Graduation Year


Document Type




Degree Name

Doctor of Philosophy (Ph.D.)

Degree Granting Department


Major Professor

Eduardo G. Moros, Ph.D.

Co-Major Professor

Ghanim Ullah, Ph.D.

Committee Member

Robert Gillies, Ph.D.

Committee Member

Geoffrey Zhang, Ph.D.


image analysis, CT image acquisition, CT image reconstruction, texture features


Radiomics treats images as quantitative data and promises to improve cancer prediction in radiology and therapy response assessment in radiation oncology. However, there are a number of fundamental problems that need to be solved in order to potentially apply radiomic features in clinic. The first basic step in computed tomography (CT) radiomic analysis is the acquisition of images using selectable image acquisition and reconstruction parameters. Radiomic features have shown large variability due to variation of these parameters. Therefore, it is important to develop methods to address these variability issues in radiomic features due to each CT parameter. To this end, texture phantoms provide a stable geometry and Hounsfield Units (HU) to characterize the radiomic features with respect to image acquisition and reconstruction parameters. In this project, normalization methods were developed to address the variability issues in CT Radiomics using texture phantoms.

In the first part of this project, variability in radiomic features due to voxel size variation was addressed. A voxel size resampling method is presented as a preprocessing step for imaging data acquired with variable voxel sizes. After resampling, variability due to variable voxel size in 42 radiomic features was reduced significantly. Voxel size normalization is presented to address the intrinsic dependence of some key radiomic features. After normalization, 10 features became robust as a function of voxel size. Some of these features were identified as predictive biomarkers in diagnostic imaging or useful in response assessment in radiation therapy. However, these key features were found to be intrinsically dependent on voxel size (which also implies dependence on lesion volume). The normalization factors are also developed to address the intrinsic dependence of texture features on the number of gray levels. After normalization, the variability due to gray levels in 17 texture features was reduced significantly.

In the second part of the project, voxel size and gray level (GL) normalizations developed based on phantom studies, were tested on the actual lung cancer tumors. Eighteen patients with non-small cell lung cancer of varying tumor volumes were studied and compared with phantom scans acquired on 8 different CT scanners. Eight out of 10 features showed high (Rs > 0.9) and low (Rs < 0.5) Spearman rank correlations with voxel size before and after normalizations, respectively. Likewise, texture features were unstable (ICC < 0.6) and highly stable (ICC > 0.9) before and after gray level normalizations, respectively. This work showed that voxel size and GL normalizations derived from texture phantom also apply to lung cancer tumors. This work highlights the importance and utility of investigating the robustness of CT radiomic features using CT texture phantoms.

Another contribution of this work is to develop correction factors to address the variability issues in radiomic features due to reconstruction kernels. Reconstruction kernels and tube current contribute to noise texture in CT. Most of texture features were sensitive to correlated noise texture due to reconstruction kernels. In this work, noise power spectra (NPS) was measured on 5 CT scanners using standard ACR phantom to quantify the correlated noise texture. The variability in texture features due to different kernels was reduced by applying the NPS peak frequency and the region of interest (ROI) maximum intensity as correction factors. Most texture features were radiation dose independent but were strongly kernel dependent, which is demonstrated by a significant shift in NPS peak frequency among kernels. Percent improvements in robustness of 19 features were in the range of 30% to 78% after corrections.

In conclusion, most texture features are sensitive to imaging parameters such as reconstruction kernels, reconstruction Field of View (FOV), and slice thickness. All reconstruction parameters contribute to inherent noise in CT images. The problem can be partly solved by quantifying noise texture in CT radiomics using a texture phantom and an ACR phantom. Texture phantoms should be a pre-requisite to patient studies as they provide stable geometry and HU distribution to characterize the radiomic features and provide ground truths for multi-institutional validation studies.