Embodiments of the invention relate generally to diagnostic imaging and, more particularly, to a system and method of pulmonary emboli detection for computed tomography.
Typically, in computed tomography (CT) imaging systems, an x-ray source emits a fan-shaped beam toward a subject or object, such as a patient or a piece of luggage. Hereinafter, the terms “subject” and “object” shall include anything capable of being imaged. The beam, after being attenuated by the subject, impinges upon an array of radiation detectors. The intensity of the attenuated beam radiation received at the detector array is typically dependent upon the attenuation of the x-ray beam by the subject. Each detector element of the detector array produces a separate electrical signal indicative of the attenuated beam received by each detector element. The electrical signals are transmitted to a data processing system for analysis which ultimately produces an image.
Generally, the x-ray source and the detector array are rotated about the gantry within an imaging plane and around the subject. X-ray sources typically include x-ray tubes, which emit the x-ray beam at a focal point. X-ray detectors typically include a collimator for collimating x-ray beams received at the detector, a scintillator for converting x-rays to light energy adjacent the collimator, and photodiodes for receiving the light energy from the adjacent scintillator and producing electrical signals therefrom.
Typically, each scintillator of a scintillator array converts x-rays to light energy. Each scintillator discharges light energy to a photodiode adjacent thereto. Each photodiode detects the light energy and generates a corresponding electrical signal. The outputs of the photodiodes are then transmitted to the data processing system for image reconstruction. Alternatively, x-ray detectors may use a direct conversion detector, such as a CZT detector, in lieu of a scintillator.
Contrast enhanced CT images are typically used to detect pulmonary embuli within the pulmonary vessels. Simple thresholds, linear contrast enhancements, intensity information, and/or knowledge of the neighborhood of image voxels are typically used to generate contrast enhanced CT images. Alternatively, large banks of information acquired from a large number of CT images may be used to train classifiers, which are then used to predict whether identified or calculated features or characteristics of three-dimensional regions in an image represent pulmonary embuli or normal anatomy.
Conventional methods of generating contrast enhanced CT images typically rely on a number of assumed features of pulmonary embuli. However, these assumptions often detect normal anatomy as pulmonary emboli (i.e., false positives). False positives may be detected due to a number of causes, including lymph nodes, water-filled airways, airway walls with intermediate intensity resulting from partial volume effects, motion, streak and/or other acquisition artifacts, and images of inadequate contrast resulting from improperly administered contrast schedules, for example.
Therefore, it would be desirable to design a system and method of detecting pulmonary emboli that overcome the aforementioned drawbacks.
In accordance with one aspect of the invention, a computer readable storage medium has stored thereon a computer program comprising instructions, which, when executed by a computer, cause the computer to acquire a set of image data comprising a plurality of image voxels and isolate a set of pulmonary emboli candidates from the plurality of image voxels. The instructions also cause the computer to apply a non-linear contrast enhancement to the set of pulmonary emboli candidates, filter the enhanced set of pulmonary emboli candidates, output a final set of pulmonary emboli candidates, and create an image comprising the final set of pulmonary emboli candidates.
In accordance with another aspect of the invention, a method includes accessing a set of CT image data corresponding to a plurality of image voxels, applying a lung mask to the plurality of image voxels, and isolating a set of pulmonary emboli candidates in the lung mask. The method also includes manipulating the set of pulmonary emboli candidates using a non-linear contrast enhancement, removing a set of false positive voxels from the set of pulmonary emboli candidates, generating a final set of pulmonary emboli candidates, and reconstructing an image using the final set of pulmonary emboli candidates.
In accordance with another aspect of the invention, an imaging system includes a rotatable gantry having an opening for receiving an object to be scanned, an x-ray source coupled to the rotatable gantry and configured to project x-rays through the opening, and a generator configured to energize the x-ray source to an energy level to generate x-rays corresponding to the energy level. The imaging system further includes a detector having pixels therein, the detector attached to the rotatable gantry and positioned to receive x-rays projected from the x-ray source. The imaging system also includes a computer programmed to acquire a CT image dataset corresponding to a plurality of image voxels, identify a set of pulmonary emboli candidates within the CT image data set, filter the set of pulmonary emboli candidates to remove false positives, and output a final set of pulmonary emboli candidates.
Various other features and advantages will be made apparent from the following detailed description and the drawings.
The drawings illustrate preferred embodiments presently contemplated for carrying out the invention.
In the drawings:
The operating environment of embodiments of the invention is described with respect to a sixty-four-slice computed tomography (CT) system. However, it will be appreciated by those skilled in the art that embodiments of the invention are equally applicable for use with other multi-slice configurations. Moreover, embodiments of the invention will be described with respect to the detection and conversion of x-rays. However, one skilled in the art will further appreciate that embodiments of the invention are equally applicable for the detection and conversion of other high frequency electromagnetic energy. Embodiments of the invention will be described with respect to a “third generation” CT scanner, but are equally applicable with other CT systems.
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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 an x-ray source 14 and a gantry motor controller 30 that controls the rotational speed and position of gantry 12. An image reconstructor 34 receives sampled and digitized x-ray data from DAS 32 and performs high speed 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 some form of operator interface, such as a keyboard, mouse, voice activated controller, or any other suitable input apparatus. An associated 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 and gantry 12. Particularly, table 46 moves patients 22 through a gantry opening 48 of
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In the operation of one embodiment, x-rays impinging within detector elements 50 generate photons which traverse pack 51, thereby generating an analog signal which is detected on a diode within backlit diode array 53. The analog signal generated is carried through multi-layer substrate 54, through flex circuits 56, to DAS 32 wherein the analog signal is converted to a digital signal.
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After isolating the lung lobes in the CT image data, technique 60 applies a vessel mask segmentation at step 66. The vessel segmentation is used to extract a mask of pulmonary emboli within the parenchyma region. Technique 60 calculates an intensity threshold for each slice of image data that models the intensity decrease of the parenchyma region moving outward from the hilum towards the extremities of arterial branching. According to one embodiment, the thresholding is applied as follows:
where the first term represents Kittler's minimum error threshold, the second term represents the intensity profile from the image center (x0, y0), and β represents an experimental constant.
Based on clinical data, it is known that voxels near the hilum are not pulmonary embuli. Accordingly, technique 60 eliminates connecting tissue present within the hilum vicinity. According to one embodiment of the invention, voxels within a given radius (e.g., approximately 96 voxels) of a circle centered at the origin are clustered based on their intensity values using a k-means clustering algorithm. The intensity threshold for this central circle is modified and voxels within this cluster may be eliminated from the vessel mask. Voxels outside the central circle are unchanged.
During step 66, technique 60 also eliminates diaphragm components that may be present within the vessel mask. Diaphragm remnants are large regions containing voxels of intermediate intensity and may contribute to false positive emboli detections. Because it is known that pulmonary emboli will not be as large as the diaphragm, a distance transform may be applied to the 2D binary image such that, for each 2D connected object, the largest value of the distance transform is estimated and objects having a value greater than a given threshold value are eliminated. According to one embodiment, a threshold value of 40 pixels may be applied to eliminate diaphragm components.
Technique 60 may also be configured to fill small holes having an area less than a threshold area (e.g., less than 50 voxels) that exist after the threshold in the image mask. Additionally, technique 60 may refine the outer boundary of the generated mask at step 66.
After completing the mask of pulmonary emboli within the parenchyma region, technique 60 applies non-linear contrast enhancement at step 68 to increase the contrast between bright and dark intensity and simplify identification of embolus detection in the CT image. The non-linear contrast enhancement applied at step 68 enhances contrast locally within a pre-defined window region, allowing the vessel intensities to be stretched over the major portion of the gray scale range of the image and enhancing the contrast between light and dark structures that may have a relatively small difference in contrast based on the initially scaled image. According to one embodiment, the image is initially scaled to a range of 0-255 Hounsfield units (HU). However, one skilled in the art will recognize that technique 60 is equally applicable to any initial image scaling.
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Next, technique 60 uses the scaled contrast values to reduce false positives within the defined candidate set using a number of filtering steps.
For example, at step 72, technique 60 removes pulmonary emboli candidates that lie on the outer periphery or boundary of the large vessels near the hilum, as these candidates are partial volume artifacts. For example, voxels having a distance lower than three voxels from the vessel boundary may be removed from the candidate set.
Technique 60 applies another filter at step 74 that may eliminate a number of pulmonary emboli candidates based on their location, as certain areas of the lungs have a greater possibility of housing pulmonary embuli and other regions of the lungs have a greater possibility of producing false positives. Technique 60 also uses mathematical morphology operations to define a wall region corresponding to an area very close to the edge of the lung mask. Pulmonary emboli candidates that are located within the wall region are removed.
At step 76, false positives are eliminated using one or more size filters. Technique 60 may implement a two-dimensional size filter to remove false positives that are outside a given size range, such as, for example, a range of approximately 4-2000 pixels. Technique 60 may also implement a three-dimensional size filter to remove candidates greater than a given threshold. For example, pulmonary emboli candidates greater than 30 voxels may be removed.
Technique 60 further reduces false positives at step 78 based on the knowledge that, although a pulmonary emboli may not have a specific shape, it will the signature of the pulmonary emboli will manifest across a number of connected image slices. Thus, technique 60 applies a filter to remove pulmonary emboli candidates that have signatures only in one image slice or only in a small number of connected image slices, according to various embodiments. For example, according to one embodiment, technique 60 examines the z-coordinates of the pulmonary emboli candidates and eliminates those candidates not connected across at least three adjacent image slices.
According to another embodiment of the invention, technique 60 may apply other filters as alternative three-dimensional processing steps to the set of pulmonary emboli candidates. These filters may be applied in addition to, or as alternatives to, the filters described with respect to steps 72-78, according to different embodiments. For example, technique 60 may apply volumetric directional diffusion, inverse diffusion, and/or mean-shift filtering to the image dataset.
In step 80, technique 60 eliminates all pulmonary emboli candidates having unscaled contrast values outside the gray scale range of the original image dataset (e.g., outside a gray scale range of −500 to +1200 HU).
At step 82, the remaining pulmonary emboli candidates are subjected to a region growing step that uses pixel intensity, two-dimensional distance transform values, and three-dimensional distance transform values to grow the given pulmonary emboli candidates into adjoining voxels. According to one embodiment, the region growing is confined to refinement structure region in the z-direction.
Technique 60 performs a morphological closing operation at step 84 that is similar to the closing filter described with respect to step 66 in order to account for any jagged edges or holes that result from the thresholding operations. The morphological closing operation fills holes below a given size that may exist within pulmonary emboli candidates. To fill the holes, the operation references neighboring voxels. At step 86, technique 60 outputs a final set of pulmonary emboli candidates.
Embodiments of the invention have been described with respect to single and energy CT imaging. However, one skilled in the art will recognize that embodiments of the invention are equally applicable to dual energy CT imaging procedures, for example.
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Embodiments of the invention have been described with respect to single energy CT imaging. However, one skilled in the art will recognize that embodiments of the invention are equally applicable to dual energy CT imaging procedures, for example. Embodiments of the invention described herein are equally applicable to other types of tomographic imaging such as CT attenuation correction images for single photon emission computed tomography (SPECT) or positron emission tomography (PET), three-dimensional x-ray imaging, vascular and surgical C-arm systems, radiation therapy planning scanners, other tomographic x-ray systems, and the like.
A technical contribution for the disclosed method and apparatus is that is provides for a computer implemented system and method of iterative pulmonary emboli detection for computed tomography.
Therefore, in accordance with one embodiment, a computer readable storage medium has stored thereon a computer program comprising instructions, which, when executed by a computer, cause the computer to acquire a set of image data comprising a plurality of image voxels and isolate a set of pulmonary emboli candidates from the plurality of image voxels. The instructions also cause the computer to apply a non-linear contrast enhancement to the set of pulmonary emboli candidates, filter the enhanced set of pulmonary emboli candidates, output a final set of pulmonary emboli candidates, and create an image comprising the final set of pulmonary emboli candidates.
In accordance with another embodiment, a method includes accessing a set of CT image data corresponding to a plurality of image voxels, applying a lung mask to the plurality of image voxels, and isolating a set of pulmonary emboli candidates in the lung mask. The method also includes manipulating the set of pulmonary emboli candidates using a non-linear contrast enhancement, removing a set of false positive voxels from the set of pulmonary emboli candidates, generating a final set of pulmonary emboli candidates, and reconstructing an image using the final set of pulmonary emboli candidates.
In accordance with yet another embodiment, an imaging system includes a rotatable gantry having an opening for receiving an object to be scanned, an x-ray source coupled to the rotatable gantry and configured to project x-rays through the opening, and a generator configured to energize the x-ray source to an energy level to generate x-rays corresponding to the energy level. The imaging system further includes a detector having pixels therein, the detector attached to the rotatable gantry and positioned to receive x-rays projected from the x-ray source. The imaging system also includes a computer programmed to acquire a CT image dataset corresponding to a plurality of image voxels, identify a set of pulmonary emboli candidates within the CT image data set, filter the set of pulmonary emboli candidates to remove false positives, and output a final set of pulmonary emboli candidates.
This written description uses examples to disclose the invention, including the best mode, and also to enable any person skilled in the art to practice the invention, including making and using any devices or systems and performing any incorporated methods. The patentable scope of the invention is defined by the claims, and may include other examples that occur to those skilled in the art. Such other examples are intended to be within the scope of the claims if they have structural elements that do not differ from the literal language of the claims, or if they include equivalent structural elements with insubstantial differences from the literal languages of the claims.