A novel method for developing contrast-detail curves from clinical patient images based on statistical low-contrast...

Purpose. To develop a method to extract statistical low-contrast detectability (LCD) and contrast-detail (C-D) curves from clinical patient images.Method. We used the region of air surrounding the patient as an alternative for a homogeneous region within a patient. A simple graphical user interface (GUI) was created to set the initial configuration for region of interest (ROI), ROI size, and minimum detectable contrast (MDC). The process was started by segmenting the air surrounding the patient with a threshold between -980 HU (Hounsfield units) and -1024 HU to get an air mask. The mask was trimmed using the patient center coordinates to avoid distortion from the patient table. It was used to automatically place square ROIs of a predetermined size. The mean pixel values in HU within each ROI were calculated, and the standard deviation (SD) from all the means was obtained. The MDC for a particular target size was generated by multiplying the SD by 3.29. A C-D curve was obtained by iterating this process for the other ROI sizes. This method was applied to the homogeneous area from the uniformity module of an ACR CT phantom to find the correlation between the parameters inside and outside the phantom, for 30 thoracic, 26 abdominal, and 23 head images.Results. The phantom images showed a significant linear correlation between the LCDs obtained from outside and inside the phantom, with R²values of 0.67 and 0.99 for variations in tube currents and tube voltages. This indicated that the air region outside the phantom can act as a surrogate for the homogenous region inside the phantom to obtain the LCD and C-D curves.Conclusion. The C-D curves obtained from outside the ACR CT phantom show a strong linear correlation with those from inside the phantom. The proposed method can also be used to extract the LCD from patient images by using the region of air outside as a surrogate for a region inside the patient.