CT Ge Siemens Philips PDF

Technology Assessment Initiative: Summit on CT Dose
Translating Protocols Between

Scanner Manufacturer and Model
Cynthia H. McCollough, PhD, FACR, FAAPM

Professor of Radiologic Physics
Director, CT Clinical Innovation Center
Department of Radiology
Mayo Clinic, Rochester MN
Disclosures
Research Support:
NIH: EB 079861
DK 083007
DK 059933
EB 004898
RR 018898
Siemens Healthcare
Off Label Usage

None
Disclosures
• Our team currently supports 25 CT systems.

Presently they are from only two manufacturers
(GE and Siemens)
– 10 distinct scanner models (all multi-slice)
– 12 distinct multi-slice models in our practice since 1998
• Examples come from the systems I know best
• Am an “equal opportunity” critic, so if I know
about weaknesses (or strengths) of other systems,
I’m happy to share those also.
The first thing you need is a “dictionary”

http://mayoresearch.mayo.edu/ctcic/educational-resources.cfm
Clarity, Transparency, and Uniformity

Collimation vs. Slice Width

The next thing you need is data
• When is a 5-mm not a 5-mm?

• Which pitch values give best images?
• Which collimations are most/least dose efficient?
• Which reconstruction algorithms/kernels have
“special features” or alter CT number accuracy?
• Which bowtie is used for which scan modes?
• Which focal spot is used when?
• etc.
Measured width of “5 mm” image

Full vs. Plus reconstruction option
Full or Plus Mode
• Full mode will retain the prescribed slice thickness

• Plus mode will give you a thicker slice thickness
than prescribed (about 20% thicker, e.g. a 5 mm
becomes a 6 mm). Correspondingly, noise level
will be about 10% lower.
Pitch vs. Image Quality
• In spiral CT, image noise is dependent on pitch

– To compensate, mAs must be changed as pitch is
changed
– Relationship is linear on some systems, but not all
• Relationship is different for cardiac reconstructions
– Noise is INDEPENDENT of pitch in cardiac CT
• Image width can be affected by pitch
• Windmill and cone beam artifacts affected by pitch
– Windmill artifacts discussed in talks by Gupta, Morin
Study to evaluate cone beam artifacts

• A thin-walled object with edges at an angle to the scan plane
• Rate of change of funnel shape is constant along the z-axis
• Scanned in air, the funnel has high contrast (~ 500 HU)
Courtesy D. Platten et al. ImPACT (RSNA 2003)

Example images
• Single slices through the
funnel appear as rings
• MIP image of many slices

results in a wider ring
• If perfect the images should

be uniform

Cone-beam algorithm on and off

• Low pitch (0.5), Siemens Sensation 16
Standard Cone-beam (AMPR)


• High pitch (1.5), Siemens Sensation 16


• High pitch (1.5), Philips Mx8000 IDT
Standard Cone-beam (COBRA)


• High pitch (1.5), Toshiba Aquilion 16
Standard Cone-beam (TCOT)

Cone-beam algorithm with pitch

• GE LightSpeed 16, cone-beam reconstruction always on
0.562 0.938 1.375 1.735

Clinical relevance
Standard
Cone-beam
Inclined (60°) Teflon rod

• High pitch (1.5), Siemens Sensation 16

Standard
13 cm off center Cone-beam
13 cm (AMPR)
off center
Dose Efficiency vs. Collimation
Siemens Sensation 16
GE Recon Algorithms
Soft
Standard
Detail
Lung
Bone
Edge
Bone Plus
CT Number Accuracy
• Some edge-enhancing algorithms/kernels can alter CT

numbers
– E.g. GE Lung and Bone Plus
• Boedeker et al. Emphysema: Effect of reconstruction
algorithm on CT imaging measures. Radiology 2004
• Zhang, McCollough, et al. Selection of Appropriate
Computed Tomographic Image Reconstruction
Algorithms for a Quantitative Multicenter Trial of
Diffuse Lung Disease. JCAT 2008
Boone: Presampled MTF in CT

(Med Phys 2000)
Siemens Recon Kernels
• B10  B90 Body

• H10  H90 Head
• U30  U90 Ultra High Resolution
• T20  T81 Topogram
• Lower number smoother
• Higher number sharper
• Multiples of 10 are the “basic” kernels
• In between values are “special” kernels
Siemens Recon Kernels
• B18 • H30
• B20 • H31– finer grain noise
• B25/B26 - cardiac • H32 – no PFO
• B30 • H37 – GE like
• B31 – finer grain noise
• H40
• B35/36 - calcium
• H41– finer grain noise
• B40
• B41 – finer grain noise • H42 – no PFO
• B45 • H47 – GE like
• B46 - cardiac/lung • H48 – GE like but sharper
• B50 • U70
• B70
Special Body Kernels

• B25 and B26 are for cardiac with edge-preserving
noise reduction.
• B35 and B36 are for Ca scoring without edge
enhancement.
• B45 is intermediate sharpness between B40 and B50
(e.g. “not very special”)
• B46 is designed specifically for accurate assessment
of inside coronary stents with 3D edge preserving
noise reduction techniques.
• B75 is comparable to B70 in sharpness but used 2D
edge-preserving noise reduction
B10
B20
B25
B26
B30
B31
B35
B36
B40
B41
B45
B46
Noise and Noise Uniformity
• B31/41 is like B30/B40 but with finer grain noise

and a milder edge enhancement. Noise more
uniform over FOV.
Special Head Kernels
• H21, H31, H41 are like H20, H30, H40 but with finer
grain noise and a milder edge enhancement.
• H22, H32, H42 don’t include iterative beam
hardening correction (PFO). Reconstruction speed is
faster, but the reconstructed images may contain
significant beam hardening artifacts.
• H37 is comparable to GE Soft
• H45 is intermediate sharpness between H40 and H50
• H47 is comparable to GE Standard
• H48 is like H47 but a bit sharper
H10
H20
H21
H22
H30
H31
H32
H37
H40
H41
H42
H45
H47
H48
H50
H60
H70
Have I made your head spin yet?

GE bowtie and focal spot selection

(once upon a time)
Moral of the story
• There are many good reasons to invoke special

features and characteristics
• Manufacturers often tie these features to protocols
where they make sense
• There are many ways to get these features when you
don’t want them or to not find them when you do
• Often users are not even educated about them
• Don’t stop having good ideas and features
– But make them transparent so user knows what they do
and when they are used
Lastly, you need “deliverables”
• To design or translate a protocol, you need to know

what the final product needs to look like
– Scan time (total) and per image (temporal resolution)
– Slice width(s) and image plane(s) required
• The thinnest image width determines the detector
configuration
• Coronals and sagitals require thinner collimation
– Image sharpness or smoothness
– Noise level
– Target anatomy/patient (pediatric, obese, cardiac, etc)
– Diagnostic reference level (CTDIvol)
Knowing terminology, operation, features

(quirks) and performance of your system(s)
• You can translate across manufacturer (make) and
model to yield the desired “deliverables”
• Usually not one way to accomplish the same results
• Usually not a lot of ways
• Evaluate options as quantitatively as possible on
phantoms and then form a WIP prootcol for clinical
evaluation/refinement
– Some differences between seemingly similar options can
show up only in patients, where motion and specific
diagnostic criteria (like noise texture or subtle
enhancement of small structures) come into play
Routine Chest
Routine Chest
Routine Chest
Routine Chest
Routine Chest
Routine Chest
Routine Chest
Mayo CT Clinic Innovation Center and Dept. of Radiology

J. Kofler, L. Yu, S. Leng, M. Bruesewitz, T. Vrieve
http://mayoresearch.mayo.edu/CTCIC

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Technology Assessment Initiative: Summit on CT Dose

Translating Protocols Between

Cynthia H. McCollough, PhD, FACR, FAAPM

Off Label Usage

• Our team currently supports 25 CT systems.

The first thing you need is a “dictionary”

Clarity, Transparency, and Uniformity

Collimation vs. Slice Width

The next thing you need is data

• When is a 5-mm not a 5-mm?

Measured width of “5 mm” image

Full or Plus Mode

• Full mode will retain the prescribed slice thickness

Pitch vs. Image Quality

• In spiral CT, image noise is dependent on pitch

Study to evaluate cone beam artifacts

Courtesy D. Platten et al. ImPACT (RSNA 2003)

• MIP image of many slices

• If perfect the images should

Courtesy D. Platten et al. ImPACT (RSNA 2003)

Cone-beam algorithm on and off

Standard Cone-beam (AMPR)

Cone-beam algorithm on and off

Standard Cone-beam (AMPR)

Cone-beam algorithm on and off

Standard Cone-beam (COBRA)

Cone-beam algorithm on and off

Standard Cone-beam (TCOT)

Cone-beam algorithm with pitch

0.562 0.938 1.375 1.735

Courtesy D. Platten et al. ImPACT (RSNA 2003)

Inclined (60°) Teflon rod

Standard Cone-beam (AMPR)

Dose Efficiency vs. Collimation

• Some edge-enhancing algorithms/kernels can alter CT

Boone: Presampled MTF in CT

Siemens Recon Kernels

• B10  B90 Body

Siemens Recon Kernels

Special Body Kernels

Noise and Noise Uniformity

• B31/41 is like B30/B40 but with finer grain noise

Special Head Kernels

Have I made your head spin yet?

GE bowtie and focal spot selection

Moral of the story

• There are many good reasons to invoke special

Lastly, you need “deliverables”

• To design or translate a protocol, you need to know

Knowing terminology, operation, features

Mayo CT Clinic Innovation Center and Dept. of Radiology

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