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145 protocols using somatom definition edge

1

Anthropomorphic Phantom CT Scans and Metal Artifact Reduction

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The anthropomorphic phantom was scanned using Brilliance Big Bore (Philips Healthcare System), SOMATOM Definition Edge (Siemens Healthcare), Revolution HD (GE Medical Systems), and Aquilion PRIME (Toshiba Medical) CT scanners. We used each scanner to acquire an image set with the bone-equivalent capsules (baseline scan) and an image set with the metal amalgam capsules (metal scan). Each metal scan was reconstructed using the respective vendor’s MAR algorithm, Philips OMAR, Toshiba SEMAR, Siemens iMAR, GE SmartMAR (corrected scan).
We applied the in-house AMPP algorithm to image sets acquired with the Siemens SOMATOM Definition Edge scanner only, due to its performance being independent of CT scanner vendor (demonstrated in the robustness study of this manuscript – Section 2.4). The parameters of each head and neck CT protocol used for the baseline and the metal scans were shown in Supplementary Table S1.
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2

Preoperative Orbital Imaging Protocols

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Data from the preoperative orbital imaging examinations were retrospectively analyzed. Of the 91 included patients, 73 underwent CT scans, 43 underwent MRI scans, and 25 underwent both CT and MRI scans.
The CT scans were performed using various scanners (GE Medical Systems, GE Lightspeed VCT, GE Discovery CT750 HD, GE OPTIMA CT660, Siemens Somatom Sensation 16, Siemens Somatom Definition AS, Siemens Somatom Definition Edge, Siemens Somatom Definition Flash) with multidetector capabilities ranging from 16 to 128 channels. The techniques and parameters varied depending on the system used; however, most examinations were performed using a 128-channel CT scanner (Somatom Definition Flash; Siemens Medical Solutions). The detailed CT imaging protocols are described in the Supplement.
The MRI scans were performed using various 3T MRI scanners (Magnetom Skyra, Siemens; Achieva, Philips Medical Systems; Ingenia CX, Philips Medical Systems) with a 16- or 64-channel head and neck coil. However, most examinations were performed with a 3T MRI scanner (Magnetom Skyra, Siemens) with a 64-channel head and neck coil. The MRI protocol for head and neck tumors consisted of axial and coronal T1- and T2-weighted turbo spin-echo sequences with diffusion-weighted imaging and dynamic contrast-enhanced (DCE)-MRI. The detailed MRI protocols are described in the Supplement.
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3

Multidetector CT Scanner Calibration Protocol

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CT was performed using seven multidetector CT scanners (Siemens Somatom Definition Edge, Definition Flash, and Force, Siemens Healthineers, Erlangen, Germany; Philips Brilliance 64 and Brilliance 16, Philips Healthcare, Best, Netherlands; Canon Aquilion One, Canon Medical Systems, Otawara, Japan; GE Revolution EVO, Madison, WI, GE Healthcare). CT was performed using a peak tube voltage of 120 kVp, a slice thickness of 2.0–5.0 mm, and adaptive tube current in helical mode. CT scans were performed using a bone kernel or a soft tissue kernel depending on the imaging purpose. All CT machines were calibrated daily with external air. The HU value of air should remain relatively constant, but it can vary slightly depending on factors such as temperature and humidity. Therefore, a calibration process is performed by conducting a scan using only air, without any specific object or phantom inside the CT bore, to adjust the HU value. Two-dimensional reconstructions were acquired in the coronal and/or sagittal planes with a bone or soft tissue kernel and a thickness of 2.0–5.0 mm.
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4

Cervical Vertebrae Phantom from CT Data

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Institutional Review Board (IRB) approved this retrospective study. A cervical vertebrae phantom was created based on a patient image volume (10 × 10 × 10 cm3) that was acquired on a clinical CT scanner (Siemens SOMATOM Definition Edge, Siemens Healthcare GmbH, Erlangen, Germany) at a tube voltage of 120 kVp with a standard diagnostic protocol. Table 1 lists detailed acquisition and reconstruction parameters for the patient scan. The patient data consist of four cervical vertebrae (C4 to C7), including the trachea and esophagus. A circular region of interest with a diameter of 10 cm was cropped in axial slices to form the phantom. HUs were converted to infill ratios based on the calibration phantom.
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5

Cervical Vertebrae Phantom Creation

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Institutional Review Board (IRB) of University of Pennsylvania approved this retrospective study. Informed consent was obtained from all subjects and their legal guardians. All methods were performed in accordance with relevant guidelines and regulations. A cervical vertebrae phantom was created based on a patient image volume (10 × 10 × 10 cm3) that was acquired on a clinical CT scanner (Siemens SOMATOM Definition Edge, Siemens Healthcare GmbH, Erlangen, Germany) at a tube voltage of 120 kVp with a standard diagnostic protocol. Table 1 lists detailed acquisition and reconstruction parameters for the patient scan. The patient data consist of four cervical vertebrae (C4 to C7), including the trachea and esophagus. A circular region of interest with a diameter of 10 cm was cropped in axial slices to form the phantom. HUs were converted to infill ratios based on the calibration phantom.
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6

MSCT for Pre-TAVR Assessment

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For all patients, we analyzed the MSCT images, which were performed as standard-of-care pre-TAVR. Patients were evaluated using a Siemens Somatom Definition Edge scanner (Siemens Medical Solutions) using collimation of 0.6 mm at a fixed pitch of 0.2 with an injection of 70 ml of iopamidol (Ultravist-370; Bayer Vital Pharma). A dedicated protocol was formulated, with kV and tube current modified according to the patient’s size. Image acquisition for the heart was performed with retrospective ECG gating. CT Digital Imaging and Communications in Medicine (DICOM) data were analyzed using Siemens syngo software, Syngo Via, for TAVR Planning. In patients with LG AS, the cardiac output was measured to assure that stroke volume index is ≤ 35 ml/m2. So all patients with LG AS in this study also have low flow status.
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7

Cervical Vertebrae CT Phantom Generation

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Due to the retrospective nature of the study, the Institutional Review Board of University of Pennsylvania waived the need of obtaining informed consent. A cervical vertebrae phantom was created based on a patient image volume (10 × 10 × 10 cm3) that was acquired on a clinical CT scanner (Siemens SOMATOM Definition Edge, Siemens Healthcare GmbH, Erlangen, Germany) at a tube voltage of 120 kVp with a standard diagnostic protocol. Table 1 lists detailed acquisition and reconstruction parameters for the patient scan. The patient data consist of four cervical vertebrae (C4 to C7), including the trachea and esophagus. A circular region of interest with a diameter of 10 cm was cropped in axial slices to form the phantom. HUs were converted to infill ratios based on the calibration phantom.

Acquisition parameters of CT image for phantom generation.

Cervical vertebraeKnee
Scanner modelSiemens SOMATOM Definition EdgePhilips iQon Spectral CT
Tube voltage120 kVp120 kVp
Tube current105 mA196 mA
Rotation time1000 ms1026 ms
Spiral pitch factor0.8Axial
Exposure131 mAs201 mAs
CTDIvol8.85 mGy17.1 mGy
Collimation width0.6/38.4 mm0.625/40.0 mm
Slice thickness0.6 mm0.67 mm
Reconstruction filterI26s\3B
Field of view99.75 × 99.75 mm2304 × 304 mm2
Matrix size228 × 228 pixel2512 × 512 pixel2
Pixel spacing0.4375 mm0.5938 mm

Collimation width values are noted as single/total collimation width.

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8

Chest X-ray and CT Imaging for COVID-19

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To identify any signs of pneumonia at admission in the emergency room, all patients suspected of SARS-CoV-2 underwent a baseline digital anteroposterior chest radiography at full inspiration using a mobile chest radiograph device (Philips Mobile Diagnost wDR, Philips Medical System SA). We performed chest uld CT in patients with signs of respiratory failure (FIO2/PaO2 < 300 mmHg), with clinical SARS-CoV-2 compatible symptoms or with suspicious SARS-CoV-2 parenchymal changes at chest X-ray. Chest uld CT images were obtained at 22.5 ± 14.1 hours (range, 3–48 hours) from chest X-ray acquisition using 2 multi-detector scanners: Siemens Somatom Definition Flash and Siemens Somatom Definition Edge (Siemens, Erlangen, Germany). Scan parameters were optimized for a patient with a normal BMI between 18.5 and 24.9 as follows: tube voltage 80 kVp; fix tube current of 20 mAs without automatic exposure control; slice thickness 2.0 mm; reconstruction interval 2 mm; with a sharp reconstruction kernel. CT images were acquired with the patient in the supine position at full inspiration, without intravenous contrast medium.
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9

Patient-Specific Cervical Phantom Creation

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The Institutional Review Board (IRB) approved this retrospective study. A cervical phantom was created based on a patient-specific image volume (10 × 10 × 10 cm3) that was acquired on a clinical CT scanner (Siemens SOMATOM Definition Edge, Siemens Healthcare GmbH, Erlangen, Germany) at 120 kVp with a standard diagnostic dose (CTDIvol: 8.8 mGy). See Table 1 for detailed acquisition parameters for the patient and phantom scans.
The patient data consist of four cervical vertebrae (C4 to C7), including a clear view of trachea and esophagus. A circular region of interest with a diameter of 10 cm was cropped in the axial slices, forming a cylindrical phantom to fit in the bore of a QRM chest phantom (QRM GmbH, Möhrendorf, Germany). HUs were converted to infill ratios, based on the results from the calibration phantom, where the maximum HU the StoneFil filament can reach was 1000 HU. Further, the maximum infill ratio was 100% (0.5 mm line width), and the minimum was 40% (0.2 mm line width).
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10

CT Acquisition for Liver Imaging

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The CT scans of the patient cohort were acquired on Siemens Somatom Definition Flash (Siemens Healthineers, Erlangen, Germany), Siemens Somatom Definition Edge (Siemens Healthineers, Erlangen, Germany) and Philips Brilliance 64 (Philips, Best, Netherlands) scanners within 6 months of MRI, as previously published [18] (link). For CT scans, a pitch of 0.8 and a detector collimation of 0.6 were used. The acquisitions were automatically adapted based on a reference of 100 kVp and 150 mAs. Axial 1-mm slices were reconstructed with an increment of 1 mm in a liver parenchyma window, using the vendor-specific iterative reconstruction algorithm.
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