Purpose: Although the mortality rate of breast cancer was reduced with the introduction of screening mammography, many women undergo unnecessary subsequent examinations due to inconclusive diagnoses. Superposition of anatomical structures especially within dense breasts in conjunction with the inherently low soft tissue contrast of absorption images compromises image quality. This can be overcome by phase-contrast imaging.
Approach: We analyze the spatial resolution of grating-based multimodal mammography using a mammographic phantom and one freshly dissected mastectomy specimen at an inverse Compton x-ray source. Here, the focus was on estimating the spatial resolution with the sample in the beam path and discussing benefits and drawbacks of the method used and the estimation of the mean glandular dose. Finally, the possibility of improving the spatial resolution is investigated by comparing monochromatic grating-based mammography with the standard one.
Results: The spatial resolution is constant or also higher for the image acquired with monochromatic radiation and the contrast-to-noise ratio (CNR) is higher in our approach while the dose can be reduced by up to 20%.
Conclusions: In summary, phase-contrast imaging helps to improve tumor detection by advanced diagnostic image quality. We demonstrate a higher spatial resolution for one mastectomy specimen and increased CNR at an equal or lower dose for the monochromatic measurements.
Purpose: About one third of all deaths worldwide can be traced to some form of cardiovascular disease. The gold standard for the diagnosis and interventional treatment of blood vessels is digital subtraction angiography (DSA). An alternative to DSA is K-edge subtraction (KES) imaging, which has been shown to be advantageous for moving organs and for eliminating image artifacts caused by patient movement. As highly brilliant, monochromatic x-rays are required for this method, it has been limited to synchrotron facilities so far, restraining the applicability in the clinical routine. Over the past decades, compact synchrotron x-ray sources based on inverse Compton scattering have been evolving; these provide x-rays with sufficient brilliance and meet spatial and financial requirements for laboratory settings or university hospitals.
Approach: We demonstrate a proof-of-principle KES imaging experiment using the Munich Compact Light Source (MuCLS), the first user-dedicated installation of a compact synchrotron x-ray source worldwide. A series of experiments were performed both on a phantom and an excised human carotid to demonstrate the ability of the proposed KES technique to separate the iodine contrast agent and calcifications.
Results: It is shown that the proposed filter-based KES method allows for the iodine-contrast agent and calcium to be clearly separated, thereby providing x-ray images only showing one of the two materials.
Conclusions: The results show that the quasimonochromatic spectrum of the MuCLS enables filter-based KES imaging and can become an important tool in preclinical research and possible future clinical diagnostics.
In clinical X-ray imaging, the quantitative information in a CT scan has recently been extended by the possibility of using dual-energy information. Dual-energy CT has found its way into clinical imaging during the last few years and has been proven to add additional diagnostic information in different pathologies. It is based on a dual measurement at different photon energies, such that the energy dependence of the linear attenuation coefficient can be used for improved material discrimination. Here, we demonstrate how the dual information accessed with grating-based phase-contrast CT can be used to provide the same quantitative information. Different from dual energy, the phase-contrast measurement directly yields the electron-density and the total attenuation coefficient in a single measurement. With algebraic basis transformation this can be used for quantitative material decomposition, allowing the visualization of quantitative material maps. Further, a simple interaction parametrization has been used for the generation of effective atomic number maps and virtual monochromatic images. The approach has been demonstrated with an experimental angiography simulation with a chicken heart. The results have been compared with iodine staining, which is a current approach for ex-vivo soft-tissue contrast enhancement. The measurements have been performed at a compact laser-undulator synchrotron X-ray source with a tunable quasi-monochromatic X-ray energy. The simultaneous image acquisition guarantees an inherent registration of the two original data-sets. In total, the method provides a range of novel quantitative image representations which can be helpful for specific material discrimination tasks in medical imaging in the future.
Although the mortality rate of breast cancer has been reduced with the introduction of screening mammography, many women undergo unnecessary subsequent examinations due to inconclusive diagnoses. Therefore, spatial resolution and soft tissue contrast must meet very high standards. The former is necessary in order to be able to detect and distinguish closely spaced microcalcifications from each other. Thus, a high spatial resolution is demanded. Superposition of anatomical structures especially within dense breasts in conjunction with the inherently low soft tissue contrast of absorption images compromises image quality. This can be overcome by phase-contrast imaging. In this study, we analyze the spatial resolution of grating-based multimodal mammography dose-dependently using a mammographic phantom and one freshly dissected mastectomy specimen at an inverse Compton X-ray source. Here, the main focus was on estimating the spatial resolution with the sample in the beam path and discussing benefits and drawbacks of the method used as well as the estimation of the mean glandular dose. Finally, the possibility of improving the spatial resolution is investigated by comparison of the monochromatic grating-based mammography with the standard one. In almost all cases, the spatial resolution is higher in our proposed approach while the dose can be significantly reduced. Additionally, phase-contrast imaging helps to improve the detection of tumor lesions
Inverse Compton scattering of infrared photons from relativistic electrons generates brilliant quasi-monochromatic X-rays with an electron accelerator with dimensions of only a few meters, e.g. at the storage ring based inverse Compton scattering X-ray source employed at the Munich Compact Light Source. Availability of synchrotron light in a laboratory comes along with broader access to synchrotron techniques, especially in - but not limited to - clinical imaging and pre-clinical biomedical applications. We have been exploring the latter in daily user operation since commissioning of the MuCLS. So far, the focus has been on dynamic in vivo small-animal respiratory imaging, grating-based phase-contrast imaging, e.g. for quantitative material decomposition, and spectroscopic imaging, e.g. for angiography.
About one third of all deaths worldwide can be traced back to some form of cardiovascular disease. The gold standard for the diagnosis and interventional treatment of blood vessels is digital subtraction angiography (DSA). An alternative to DSA is K-edge subtraction (KES) imaging, which has been shown to be advantageous for moving organs and to eliminate image artifacts caused by patient movement. As highly brilliant, monochromatic X-rays are required for this method, it has been limited to synchrotron facilities so far, restraining the applicability in clinical routine. Over the past decades, compact synchrotron X-ray sources based on inverse Compton scattering have been evolving, which provide X-rays with sufficient brilliance and that meet spatial and financial requirements affordable in laboratory settings or for university hospitals. In this study, we demonstrate a proofof-principle KES imaging experiment using the Munich Compact Light Source (MuCLS), the first user-dedicated installation of a compact synchrotron X-ray source worldwide. It is shown that the proposed filter-based KES method allows for iodine-contrast agent and calcium to be clearly separated, thereby providing X-ray images only showing one of the two materials. The results show that the quasi-monochromatic spectrum of the MuCLS enables filter-based K-edge subtraction imaging and can become an important tool in pre-clinical research and possible future clinical diagnostics.
Purpose: To evaluate the performance of an experimental X-ray dark-field radiography system for chest imaging in humans and to compare with conventional diagnostic imaging. Materials and Methods: The study was institutional review board (IRB) approved. A single human cadaver (52 years, female, height: 173 cm, weight: 84 kg, chest circumference: 97 cm) was imaged within 24 hours post mortem on the experimental x-ray dark-field system. In addition, the cadaver was imaged on a clinical CT system to obtain a reference scan. The grating-based dark-field radiography setup was equipped with a set of three gratings to enable grating-based dark-field contrast x-ray imaging. The prototype operates at an acceleration voltage of up to 70 kVp and with a field-of-view large enough for clinical chest x-ray (>35 x 35 cm2). Results: It was feasible to extract x-ray dark-field signal of the whole human thorax, clearly demonstrating that human x-ray dark-field chest radiography is feasible. Lung tissue produced strong scattering, reflected in a pronounced x-ray dark-field signal. The ribcage and the backbone are less prominent than the lung but are also distinguishable. Finally, the soft tissue is not present in the dark-field radiography. The regions of the lungs affected by edema, as verified by CT, showed less dark-field signal compared to healthy lung tissue. Conclusion: Our results reveal the current status of translating dark-field imaging from a micro (small animal) scale to a macro (patient) scale. The performance of the experimental x-ray dark-field radiography setup offers, for the first time, obtaining multi-contrast chest x-ray images (attenuation and dark-field signal) from a human cadaver.
Grating based x-ray phase-contrast reveals differential phase-contrast (DPC) and dark-field contrast (DFC) on top of the conventional absorption image. X-ray vector radiography (XVR) exploits the directional dependence of the DFC and yields the mean scattering strength, the degree of anisotropy and the orientation of scattering structures by combining several DFC-projections. Here, we perform an XVR of an ex vivo human hand specimen. Conventional attenuation images have a good contrast between the bones and the surrounding soft tissue. Within the bones, trabecular structures are visible. However, XVR detects subtler differences within the trabecular structure: there is isotropic scattering in the extremities of the phalanx in contrast to anisotropic scattering in its body. The orientation changes as well from relatively random in the extremities to an alignment along the longitudinal trabecular orientation in the body. In the other bones measured, a similar behavior was found. These findings indicate a deeper insight into the anatomical configuration using XVR compared to conventional radiography. Since microfractures cause a discontinuous trabecular structure, XVR could help to detect so-called radiographically occult fractures of the trabecular bones.
While conventional x-ray tube sources reliably provide high-power x-ray beams for everyday clinical practice, the broad spectra that are inherent to these sources compromise the diagnostic image quality. For a monochromatic x-ray source on the other hand, the x-ray energy can be adjusted to optimal conditions with respect to contrast and dose. However, large-scale synchrotron sources impose high spatial and financial demands, making them unsuitable for clinical practice. During the last decades, research has brought up compact synchrotron sources based on inverse Compton scattering, which deliver a highly brilliant, quasi-monochromatic, tunable x-ray beam, yet fitting into a standard laboratory. One application that could benefit from the invention of these sources in clinical practice is coronary angiography. Being an important and frequently applied diagnostic tool, a high number of complications in angiography, such as renal failure, allergic reaction, or hyperthyroidism, are caused by the large amount of iodine-based contrast agent that is required for achieving sufficient image contrast. Here we demonstrate monochromatic angiography of a porcine heart acquired at the MuCLS, the first compact synchrotron source. By means of a simulation, the CNR in a coronary angiography image achieved with the quasi-mono-energetic MuCLS spectrum is analyzed and compared to a conventional x-ray-tube spectrum. The results imply that the improved CNR achieved with a quasi-monochromatic spectrum can allow for a significant reduction of iodine contrast material.
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