Dynamic beam filtering for miscentered patients.

Purpose: Accurate centering of the patient within the bore of a CT scanner takes time and is often difficult to achieve precisely. Patient miscentering can result in significant dose and image noise penalties with the use of traditional bowtie filters. This work describes a system to dynamically position an x-ray beam filter during image acquisition to enable more consistent image performance and potentially lower dose needed for CT imaging.

Methods: We propose a new approach in which two orthogonal low-dose scout images are used to estimate a parametric model of the object describing its shape, size, and location within the field of view (FOV). This model is then used to compute an optimal filter motion profile by minimizing the variance of the expected detector fluence for each projection. Dynamic filtration was implemented on a cone-beam CT (CBCT) test bench using two different physical filters: 1) an aluminum bowtie and 2) a structured binary filter called a multiple aperture device (MAD). Dynamic filtration performance was compared to a static filter in studies of dose and reconstruction noise as a function of the degree of miscentering of a homogeneous water phantom.

Results: Estimated filter trajectories were found to be largely sinusoidal with an amplitude proportional to the amount of miscentering. Dynamic filtration demonstrated an improved ability to keep the spatial distribution of dose and reconstruction noise at baseline levels across varying levels of miscentering, reducing the maximum noise and dose deviation from 53% to 15% and 42% to 14% respectively for the bowtie filter, and 25% to 8% and 24% to 15% respectively for the MAD filter.

Conclusion: Dynamic positioning of beam filters during acquisition improves dose utilization and image quality over static filters for miscentered patients. Such dynamic filters relax positioning requirements and have the potential to reduce set-up time and lower dose requirements.