”) is the axial translation per gantry rotation, as a fraction of detector spacing Δd. The helical path of the x-ray source during a helical scan is illustrated in
One aspect of the present invention is a new method of using the sinogram data sets produced during a helical scan to reconstruct a high resolution digital subtraction angiogram. This concept will be explained first with sinogram data produced during a helical scan using either the 3rd or 4th generation fan beam systems of
Referring particularly to
ZN=Z1+pΔdN, (1)
where Z1 is the location of the first projection view, p is the pitch of the helical scan, Δd is detector spacing, and ZN is the z-axis location of the same projection in the Nth gantry revolution.
Referring particularly to
The topograph image 412 is then produced by mapping the individual attenuation measurements in each projection view of topographic data set Tθ to a specific pixel location. Each attenuation measurement has coordinates N and R and these are converted to positions along respective axes z and d in the topograph 412. The z-axis location is given by equation (1) above and the d axis location is determined in the usual fashion by the geometry of the detector array (e.g., Δd) and the gantry. The attenuation measurements control the intensity of their corresponding pixels in the topograph 412. The axis d is in the x,y plane, perpendicular to the z-axis and it is perpendicular to the selected view angle θ0.
When the topograph image 412 is displayed one sees a 2D projection image of the subject from the selected view angle θ0. The view angle θ0 can be selected to produce a topograph image 412 that lies in either the xz plane or the yz plane, or many angles therebetween. Topograph images 412 can be reconstructed at many different view angles θ using the same acquired data sets, and these can be sequentially displayed to rotate the subject.
In the embodiment described above a single spiral data acquisition pattern is produced. This pattern is applicable to a fan beam system in which a single row of detector elements acquire data at a single z-axis location during each view acquisition. It can be appreciated that when a cone beam system is employed, each view acquisition acquires data at a plurality of z-axis locations corresponding to the plurality of rows in the 2D detector array 718. As a result a plurality of interleaved spiral patterns of data are acquired and stored in a corresponding plurality of sets of sinograms. Thus, instead of the single set of sinograms 402 illustrated in
In the embodiments described above only views stored at a selected view angle θ0 are employed to produce the topograph image 412. However, the resolution of the topograph 412 can be doubled in the z-axis direction by also employing the views acquired on the opposite side of the gantry (i.e., θ0+180°). That is, the attenuation data acquired at view angle θ0+180° sees the subject at the same view angle θ0 , but from the opposite side of the subject and at z-axis locations interleaved with the attenuation data acquired at view angle θ0. Because the attenuation data is acquired with a fan beam having non-parallel rays, however, it is necessary to rebin the raw “diverging rays” projection data to form parallel rays. Such a rebinning step is described, for example, in U.S. Pat. No. 5,216,601 issued on Jun. 1, 1993 and entitled “Method For Fan Beam Helical Scanning Using Rebinning” which is incorporated herein by reference.
In the above-described embodiments the acquired views stored in the sinogram arrays 402 are used to reconstruct the topograph image 412. In commercially available CT systems the data in these sinograms is processed first to form complete sinograms at specific z-axis slice locations. This is an interpolation process as described in the above cited U.S. Pat. No. 5,270,923, and the result is a set of sinogram data sets at specific z-axis slice locations. These slice sinogram data sets may be used in the same manner as described above to form the topographic plane data set 414. However, equation (1) is not used to map attenuation values to pixel locations in the topograph image 412. Instead, all the attenuation values in a row of the topographic plane data set 414 are mapped to a z-axis location corresponding to its slice location. In this case the resolution of the topograph 412 is determined by the z-axis spacing of the slice sinogram data sets.
Another aspect of the present invention is the reconstruction of images from acquired sinogram data sets in which artifacts caused by metallic objects in the field of view are substantially suppressed. This is achieved by acquiring a first set of sinogram data sets as described above and then acquiring a substantially identical set of sinogram data sets after the IV injection of a contrast agent. Artifact suppression is achieved by subtracting the acquired projection views in the first set of sinogram data sets from the corresponding projection views in the second set of sinogram data sets to produce a set of difference sinogram data sets. These difference sinogram data sets are then employed to produce the topograph image 412 as described above.
It is also a discovery of the present invention that image artifacts may be substantially suppressed in tomographically reconstructed images by employing the difference sinogram data sets. Rather than reconstructing tomographic images from the respective first and second sets of sinogram data sets and then subtracting the resulting two images as is done with computed tomography angiography (CTA), according to the present invention the corresponding acquired projection views are subtracted prior to image reconstruction. An important requirement for this to work properly is that corresponding projection views in the two sets of sinogram data sets are acquired at substantially the same projection angle (θ) and z-axis location. To accomplish this the starting point (θ, z) of the two helical scans should be substantially identical and the helical scan paths should be substantially the same.
Referring particularly to
The patient is then injected with a suitable contrast agent as indicated at process block 514. After a short period of time during which the contrast agent flows into the field of view and alters the x-ray attenuation characteristics of the tissues of interest, a second helical scan is performed as indicated at process block 516 to produce a second set of sinogram data sets 518. As mentioned above, it is important that these two helical scans are the same and are geometrically registered with each other so that corresponding projection views in the two data sets 510 and 518 are acquired at the same projection angles θ and z-axis locations.
As indicated at process block 520, the next step is to subtract corresponding projection views in the two sets of sinogram data sets 510 and 518. This results in difference sinogram data sets 522 which depict the difference in x-ray attenuation of the subject tissues before and after contrast injection.
The difference sinogram data sets 522 can be processed in a number of different ways to produce a variety of images. If a topographic image is to be produced as indicated at decision block 524, the operator is prompted to select a topographic view angle at process block 526. In the alternative a number of view angles may be selected or a range of view angles may be selected. The topographic image, or images are then produced as described above by selecting from the difference sinogram data sets 522 the projection views at the selected view angle (or view angles) as indicated at process block 528. The topographic images may be displayed so that the operator may see a radiograph-like projection of the subject from the selected view angle or angles. These topographic images may also be stored for later viewing.
If a tomographic image is to be produced as indicated at decision block 530, the difference sinogram data sets are interpolated to produce discrete slice sinogram data sets at specific slice intervals along the z-axis as indicated at process block 531. This is a well known procedure in the art as discussed above for converting data acquired with a helical scan to sinograms at successive slice locations along the z-axis. As indicated at process block 532, a conventional tomographic image reconstruction is then performed with each slice sinogram data set. A well known filtered backprojection method is employed in the preferred embodiment. The reconstructed slice images may be displayed separately as indicated at process block 534, but preferably a three-dimensional image is produced by concatenating the 2D slice images. The 3D image can be displayed by projecting it at any view angle onto the viewing plane, or slices through the 3D image at any location and angle may be viewed.
The present invention provides a number of valuable tools for the physician. In a single study it provides a 2D or 3D computed tomography image which is known for its high definition anatomical depiction of the subject. In addition, high resolution 2D topograph images that exceed the resolution of the current gold standard DSA images may be produced. The difference sinogram data sets can also be reconstructed into 3D tomographic images that are free of bone and metal artifacts and can be manipulated for viewing in any plane. Furthermore, the IV injection of contrast agent according to the present invention avoids the need for direct arterial catheterization required by DSA and, therefore, does not carry with it the attendant medical risks and the high costs of qualified medical personnel needed by the catheterization procedure.
This invention was made with government support under Grant No. NIH EB001683 awarded by the National Institute of Health. The United States Government has certain rights in this invention.