Dual-energy computed radiography: improvements in processing

We have reported on a single-exposure dual-energy system based on computed radiography (CR) technology. In a clinical study conducted over a two year period, the dual-energy system proved to be highly successful in improving the detection (p=0.0005) and characterization (p=0.005) of pulmonary nodules when compared to conventional screen-film radiography. The basic components of our dual-energy detector system include source filtration with gadolinium to produce a bi-modal x-ray spectrum and a cassette containing four CR imaging plates. The front and back plates record the low-energy and high-energy images, respectively, and the middle two plates serve as an intermediate filter. Since our initial report, a number of improvements have been made to make the system more practical. An automatic registration algorithm based on image features has been developed to align the front and back image plates. There have been two improvements in scatter correction: a simple correction is now made to account for scatter within the multi-plate detector; and a correction algorithm is applied to account for scatter variations between patients. An improved basis material decomposition (BMD) algorithm has been developed to facilitate automatic operation of the algorithm. Finally, two new noise suppression techniques are under investigation: one adjusts the noise filtering parameters depending on the strength of edge signals in the detected image in order to greatly reduce quantum mottle while minimizing the introduction of artifacts; a second routine uses knowledge of the region of valid low-energy and high-energy image data to suppress noise with minimal introduction of artifacts. This paper is a synthesis of recent work aimed at improving the performance of dual-energy CR conducted at three institutions: Philips Medical Systems, the University of Wisconsin, and Duke University.