Evaluation of energy-subtraction CT images

using diffracted monochromatic x rays

Hideki Sakakibara1, Koji Maeda2, Yuki Nakahara1 , Yoshitake Ueda2 and Masao Matsumoto 3
1

Graduate School of Integrated Human Sciences Studies, Hiroshima International University, Higashi-Hiroshima, Japan
2
Faculty of Health Sciences, Hiroshima International University, Higashi-Hiroshima, Japan
3
Graduate School of Medicine, Osaka University, Suita, Japan

Abstract The energy subtraction (ES) method is a technique that eliminates one tissue with the same attenuation
coefficient by subtraction between two kinds of images obtained for x rays with different energy. Recently, the development of the dual source CT has made possible to acquire simultaneously two kinds of images for different x-ray energy
and to perform the ES processing. Since the attenuation coefficient of a material, however, varies with position in a body on
using white x rays, even the same material shows a different
value of the coefficient and is hard to be eliminated. If x rays
are monochromatic, an arbitrary tissue image can be eliminated by the ES processing and be discriminated from the other
tissues.
We attempted to use diffracted monochromatic x rays for
CT. Single crystal wafer of Si with the surface orientation
{111} was used as a monochromator for x-ray diffraction. A
cylindrical phantom was made of water and iodine contrast
media. X-ray projection data were acquired with an imaging
plate for high- and low-energy x rays. CT images were obtained by reconstructing the projection data.
In the profile of the monochromatic x-ray CT images, pixel
values of water and iodine contrast media were constant, and
the influence of beam hardening (or cupping artifact) was not
observed. On the other hand, in white x-ray CT images, the
more a pixel approached the center region of the cylindrical
phantom, the more the pixel value of water and iodine contrast
media decreased, and the cupping artifact appeared. Therefore,
it was confirmed that it was essential for a CT image to use
monochromatic x rays causing no beam hardening.

Recently, two kinds of CT images for different x-ray

energy are simultaneously obtained by the dual source CT
and the ES processing is attempted. However, when white x
rays are used for CT images, the beam hardening effect
occurs during their transmission. Since the attenuation coefficient of a material varies with a position in a body, even
the same material will have different values of the coefficient and be hard to be eliminated.
In general, monochromatic photons can be obtained by
gamma rays from radioisotopes and diffraction of white x
rays. Radioisotopes have problems such as unsharpness due
to the source size or the difficult control of high dose rate.
Since intensity is decreased remarkably by using the x-ray
diffraction, investigations that use SOR facilities are performed. However, these practices are unsuitable for general
clinical use. Therefore, the diffraction with x-ray equipments in clinical use is suitable for clinical diagnosis; although the diffraction has the problem of low intensity.
In the present study, CT images with the diffracted monochromatic x rays generated from a usual x-ray tube in
clinical use are evaluated for the beam hardening effect
(showing the cupping artifact or not). In addition, these ESCT images acquired by two kinds of energy of monochromatic x rays are compared with those by two kinds of energy of white x rays.
II. MATERIALS AND METHODS

Keywords energy subtraction, beam hardening, diffracted x

rays, monochromatic x rays CT, cupping artifact

I. INTRODUCTION
The energy subtraction (ES) method is a technique that
eliminates one tissue with the same attenuation coefficient
by subtraction between two kinds of images obtained for
high- and low-energy x rays. As for all the elements, the
mass attenuation coefficients have the energy-dependent
characteristics. Therefore, if x rays are monochromatic, an
arbitrary tissue image can be eliminated by the ES
processing and be discriminated from the other tissues.

When white x rays are incident on the material with crystal structure, monochromatic x rays of energy wavelength
can be generated selectively under the Bragg condition.

2d sin T

nO

ere d is lattice spacing, is x-ray incident angle for lattice plane, n is a positive integer, and is x-ray wavelength.
An x-ray generator was combined with an x-ray tube (Hitachi, U-6CE-55TB) and an inverter high-voltage generator
(Hitachi, HF-153HII) in usual clinical use. A monochromator for x-ray diffraction was a Si single crystal wafer with
the surface orientation {111}.

O. Dssel and W.C. Schlegel (Eds.): WC 2009, IFMBE Proceedings 25/II, pp. 7982, 2009.
www.springerlink.com

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H. Sakakibara et al.

25 mm

Iodine contrast media

Water

Fig. 1 Phantom
A phantom as shown in Fig.1 consisted of water and
iodine contrast media. This phantom consisted of 15 mg/ml
diluted iodine contrast media in a cylindrical tube of 25 mm
diameter at the center of a 35 mm diameter cylindrical tube
which was made of polypropylene and filled with water.
An imaging plate (IP) was used for acquisition of the
projection data to get CT images at each angle. Energy
spectrum of diffracted monochromatic x rays was measured
with a high resolution Schottky CdTe semiconductor detector.
Figure 2 shows the experimental setup for CT using monochromatic x rays. X rays irradiated from an x-ray tube are
diffracted by the Si wafer, and diffracted monochromatic x
rays are penetrated through the phantom. A pair of 1-mm Pb
slits were set to remove scattered x rays before and after the
Si wafer. The low-energy monochromatic x rays of 27.8
keV (tube voltage: 55 kV and x-ray incident angle: 4.1
degree) and the high-energy monochromatic x rays of 49.0
keV (tube voltage: 80 kV and x-ray incident angle: 2.3
degree) were selected.
Pb slit

Phantom

Focal point

IP
Si wafer {111}

20 cm

23.5 cm

17 cm

Fig. 2 Experimental setup for CT using monochromatic x rays

Figure 3 shows the spectra of the diffracted x rays from

the Si single crystal wafer.
CT images were reconstructed from the projection data
using the Shepp-Logan filter. In addition, the CT images
acquired for high-energy x rays and low-energy x rays were
ES processed, and the discrimination ability of materials
was evaluated.

Relative Photon Number

35 mm

1
Low 27.8 keV

High 49.0 keV

0.5

0
0

20

40
60
Photon Energy (keV)

80

Fig. 3 Spectra of diffracted monochromatic x rays

III. RESULTS AND DISCUSSION

Figures 4 (a) and (b) show profiles of the relative pixel
value along the straight line via the center of the CT images
acquired by monochromatic x rays. The profile in Fig.4 (a)
is drown from the low-energy CT image, and the profile of
Fig.4 (b) from the high-energy CT image. These profiles
were obtained by using an imaginary slit 30 pixels in width.
The pixel values of water and iodine contrast media are
constant and the influence of beam hardening (or the cupping artifact) is not observed in these profiles.
Figures 5 (a) and (b) show profiles of the relative pixel
value along the straight line via the center of the CT images
acquired by white x rays. The more it approached the center
region of the cylindrical tube, the more the pixel values of
water and iodine contrast media decreased and the cupping
artifact appeared in these profiles.
The ES images, from which the image of water was eliminated, were made by using each of the CT images obtained
by monochromatic x rays and white x rays.

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Relative Pixel Value

Evaluation of Energy-Subtraction CT Images Using Diffracted Monochromatic X Rays

200

100

20
Position (mm)

40

81

The exposure dose can be reduced by using monochromatic x rays. Moreover, as an example, the diagnosis of an
infant green stick fracture which is difficult by means of the
white x-ray CT is expected to be improved by the monochromatic x-ray CT. In this experiment, however, CT images
using monochromatic x rays were noisy because of the
weak intensity of the diffracted x rays compared with that of
white x rays. This problem will be resolved by using an xray tube that has the large maximum input load. Further, it
is necessary to examine the monochromatic x-ray CT image
on a phantom close to a structure of real biomedical tissues.

Relative Pixel Value

Relative Pixel Value

(a) Low energy CT

200

100

200

100

20
Position (mm)

40

20
Position (mm)
(a)

40

Low energy CT

Fig. 4 Profiles acquired from the monochromatic x-ray CT images

Figures 6 (a) and (b) show the ES-CT images for (a) monochromatic x rays and (b) white x rays. The ES-CT image
by monochromatic x rays was possible to eliminate only the
surrounding water, and the central image of iodine contrast
media was shown clearly. On the other hand, the images of
water and iodine contrast media were simultaneously eliminated out from the ES-CT image for white x rays.
Figures 7 (a) and (b) show the central profiles of the ESCT images in Figs. 6 (a) and (b). In the case of the monochromatic x rays, the contrast of the iodine contrast media
could reach a relative pixel value of about 160. On the other
hand, in the case of the white x rays, the contrast of the
iodine contrast media could get only a relative pixel value
of about 20.
When white x rays are used, the effective energy of the x
rays are increased during penetrating through the phantom
(i.e. beam hardening). Then, the attenuation coefficient of
the central iodine media was estimated to be especially low
because of its position, and the contrast of the iodine image
of the white x-ray ES-CT was eliminated by the ES
processing. Therefore, it was confirmed that it was essential
for a CT image to use monochromatic x rays causing no
beam hardening.

Relative Pixel Value

(b) High energy CT

200

100

20
Position (mm)

(b) High energy CT

Fig. 5 Profiles acquired from the white x-ray CT images

(a) Monochromatic x-ray CT

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(b) White x-ray CT

Fig. 6 CT images after the ES processing

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H. Sakakibara et al.
Address of the corresponding author.

Relative Pixel Value

200

Author:
Institute:
Street:
City:
Country:
Email:

100

0
0

20
Position (mm)
(a)

40

Monochromatic x rays

Relative Pixel Value

200

100

0
0

20
Position (mm)

40

(b) White x rays

Fig. 7 Profiles after the ES processing

IV. CONCLSION
In this study, CT images with diffracted monochromatic
x rays generated from a usual x-ray tube in clinical use were
evaluated for the beam hardening effect (or the cupping
artifact). In addition, the energy-subtraction CT images
acquired for two kinds of energy of monochromatic x rays
were compared with those for two kinds of energy of white
x rays. It was confirmed that it was essential for a CT image
to use monochromatic x rays causing no beam hardening.

REFERENCES
1.
2.

Sarnelli A, Taibi A, Tuffanelli A, et al.: K-edge digital subtraction

imaging based on a dichromatic and compact x-ray source. Physics in
Medicine and Biology 49: 3291-3305 (2004)
Maeda K, Kuramoto T, Oshita M, et al.: Evaluation of discriminating
power for energy subtraction technique based on monochromatic x
rays obtained by diffraction. Japanese Journal of Medical Phisics 26:
71-72 (2006)

IFMBE Proceedings Vol. 25

Yoshitake Ueda
Hiroshima International University
555-36, Kurose Gakuendai
Higashi-Hiroshima
Japan
y-ueda@hs.hirokoku-u.ac.jp