Optimization of image acquisition techniques for dual-energy imaging of the chest

Experimental and theoretical studies were conducted to determine optimal acquisition techniques for a prototype dual-energy (DE) chest imaging system. Technique factors investigated included the selection of added x-ray filtration, kVp pair, and the allocation of dose between low- and high-energy projections, with total dose equal to or less than that of a conventional chest radiograph. Optima were computed to maximize lung nodule detectability as characterized by the signal-difference-to-noise ratio (SDNR) in DE chest images. Optimal beam filtration was determined by cascaded systems analysis of DE image SDNR for filter selections across the periodic table (Z(filter) = 1-92), demonstrating the importance of differential filtration between low- and high-kVp projections and suggesting optimal high-kVp filters in the range Z(filter) = 25-50. For example, added filtration of approximately 2.1 mm Cu, approximately 1.2 mm Zr, approximately 0.7 mm Mo, and approximately 0.6 mm Ag to the high-kVp beam provided optimal (and nearly equivalent) soft-tissue SDNR. Optimal kVp pair and dose allocation were investigated using a chest phantom presenting simulated lung nodules and ribs for thin, average, and thick body habitus. Low- and high-energy techniques ranged from 60-90 kVp and 120-150 kVp, respectively, with peak soft-tissue SDNR achieved at [60/120] kVp for all patient thicknesses and all levels of imaging dose. A strong dependence on the kVp of the low-energy projection was observed. Optimal allocation of dose between low- and high-energy projections was such that approximately 30% of the total dose was delivered by the low-kVp projection, exhibiting a fairly weak dependence on kVp pair and dose. The results have guided the implementation of a prototype DE imaging system for imaging trials in early-stage lung nodule detection and diagnosis.