Quantifying the importance of the statistical assumption in statistical X-ray CT image reconstruction

Statistical image reconstruction (SIR) is a promising approach to reducing radiation dose in clinical computerized tomography (CT) scans. Clinical CT scanners use energy-integrating detectors. The CT signal follows a compound Poisson distribution, its probability density function (PDF) does not have an analytical form hence cannot be used in an SIR method. The goal of this work is to quantify the effects of using an approximate statistical assumption in SIR methods for clinical CT applications. We apply a pseudo-Ideal Observer (pIO) to simulated CT projection data of the fanbeam geometry at different dose levels. The simulation models the polychromatic X-ray tube spectrum, the effects of the bowtie filter, and the energy-integrating detectors. The pIO uses a pseudo likelihood function (pLF) to calculate the pseudo likelihood ratio, which is the decision variable used by the pIO in a binary detection task. The pLF is an approximation to the true LF of the underlying data. The pIO has inferior performance than the IO unless the pLF coincides with the LF; this performance difference quantifies the closeness between the pseudo likelihood and the exact one. Using lesion detectability in a signal known exactly, background known exactly binary detection task as a figure-of-merit, our results show that at down to 0.1% of a reference tube current level I₀ , the pIO that uses a Poisson approximation, or a matched variance Gaussian approximation in either the transmission or the line integral domain, achieves 99% the performance of the IO. The constant variance Gaussian approximation has only 70%-80% of the IO performance. At tube currents lower than 0.1% I₀, the performance difference is more substantial. We conclude that at current clinical dose levels, it is important to account for the mean-dependent variance in CT projection data in SIR problem formulation, the exact PDF of the CT signal is not as important.