title: Alpha image reconstruction (AIR): a new iterative CT image reconstruction approach using voxel-wise alpha blending.
abstract: OBJECTIVE
  Iterative image reconstruction gains more and more interest in clinical routine, as it promises to reduce image noise (and thereby patient dose), to reduce artifacts, or to improve spatial resolution. Among vendors and researchers, however, there is no consensus of how to best achieve these aims. The general approach is to incorporate a priori knowledge into iterative image reconstruction, for example, by adding additional constraints to the cost function, which penalize variations between neighboring voxels. However, this approach to regularization in general poses a resolution noise trade-off because the stronger the regularization, and thus the noise reduction, the stronger the loss of spatial resolution and thus loss of anatomical detail. The authors propose a method which tries to improve this trade-off. The proposed reconstruction algorithm is called alpha image reconstruction (AIR). One starts with generating basis images, which emphasize certain desired image properties, like high resolution or low noise. The AIR algorithm reconstructs voxel-specific weighting coefficients that are applied to combine the basis images. By combining the desired properties of each basis image, one can generate an image with lower noise and maintained high contrast resolution thus improving the resolution noise trade-off.
  
  
  METHODS
  All simulations and reconstructions are performed in native fan-beam geometry. A water phantom with resolution bar patterns and low contrast disks is simulated. A filtered backprojection (FBP) reconstruction with a Ram-Lak kernel is used as a reference reconstruction. The results of AIR are compared against the FBP results and against a penalized weighted least squares reconstruction which uses total variation as regularization. The simulations are based on the geometry of the Siemens Somatom Definition Flash scanner. To quantitatively assess image quality, the authors analyze line profiles through resolution patterns to define a contrast factor for contrast-resolution plots. Furthermore, the authors calculate the contrast-to-noise ratio with the low contrast disks and the authors compare the agreement of the reconstructions with the ground truth by calculating the normalized cross-correlation and the root-mean-square deviation. To evaluate the clinical performance of the proposed method, the authors reconstruct patient data acquired with a Somatom Definition Flash dual source CT scanner (Siemens Healthcare, Forchheim, Germany).
  
  
  RESULTS
  The results of the simulation study show that among the compared algorithms AIR achieves the highest resolution and the highest agreement with the ground truth. Compared to the reference FBP reconstruction AIR is able to reduce the relative pixel noise by up to 50% and at the same time achieve a higher resolution by maintaining the edge information from the basis images. These results can be confirmed with the patient data.
  
  
  CONCLUSIONS
  To evaluate the AIR algorithm simulated and measured patient data of a state-of-the-art clinical CT system were processed. It is shown, that generating CT images through the reconstruction of weighting coefficients has the potential to improve the resolution noise trade-off and thus to improve the dose usage in clinical CT.
authors.affiliation: Institute of Medical Physics, Friedrich-Alexander University (FAU), Erlangen 91052, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Hofmann
authors.affiliation: Medical Physics in Radiology, German Cancer Research Center (DKFZ), Heidelberg 69120, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Sawall
authors.affiliation: Medical Physics in Radiology, German Cancer Research Center (DKFZ), Heidelberg 69120, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Knaup
authors.affiliation: Institute of Medical Physics, Friedrich-Alexander University (FAU), Erlangen 91052, Germany and Medical Physics in Radiology, German Cancer Research Center (DKFZ), Heidelberg 69120, Germany.
authors.forename: Marc
authors.initials: M
authors.lastname: Kachelrieß
mesh_terms: D000465:Algorithms; D016477:Artifacts; D003198:Computer Simulation; D006801:Humans; D016018:Least-Squares Analysis; D019047:Phantoms, Imaging; D014057:Tomography, X-Ray Computed / Q000295:instrumentation / Q000379:methods*; D014867:Water
chemical_list: D014867:Water