# US 10,368,818 B2 · System and method of quantitative angiograpy

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- Number: US 10,368,818 B2
- Document ID: US10368818B2
- Status: Granted
- Kind: B2
- Application number: 15/723,125
- Filed: 2017-10-02
- Published: 2019-04-04
- Granted: 2019-08-06
- Earliest claimed: 2017-10-02
- Assignees: Wisconsin Alumni Research Foundation
- Applicants: Wisconsin Alumni Research Foundation
- Inventors: Charles Mistretta; Charles Strother
- Web page: https://patentgrep.com/patent/US10368818B2

## CPC

- A61B 6/032: {Transmission computed tomography [CT]}
- A61B 6/463: {characterised by displaying multiple images or images and diagnostic data on one display}
- A61B 6/466: {adapted to display 3D data}
- A61B 6/504: {for diagnosis of blood vessels, e.g. by angiography}
- A61B 6/507: {for determination of haemodynamic parameters, e.g. perfusion CT}
- A61B 6/5205: {involving processing of raw data to produce diagnostic data}
- A61B 6/5217: {extracting a diagnostic or physiological parameter from medical diagnostic data}
- G06T 5/70: Denoising; Smoothing
- G06T 7/0016: {involving temporal comparison}
- G06T 7/11: Region-based segmentation
- G06T 11/60: Creating or editing images; Combining images with text
- G06T 12/10: Image preprocessing, e.g. calibration, positioning of sources or scatter correction
- G06T 12/20: Inverse problem, i.e. transformations from projection space into object space
- G16H 50/30: for calculating health indices; for individual health risk assessment
- G06T 2207/10076: 4D tomography; Time-sequential 3D tomography
- G06T 2207/10081: Computed x-ray tomography [CT]
- G06T 2207/30104: Vascular flow; Blood flow; Perfusion
- G06T 2211/404: Angiography
- A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D)
- G06T: IMAGE DATA PROCESSING OR GENERATION, IN GENERAL
- G16H: HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA

## Abstract

Methods and systems are provided for generating quantitative computed tomography (CT) angiographic images using imaging systems that acquire a set of projection views forming CT angiographic image data of a patient using a projection duration of less than 50 milliseconds. The method may include producing a composite image from the CT angiographic image data that indicates an attenuation value at each composite image pixel of the patient, backprojecting each projection view in the CT angiographic image data and weighting a value backprojected into at image pixel by an attenuation value of a corresponding pixel in the composite image and summing backprojected values for each image pixel to produce a CT image of the patient. The method may further include performing a scatter correction and determining at least one of a flow direction or a velocity of flow with a vessel in the patient to provide the quantitative CT angiographic images.

## Claims

### Claim 1

A method for generating quantitative computed tomography (CT) angiographic images, the method comprising:
acquiring a set of projection views forming CT angiographic image data of a patient using a projection duration of less than 50 milliseconds;
producing a composite image from the CT angiographic image data that indicates an attenuation value at each composite image pixel of the patient;
backprojecting each projection view in the CT angiographic image data and weighting a value backprojected into at image pixel by an attenuation value of a corresponding pixel in the composite image;
summing backprojected values for each image pixel to produce a CT image of the patient;
performing a scatter correction on at least one of the CT angiographic image data and the CT image of the patient;
determining at least one of a flow direction or a velocity of flow with a vessel in the patient; and
displaying the at least one of the flow direction or the velocity of flow with the vessel in the patient with the CT image of the patient to provide the quantitative CT angiographic images.

### Claim 2 (depends on 1)

The method of claim 1 further comprising generating a time-series of two-dimensional images from at least a portion of the CT angiographic image data, reconstructing a three-dimensional image substantially without temporal resolution from at least a portion of CT angiographic image data, and producing a time-resolved three-dimensional image of the subject by selectively combining the three-dimensional image substantially without temporal resolution and the time-series of two-dimensional images.

### Claim 3 (depends on 2)

The method of claim 2 further comprising determining a temporal parameter for each voxel of the time-resolved three-dimensional image to determine the at least one of the flow direction or the velocity of flow.

### Claim 4 (depends on 3)

The method of claim 3 wherein the temporal parameter is a mean transit time (MTT) through the vessel in the patient.

### Claim 5 (depends on 2)

The method of claim 2 further comprising superimposing a color coded display of the temporal parameter on at least one of the time-resolved three-dimensional image and a blood volume image generated from the three-dimensional image substantially without temporal resolution to display the at least one of the flow direction or the velocity of flow with the vessel in the patient with the CT image of the patient.

### Claim 6 (depends on 1)

The method of claim 1 further comprising calculating a mean transit time (MTT) through the vessel in the patient to determine at least one of a flow direction or a velocity of flow with a vessel in the patient.

### Claim 7 (depends on 1)

The method of claim 1 further comprising calculating a mean transit time (MTT) through the vessel in the patient to over an interval for each of a plurality of positions along the vessel to determine at least one of a flow direction or a velocity of flow with a vessel in the patient and wherein the MTT is calculated using a rising integrated signal (conrise) for the plurality of positions along the vessel in the patient.

### Claim 8 (depends on 1)

The method of claim 1 further comprising deriving information about a movement of the patient during acquisition of the set of projection views forming CT angiographic image data and adjusting a magnification of each projection relative to the detector based on the information about the movement of the patient.

### Claim 9 (depends on 1)

The method of claim 1 further comprising producing a series of intermediate composite images that progress along with the additional projection views forming CT angiographic image data.

### Claim 10

A method for generating quantitative computed tomography (CT) angiographic images, the method comprising:
acquiring a set of projection views forming CT angiographic image data of a patient using a projection duration of less than 50 milliseconds;
producing a composite image from the CT angiographic image data that indicates an attenuation value at each composite image pixel of the patient;
backprojecting each projection view in the CT angiographic image data and weighting a value backprojected into at image pixel by ban attenuation value of a corresponding pixel in the composite image;
summing backprojected values for each image to produce a CT image of the patient;
performing a scatter correction on at least one of the CT angiographic image data and the CT image of the patient;
determining at least one of a flow direction or a velocity of flow with a vessel in the patient;
displaying the at least one of the flow direction or the velocity of flow with the vessel in the patient with the CT image of the patient to provide the quantitative CT angiographic images; and
further comprising, to preform the scatter correction:
convolving the CT image of the patient with a blurring kernel to create a scatter image;
at a plurality of points in the CT image of the patient, estimating a scatter fraction; and
subtracting the scatter image from the CT image of the patient using the scatter fraction.

### Claim 11 (depends on 10)

The method of claim 10 wherein the scatter image is spatially dependent to have larger values in regions of low signal intensity in the CT angiographic image data.

### Claim 12 (depends on 10)

The method of claim 10 further comprising using lead blocker data or a look-up table of scatter fraction vs. detected intensity to estimate the scatter fraction.

### Claim 13

A method for generating quantitative computed tomography (CT) angiographic images, the method comprising:
acquiring a set of projection views forming CT angiographic image data of a patient using a projection duration of less than 50 milliseconds;
producing a composite image from the CT angiographic image data that indicates an attenuation value at each composite image pixel of the patient;
backprojecting each projection view in the CT angiographic image data and weighting a value backprojected into at image pixel by an attenuation value of a corresponding pixel in the composite image;
summing backprojected values for each image pixel to produce a CT image of the patient;
performing a scatter correction on at least one of the CT angiographic image data and the CT image of the patient;
determining at least one of a flow direction or a velocity of flow with a vessel in the patient;
displaying the at least one of the flow direction or the velocity of flow with the vessel in the patient with the CT image of the patient to provide the quantitative CT angiographic images; and
further comprising:
determining a centerline for the vessel in the patient using the CT image of the patient;
generating signal vs. time curves for a plurality of points along the centerline of the vessel;
convolving the signal vs. time curves with a temporal kernel to reduce effects of pulsatility;
calculating a rising integrated signal (conrise) for a plurality of positions along the vessel in the patient; and
calculating the MTT through the vessel in the patient over an interval selected based on the conrise for each of the plurality of positions.

### Claim 14 (depends on 13)

The method of claim 13 further comprising generating the temporal kernel using a plurality of image frames from the CT angiographic image data.

### Claim 15 (depends on 13)

The method of claim 13 further comprising generating a MTT curve based on the MTT through the vessel across the plurality of positions and deriving velocity using a slope of the MTT curve.

### Claim 16

A system for generating quantitative computed tomography (CT) angiographic images, the system comprising:
a rotatable gantry including a radiation source and a detector coupled thereto, wherein the rotatable gantry is configured to receive a patient to rotate the radiation source and the detector around the patient to acquire a set of projection views forming CT angiographic image data of the patient using a projection duration of less than 50 milliseconds;
a computer system programmed to receive the CT angiographic image data from the detector and generate quantitative CT angiographic images by:
producing a composite image that indicates an attenuation value at each composite image pixel of the patient;
reconstructing the quantitative CT angiographic images of the patient by:
backprojecting each projection view in the CT angiographic image data and weighting a value backprojected into at image pixel by an attenuation value of a corresponding pixel in the composite image;
summing backprojected values for each image pixel to produce a CT image of the patient;
performing a scatter correction on at least one of the CT angiographic image data and the CT image of the patient;
determining at least one of a flow direction or a velocity of flow with a vessel in the patient; and
combining the at least one of the flow direction or the velocity of flow with the vessel in the patient with the CT image of the patient to generate the quantitative CT angiographic images.

### Claim 17 (depends on 16)

The system of claim 16 wherein the computer system is further programmed to generate quantitative CT angiographic images by generating a time-series of two-dimensional images from at least a portion of the CT angiographic image data, reconstruct a three-dimensional image substantially without temporal resolution from at least a portion of CT angiographic image data; and produce a time-resolved three-dimensional image of the subject by selectively combining the three-dimensional image substantially without temporal resolution and the time-series of two-dimensional images.

### Claim 18 (depends on 17)

The system of claim 17 wherein the computer system is further programmed to determine the at least one of the flow direction or the velocity of flow by determining a temporal parameter for each voxel of the time-resolved three-dimensional image.

### Claim 19 (depends on 18)

The system of claim 18 wherein the temporal parameter is a mean transit time (MTT) through the vessel in the patient.

### Claim 20 (depends on 17)

The system of claim 17 wherein the computer system is further programmed to superimpose a color coded display of the temporal parameter on at least one of the time-resolved three-dimensional image and a blood volume image generated from the three-dimensional image substantially without temporal resolution to combine the at least one of the flow direction or the velocity of flow with the vessel in the patient with the CT image of the patient.

### Claim 21 (depends on 16)

The system of claim 16 wherein the computer system is further programmed to calculate a mean transit time (MTT) through the vessel in the patient to determine at least one of a flow direction or a velocity of flow with a vessel in the patient.

### Claim 22

A system for generating quantitative computed tomography (CT) angiographic images, the system comprising:
a rotatable gantry including a radiation source and a detector coupled thereto, wherein the rotatable gantry is configured to receive a patient to rotate the radiation source and the detector around the patient to acquire a set of projection views forming CT angiographic image data of the patient using projection duration of less than 50 milliseconds;
a computer system programed to receive the CT angiographic image data from the detector and generate quantitative CT angiographic images by:
producing a composite image that indicates an attenuation value at each composite image pixel of the patient;
reconstructing the quantitative CT angiographic images of the patient by;
backprojecting each projection view in the CT angiographic image data and weighting a value backprojected into at image pixel by an attenuation value of a corresponding pixel in the composite image;
summing backprojected values for each image pixel to produce a CT image of the patient;
performing a scatter correction on at least one of the CT angiographic image data and the CT image of the patient;
determining at least one of a flow direction or a velocity of flow with a vessel in the patient;
combining the at least one of the flow direction or the velocity of flow with the vessel in the patient with the CT image of the patient to generate the quantitative CT angiographic images;
wherein, to perform the scatter correction, the computer system is further programmed to:
convolve the CT image of the patient with a blurring kernel to create a scatter image;
at each point in the CT image of the patient, estimate a scatter fraction; and
subtract the scatter image from the CT image of the patient using the scatter fraction.

### Claim 23 (depends on 22)

The system of claim 22 wherein the scatter image is spatially dependent to have larger values in regions of low signal intensity in the angiographic image data.

### Claim 24 (depends on 22)

The system of claim 22 wherein computer system is further programmed to estimate the scatter fraction using lead blocker data or a look-up table of scatter fraction vs. detected intensity.

### Claim 25

A system for generating quantitative computed tomography (CT) angiographic images, the system comprising:
a rotatable gantry including a radiation source and a detector coupled thereto, wherein the rotatable gantry is configured to receive a patient to rotate the radiation source and the detector around the patient to acquire a set of projection views forming CT angiographic image data of the patient using a projection duration of less than 50 milliseconds;
a computer system programmed to receive the CT angiographic image data from the detector and generate quantitative CT angiographic images by:
producing a composite image that indicates an attenuation value at each composite image pixel of the patient;
reconstructing the quantitative CT angiographic images of the patient by;
backprojecting each projection view in the CT angiographic image data and weighting a value backprojected into at image pixel by an attenuation value of a corresponding pixel in the composite image;
summing backprojected values for each image pixel to produce a CT image of the patient;
performing a scatter correction on at least one of the CT angiographic image data and the CT image of the patient;
determining at least one of a flow direction or a velocity of flow with a vessel in the patient;
combining the at least one of the flow direction or the velocity of flow with the vessel in the patient with the CT image of the patient to generate the quantitative CT angiographic images;
wherein the computer system is further programmed to:
determine a centerline for the vessel in the patient using the CT image of the patient;
generate signal vs. time curves for a plurality of points along the centerline of the vessel;
convolve the signal vs. time curves with a temporal kernel to reduce effects of pulsatility;
calculate a conrise for a plurality of positions along the vessel in the patient; and
calculate the MTT through the vessel in the patient over an interval selected based on the conrise for each of the plurality of positions.

### Claim 26 (depends on 25)

The system of claim 25 wherein the computer system is further programmed to generate the temporal kernel using a plurality of image frames from the CT angiographic image data.

### Claim 27 (depends on 25)

The system of claim 25 wherein the computer system is further programmed to generate a MTT curve based on the MTT through the vessel across the plurality of positions and derive velocity using a slope of the MTT curve.

### Claim 28 (depends on 16)

The system of claim 16 wherein the detector may include a detector array configured to acquire at least 256 slices simultaneously.

### Claim 29 (depends on 16)

The system of claim 16 wherein the computer system is further programmed to derive information about a movement of the patient through the gantry when acquiring the set of projection views forming CT angiographic image data and adjust a magnification of each projection relative to the detector as the patient moves through the gantry.

### Claim 30 (depends on 16)

The system of claim 16 wherein the computer system is further programmed to produce a series of intermediate composite images that progress along with the additional projection views forming CT angiographic image data.

### Claim 31

A method for generating quantitative computed tomography (CT) angiographic images, the method comprising:
acquiring a set of projection views forming CT angiographic image data of a patient using a projection duration of less than 50 milliseconds;
producing a composite image from the CT angiographic image data that indicates an attenuation value at each composite image pixel of the patient;
backprojecting each projection view in the CT angiographic image data and weighting a value backprojected into at image pixel by an attenuation value of a corresponding pixel in the composite image;
summing backprojected values for each image pixel to produce a CT image of the patient;
determining at least one of a flow direction or a velocity of flow with a vessel in the patient by:
determining a centerline for the vessel in the patient using the CT image of the patient;
generating signal vs. time curves for a plurality of points along the centerline of the vessel;
convolving the signal vs. time curves with a temporal kernel to reduce effects of pulsatility;
calculating a conrise for a plurality of positions along the vessel in the patient;
calculating a meant transit time (MTT) through the vessel in the patient over an interval selected based on the conrise for each of the plurality of positions; and
displaying the at least one of the flow direction or the velocity of flow with the vessel in the patient with the CT image of the patient to provide the quantitative CT angiographic images.

### Claim 32 (depends on 31)

The method of claim 31 further comprising performing a scatter correction on at least one of the CT angiographic image data and the CT image of the patient.

### Claim 33 (depends on 31)

The method of claim 31 wherein the projection duration is not greater than 1 millisecond.