Author ORCID Identifier

https://orcid.org/0009-0007-5376-9496

Defense Date

2026

Document Type

Dissertation

Degree Name

Doctor of Philosophy

Department

Medical Physics

First Advisor

Siyong Kim, PhD

Second Advisor

Ford Sleeman IV, PhD

Third Advisor

Lulin Yuan, PhD

Fourth Advisor

Yuichi Motai, PhD

Fifth Advisor

Pei-Jan Paul Lin, PhD

Abstract

In projectional X-ray imaging, acquisition energy fundamentally influences subject contrast, image noise, and radiation dose. While dual-energy techniques exploit spectral differences to optimize contrast and enable material separation, acquiring multiple images of the same anatomy often requires additional exposures and increased system complexity.

This dissertation presents a framework for digital energy modulation (DEM), in which computational models are trained to translate projection images between energy domains without requiring additional X-ray acquisitions. DEM is conceived as a generalizable strategy for controlled contrast modulation in projection imaging, with potential applications in image optimization, radiation therapy alignment, and dual-energy applications.

The framework was first evaluated using digitally reconstructed radiographs (DRRs) generated from dual-energy CT datasets. Supervised generative models demonstrated high structural similarity (SSIM ~0.90–0.95) across energy translation tasks, establishing proof-of-concept feasibility under controlled pairing conditions, though resolution and bit-depth constraints limited fidelity. To enable higher-fidelity evaluation, the framework was extended using simulated mammography projections generated with the VICTRE pipeline and full 16-bit attenuation-based (μx) representations. Structural similarity remained high (SSIM ~0.94 unmasked; ~0.90 breast-masked), and task-based analysis demonstrated that translation performance was lesion-dependent. Mass lesion contrast-to-noise ratio (CNR) remained comparable to ground truth under many conditions, whereas calcification CNR metrics exhibited greater variability.

These findings demonstrate that energy-domain translation can approximate energy-dependent contrast transformations under controlled conditions while emphasizing the importance of task-based evaluation and contrast–dose tradeoffs. This work establishes digital energy modulation as a structured computational framework for investigating contrast manipulation in projectional X-ray imaging.

Rights

© Richard Ryan Wargo

Is Part Of

VCU University Archives

Is Part Of

VCU Theses and Dissertations

Date of Submission

4-16-2026

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