The effects of the skull on CT imaging of the brain: a skull and brain phantom study

Abstract

Objective: To investigate the effects of beam hardening by the skull on the measured radiodensity of the brain. To test a hypothesis that these effects of beam hardening are decreased using a monochromatic energy source. Methods: Selected clinical cases were reviewed in illustration. An anthropomorphic skull and brain phantom was created and scanned in a clinical CT scanner with skull, without skull, and with hemicraniectomy. The effects of beam hardening were illustrated by scanning the phantom with mono- and poly-chromatic X-ray sources. Results: In clinical cases, the HU values of the brain were consistently lower when the X-ray beam traversed the skull than when it did not. An anthropomorphic skull-and-brain phantom further demonstrated these effects, which were evident with a polychromatic energy source and absent with a virtual monochromatic energy source. Conclusions: Beam hardening by the skull lowers the measured HU values of the brain. The effects, which can impact quantitative imaging, may be mitigated by a virtual monochromatic energy source. Advances in knowledge: Beam hardening by the skull lowers the measured radiodensity of the brain. The effects may be mitigated by a virtual monochromatic energy source.