Iterative reconstruction for low-dose cerebral perfusion computed tomography using prior image induced diffusion tensor

Cerebral perfusion computed tomography (CPCT) can depict the functional status of cerebral circulation at the tissue level; hence, it has been increasingly used to diagnose patients with cerebrovascular disease. However, there is a significant concern that CPCT scanning protocol could expose patients to excessive radiation doses. Although reducing the x-ray tube current when acquiring CPCT projection data is an effective method for reducing radiation dose, this technique usually results in degraded image quality. To enhance the image quality of low-dose CPCT, we present a prior image induced diffusion tensor (PIDT) for statistical iterative reconstruction, based on the penalized weighted least-squares (PWLS) criterion, which we referred to as PWLS-PIDT, for simplicity. Specifically, PIDT utilizes the geometric features of pre-contrast scanned high-quality CT image as a structure prior for PWLS reconstruction; therefore, the low-dose CPCT images are enhanced while preserving important features in the target image. An effective alternating minimization algorithm is developed to solve the associated objective function in the PWLS-PIDT reconstruction. We conduct qualitative and quantitative studies to evaluate the PWLS-PIDT reconstruction with a digital brain perfusion phantom and patient data. With this method, the noise in the reconstructed CPCT images is more substantially reduced than that of other competing methods, without sacrificing structural details significantly. Furthermore, the CPCT sequential images reconstructed via the PWLS-PIDT method can derive more accurate hemodynamic parameter maps than those of other competing methods.