S Ulzheimer

Publications (10)46.73 Total impact

• Article: Image reconstruction and image quality evaluation for a 64-slice CT scanner with z-flying focal spot.

  T G Flohr, K Stierstorfer, S Ulzheimer, H Bruder, A N Primak, C H McCollough
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  ABSTRACT: We present a theoretical overview and a performance evaluation of a novel z-sampling technique for multidetector row CT (MDCT), relying on a periodic motion of the focal spot in the longitudinal direction (z-flying focal spot) to double the number of simultaneously acquired slices. The z-flying focal spot technique has been implemented in a recently introduced MDCT scanner. Using 32 x 0.6 mm collimation, this scanner acquires 64 overlapping 0.6 mm slices per rotation in its spiral (helical) mode of operation, with the goal of improved longitudinal resolution and reduction of spiral artifacts. The longitudinal sampling distance at isocenter is 0.3 mm. We discuss in detail the impact of the z-flying focal spot technique on image reconstruction. We present measurements of spiral slice sensitivity profiles (SSPs) and of longitudinal resolution, both in the isocenter and off-center. We evaluate the pitch dependence of the image noise measured in a centered 20 cm water phantom. To investigate spiral image quality we present images of an anthropomorphic thorax phantom and patient scans. The full width at half maximum (FWHM) of the spiral SSPs shows only minor variations as a function of the pitch, measured values differ by less than 0.15 mm from the nominal values 0.6, 0.75, 1, 1.5, and 2 mm. The measured FWHM of the smallest slice ranges between 0.66 and 0.68 mm at isocenter, except for pitch 0.55 (0.72 mm). In a centered z-resolution phantom, bar patterns up to 15 lp/cm can be visualized independent of the pitch, corresponding to 0.33 mm longitudinal resolution. 100 mm off-center, bar patterns up to 14 lp/cm are visible, corresponding to an object size of 0.36 mm that can be resolved in the z direction. Image noise for constant effective mAs is almost independent of the pitch. Measured values show a variation of less than 7% as a function of the pitch, which demonstrates correct utilization of the applied radiation dose at any pitch. The product of image noise and square root of the slice width (FWHM of the respective SSP) is the same constant for all slices except 0.6 mm. For the thinnest slice, relative image noise is increased by 17%. Spiral windmill-type artifacts are effectively suppressed with the z-flying focal spot technique, which has the potential to maintain a low artifact level up to pitch 1.5, in this way increasing the maximum volume coverage speed that can be clinically used.
  Medical Physics 09/2005; 32(8):2536-47. · 2.83 Impact Factor
• Article: Performance evaluation of a 64-slice CT system with z-flying focal spot.

  T Flohr, K Stierstorfer, R Raupach, S Ulzheimer, H Bruder
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  ABSTRACT: The meanwhile established generation of 16-slice CT systems enables routine sub-millimeter imaging at short breath-hold times. Clinical progress in the development of multidetector row CT (MDCT) technology beyond 16 slices can more likely be expected from further improvement in spatial and temporal resolution rather than from a mere increase in the speed of volume coverage. We present an evaluation of a recently introduced 64-slice CT system (SOMATOM Sensation 64, Siemens AG, Forchheim, Germany), which uses a periodic motion of the focal spot in longitudinal direction (z-flying focal spot) to double the number of simultaneously acquired slices. This technique acquires 64 overlapping 0.6 mm slices per rotation. The sampling scheme corresponds to that of a 64 x 0.3 mm detector, with the goal of improved longitudinal resolution and reduced spiral artifacts. After an introduction to the detector design, we discuss the basics of z-flying focal spot technology (z-Sharp). We present phantom and specimen scans for performance evaluation. The measured full width at half maximum (FWHM) of the thinnest spiral slice is 0.65 mm. All spiral slice widths are almost independent of the pitch, with deviations of less than 0.1 mm from the nominal value. Using a high-resolution bar pattern phantom (CATPHAN, Phantom Laboratories, Salem, NY), the longitudinal resolution can be demonstrated to be up to 15 lp/cm at the isocenter independent of the pitch, corresponding to a bar diameter of 0.33 mm. Longitudinal resolution is only slightly degraded for off-center locations. At a distance of 100 mm from the isocenter, 14 lp/cm can be resolved in the z-direction, corresponding to a bar diameter of 0.36 mm. Spiral "windmill" artifacts presenting as hyper- and hypodense structures around osseous edges are effectively reduced by the z-flying focal spot technique. Cardiac scanning benefits from the short gantry rotation time of 0.33 s, providing up to 83 ms temporal resolution with 2-segment ECG-gated reconstruction.
  RöFo - Fortschritte auf dem Gebiet der R 01/2005; 176(12):1803-10. · 2.76 Impact Factor
• Article: [Influence of heart rate on image quality and detection of coronary stenoses with multislice spiral CT].

  M Mennicke, T Giesler, D Ropers, U Baum, S Ulzheimer, E Wenkel, K Pohle, W G Daniel, S Achenbach
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  ABSTRACT: Multi-slice spiral CT (MSCT) permits the detection of coronary stenoses. We investigated the influence of the patient's heart rate (HR) during the scan on stenosis detection and the presence of motion artifacts. In 100 patients MSCT was performed and retrospectively ECG-gated cross-sectional images were reconstructed. 115 of 400 coronary arteries (29%) were unevaluable due to motion artifacts (84/115) or other reasons (31/115). In evaluable arteries, sensitivity was 91% (51/56 high grade stenoses detected), specificity was 89%. With increasing HR, the number of unevaluable arteries increased and overall sensitivity for stenosis detection decreased from 62% (HR < or = 70 bpm) to 33% (HR > 70 bpm). MSCT permits detection of coronary stenoses, but evaluability and accuracy decrease with increasing HR.
  Biomedizinische Technik 02/2002; 47 Suppl 1 Pt 2:782-5. · 0.86 Impact Factor
• Article: Investigation of aortocoronary artery bypass grafts by multislice spiral computed tomography with electrocardiographic-gated image reconstruction.

  D Ropers, S Ulzheimer, E Wenkel, U Baum, T Giesler, H Derlien, W Moshage, W A Bautz, W G Daniel, W A Kalender, S Achenbach
  The American Journal of Cardiology 11/2001; 88(7):792-5. · 3.37 Impact Factor
• Source

  Available from: Evelyn Wenkel

  Article: Detection of coronary artery stenoses by contrast-enhanced, retrospectively electrocardiographically-gated, multislice spiral computed tomography.

  S Achenbach, T Giesler, D Ropers, S Ulzheimer, H Derlien, C Schulte, E Wenkel, W Moshage, W Bautz, W G Daniel, W A Kalender, U Baum
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  ABSTRACT: Multislice spiral computed tomography (MSCT) with retrospectively ECG-gated image reconstruction permits coronary artery visualization. We investigated the method's ability to identify high-grade coronary artery stenoses and occlusions. A total of 64 consecutive patients were studied by MSCT (4x1 mm cross-sections, 500-ms rotation, table feed 1.5 mm/rotation, intravenous contrast agent, retrospectively ECG-gated image reconstruction). All coronary arteries and side branches with a luminal diameter >/=2.0 mm were assessed concerning evaluability and the presence of high-grade stenoses (>70% diameter stenosis) or occlusions. Results were compared with quantitative coronary angiography. Of 256 coronary arteries (left main, left anterior descending, left circumflex and right coronary artery, including their respective side branches), 174 could be evaluated (68%). In 19 patients (30%), all arteries were evaluable. Artifacts caused by coronary motion were the most frequent reason for unevaluable arteries. Overall, 32 of 58 high-grade stenoses and occlusions were detected by MSCT (58%). In evaluable arteries, 32 of 35 lesions were detected, and the absence of stenosis was correctly identified in 117 of 139 arteries (sensitivity, 91%; specificity, 84%). If analysis was extended to all stenoses with >50% diameter reduction, sensitivity was 85% (40 of 47) and specificity was 76% (96 of 127). MSCT with retrospective ECG gating permits the detection of coronary artery stenoses with high accuracy if image quality is sufficient, but its clinical use may presently be limited due to degraded image quality in a substantial number of cases, mainly due to rapid coronary motion.
  Circulation 05/2001; 103(21):2535-8. · 14.74 Impact Factor
• Article: [New developments in computer tomography: EKG-correlated subsecond multi-slice spiral CT].

  M Kachelriess, S Ulzheimer, W A Kalender
  Rontgenpraxis 02/2001; 53(4):134-40.
• Article: Noninvasive coronary angiography by retrospectively ECG-gated multislice spiral CT.

  S Achenbach, S Ulzheimer, U Baum, M Kachelriess, D Ropers, T Giesler, W Bautz, W G Daniel, W A Kalender, W Moshage
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  ABSTRACT: We investigated the applicability and image quality of contrast-enhanced coronary artery visualization by multislice spiral CT using retrospective ECG gating. Twenty-five patients in sinus rhythm (significant coronary artery stenoses ruled out by invasive angiography) were studied with a multislice spiral CT (Siemens SOMATOM Volume Zoom). In inspiration (mean breath-hold, 37 seconds), a volume data set of the heart was acquired (intravenous contrast agent; 4 x 1-mm slice thickness; 500-ms rotation; table feed, 1.5 mm/360 degrees ). Simultaneous recording of the ECG permitted retrospective reconstruction of contiguous cross sections in intervals of 1 mm at any desired interval of the cardiac cycle. The mean duration of the image reconstruction window was 185 ms. Next to 3-dimensional reconstructions of the heart and coronary arteries, multiplanar reconstructions were rendered to determine the visualized length of the coronary arteries, the contrast-to-noise ratio, and the correlation of coronary artery diameters to quantitative coronary angiography. The coronary arteries could be visualized over long segments (left main, 9+/-4 mm; left anterior descending, 112+/-34 mm; left circumflex, 80+/-29 mm; right coronary artery, 116+/-33 mm). On average, 78+/-16% of these distances were visualized free of motion artifacts. The mean contrast-to-noise ratio was 9.3+/-3.3. Coronary artery diameters in multislice spiral CT showed close correlation to quantitative coronary angiography (CT, 3.3+/-1.0 mm; angiography, 3. 2+/-0.9 mm; mean difference, 0.38 mm; r=0.86). Contrast-enhanced multislice spiral CT permits visualization of the coronary artery lumen. Further studies are necessary to determine whether image quality is sufficient to reliably detect coronary artery stenoses.
  Circulation 01/2001; 102(23):2823-8. · 14.74 Impact Factor
• Source

  Available from: uni-erlangen.de

  Article: ECG-correlated imaging of the heart with subsecond multislice spiral CT.

  M Kachelriess, S Ulzheimer, W A Kalender
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  ABSTRACT: The new spiral multislice computed tomography (CT) scanners and the significant increase in rotation speed offer great potential for cardiac imaging with X-ray CT. We have therefore developed the dedicated cardiac reconstruction algorithms 180 degrees multislice cardio interpolation (MCI) and 180 degrees multislice cardio delta (MCD) and here offer further details and validation. The algorithm 180 degreesMCI is an electrocardiogram (ECG)-correlated filtering (or weighting) algorithm in both the cardiac phase and in the z-position. Effective scan times (absolute temporal resolution) of as low as t(eff) = 56 ms are possible, assuming M 4 simultaneously measured slices at a rotation time of t(rot) = 0.5 s and S < or = d < or = 3S for the table feed d per rotation, where S denotes the collimated slice thickness. The relative temporal resolution w (fraction of the heart cycle depicted in the image), which is the more important parameter in cardiac imaging, will then be as low as w = 12.5% of the heart cycle. The second approach, 180 degreesMCD, is an ECG-correlated partial scan reconstruction of 180 degrees + delta data with delta < phi (fan-angle). Its absolute temporal resolution lies in the order of 250 ms (for the central ray, i.e., for the center of rotation), and the relative temporal resolution w increases with increasing heart rate, e.g., from typically w = 25% at fH = 60 min(-1) to w = 50% at fH = 120 min(-1), assuming again t(rot) = 0.5 s. For validation purposes, we have done simulations of a virtual cardiac motion phantom, measurements of a dedicated cardiac calibration and motion phantom, and we have reconstructed patient data with simultaneously acquired ECG. Both algorithms significantly improve the image quality compared with the standard reconstruction algorithms 180 degrees multislice linear interpolation (MLI) and 180 degrees multislice filtered interpolation (MFI). However, 180 degreesMCI is clearly superior to 180 degreesMCD for all heart rates. This is best illustrated by multiplanar reformations (MPR) or other three-dimensional (3-D) displays of the volume. 180 degreesMCI, due to its higher temporal resolution, is best for spatial and temporal four-dimensional (4-D) tracking of the anatomy. A tunable scanner rotation time to avoid resonance behavior of the heart rate and the scanner's rotation and shorter rotation times would be of further benefit.
  IEEE Transactions on Medical Imaging 09/2000; 19(9):888-901. · 3.64 Impact Factor
• Source

  Available from: uni-erlangen.de

  Article: ECG-correlated image reconstruction from subsecond multi-slice spiral CT scans of the heart.

  M Kachelriess, S Ulzheimer, W A Kalender
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  ABSTRACT: Subsecond spiral computed tomography (CT) offers great potential for improving heart imaging. The new multi-row detector technology adds significantly to this potential. We therefore developed and validated dedicated cardiac reconstruction algorithms for imaging the heart with subsecond multi-slice spiral CT utilizing electrocardiogram (ECG) information. The single-slice cardiac z-interpolation algorithms 180 degrees CI and 180 degrees CD [Med. Phys. 25, 2417-2431 (1998)] were generalized to allow imaging of the heart for M-slice scanners. Two classes of algorithms were investigated: 180 degrees MCD (multi-slice cardio delta), a partial scan reconstruction of 180 degrees + delta data with a < phi (fan angle) resulting in effective scan times of 250 ms (central ray) when a 0.5 s rotation mode is available, and 180 degrees MCI (multi-slice cardio interpolation), a piecewise weighted interpolation between successive spiral data segments belonging to the same heart phase, potentially providing a relative temporal resolution of 12.5% of the heart cycle when a four-slice scanner is used and the table increment is chosen to be greater than or equal to the collimated slice thickness. Data segments are selected by correlation with the simultaneously recorded ECG signal. Theoretical studies, computer simulations, as well as patient measurements were carried out for a multi-slice scanner providing M = 4 slices to evaluate these new approaches and determine the optimal scan protocol. Both algorithms, 180 degrees MCD and 180 degrees MCI, provide significant improvements in image quality, including extremely arythmic cases. Artifacts in the reconstructed images as well as in 3D displays such as multiplanar reformations were largely reduced as compared to the standard z-interpolation algorithm 180 degrees MLI (multi-slice linear interpolation). Image quality appears adequate for precise calcium scoring and CT angiography of the coronary arteries with conventional subsecond multislice spiral CT. It turned out that for heart rates fH > or = 70 min(-1) the partial scan approach 180 degrees MCD yields unsatisfactory results as compared to 180 degrees MCI. Our theoretical considerations show that a freely selectable scanner rotation time chosen as a function of the patient's heart rate, would further improve the relative temporal resolution and thus further reduce motion artifacts. In our case an additional 0.6 s mode besides the available 0.5 s mode would be very helpful. Moreover, if technically feasible, lower rotation times such as 0.3 s or even less would result in improved image quality. The use of multi-slice techniques for cardiac CT together with the new z-interpolation methods improves the quality of heart imaging significantly. The high temporal resolution of 180 degrees MCI is adequate for spatial and temporal tracking of anatomic structures of the heart (4D reconstruction).
  Medical Physics 08/2000; 27(8):1881-902. · 2.83 Impact Factor
• Article: [Subsecond multislice spiral CT as an alternative to electron beam computerized tomography].

  W A Kalender, M Kachelriess, S Ulzheimer
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  ABSTRACT: X-ray computed tomography (CT) has exhibited rapid technological advances in recent years which has made it a potential alternative to electron beam computed tomography (EBCT). In addition to the development of spiral CT, rotation times in the subsecond range and the development of multislice detectors were decisive steps. These technical developments will be sketched briefly; the necessary adaptation of image reconstruction and evaluation will be explained. Particular emphasis will be placed on the necessary steps of quality assurance and calibration in quantitative procedures, as for example coronary calcium measurements. The exposure for typical CT examinations of the heart are in the order of half to five times the natural exposure per year. With synchronous recording of the ECG, the complete heart can be imaged continuously with thin slices and high spatial resolution in less than 30 s. In spite of the very short validation phase up to now, we consider multislice spiral CT an alternative to EBCT.
  Zeitschrift für Kardiologie 02/2000; 89 Suppl 1:50-4. · 0.97 Impact Factor