A fluence modulation and scatter shielding apparatus for dedicated breast CT: Theory of operation

To introduce an auxiliary apparatus of fluence modulation and scatter shielding for dedicated breast computed tomography (bCT) and the corresponding patient-specific method of image acquisition.

The apparatus is composed of two assemblies, referred to herein as the "Dynamic Fluence Gate" (FG) and "Scatter Shield" (SS), that work in synchrony to form a narrow beam sweeping the entire fan angle coverage of the imaging system during a projection. The apparatus, as a whole, is referred to as FG-SS. FG and SS are pre-patient and post-patient units, respectively. Each is composed of a rotating drum, on top of which are installed two sheets of high x-ray attenuating material, a sensory system, and the constituent robotics. The sheets of each unit are positioned such that an opening - a window Fluence Modulation and Scatter Shielding is formed between them. The rotations of the drums and positioning of the sheets are synchronized and adjusted such that a line of sight is created between the source, FG window, the breast, and the SS window. With line of sight achieved, the narrow beam transitions from the source to the detector. The fluence of the narrow beam during a projection depends on the size, shape, and positioning of the breast. The FG-SS method of imaging is discussed mathematically and demonstrated using computer simulations. A series of Monte Carlo simulations are conducted to evaluate the performance of the system as relates to its impact on the imager's dynamic range, dose distribution to the breast, noise inhomogeneity in reconstructed images, and scatter buildup in projections within small, medium, and large breasts composed of homogeneous medium breast tissue.

Implementation of FG-SS results in near scatter-free projections, reduction in both dose and the required dynamic range of the imager, and equalization of the quantum noise distribution in the reconstructed image. Using the disclosed design, the dynamic range was reduced by factors ranging from 1.6 to 5.5 across the range of breast sizes studied. A reduction in the acquisition of the scattered rays, varying between the factors of 6.1 (in the small breast) and 9.8 (in that large breast) was achieved and consequently, shading artifacts were suppressed. Noise in the CT image was equalized by reducing the overall spatial variation from 29% to <5% in small breast and from 45% to 14% in the large breast. An overall reduction in deposited dose to the breast was achieved - between 26% and 39% depending on the breast size.

Utilization of the FG-SS apparatus and technique was demonstrated via simulations to result in: significant reductions in dose to the breast, reductions in scatter uptake in projections, reduced required dynamic range of the imager, and homogenizing of quantum noise throughout the reconstructed image.