An update on carbon nanotube-enabled X-ray sources for biomedical imaging

Second generation stationary chest tomosynthesis with faster scan time and wider angular span

BACKGROUND

Digital tomosynthesis has shown potential for increasing specificity and sensitivity compared to radiography for low-dose chest imaging. Prior investigation of the s-DCT system indicated potential, but additional iteration with improved scan speed, power, and angular span was necessary for translation.

PURPOSE

The study aims to demonstrate and characterize a second-generation stationary digital chest tomosynthesis (s-DCT) scanner with increased x-ray energy, tube current, and larger angular span.

METHODS

The second-generation s-DCT system employed a meter-long linear carbon nanotube (CNT) source array integrated with a digital detector and patient imaging table. Tube output, focal spot size, modulation transfer function (MTF), artifact spread function (ASF), and imaging performance were evaluated. A lung phantom with simulated nodules was imaged for clinical task-based demonstration.

RESULTS

The scanner achieved a 6 s scan time, significantly improved from the prior generation's 16 s. The x-ray tube exhibited good current stability, with 20.4 ± 0.6 mA tube current and focal spot size aligned with specifications (IEC 0.8). The MTF confirmed enhanced spatial resolution of 2.4 lp/mm, comparable to commercial chest tomosynthesis systems. The ASF indicated improved depth resolution (5.2 mm, previously 9.5 mm). Phantom imaging showcased visualization of both high and low-attenuation lung nodules.

CONCLUSION

The second-generation s-DCT system exhibited improved performance in terms of tube power, scan time, and image quality. Enhanced in-plane and depth resolution, along with faster imaging, suggest potential clinical benefits for improved diagnoses. Further clinical validation is warranted to ascertain the system's clinical utility.

Stationary prospective cardiac gated computed tomography-dynamic study in phantoms andin vivo

Objective.This study explores the feasibility of a stationary gantry cardiac gated computed tomography (CT) with carbon nanotube (CNT) linear x-ray source arrays.Approach.We developed a stationary gantry CT system utilizing multipixel CNT x-ray sources. Given the advantages of straightforward x-ray pulse control with these sources, we investigated the potential for gated prospective imaging. We implemented prospective respiratory and cardiac gating control and evaluated the system through dynamic phantom imaging studies followed by imaging of a porcine model.Main Results.The findings revealed minimal anatomical motion artifacts in the heart and lungs, confirming successful physiologic gated acquisition in stationary gantry cardiac CT. This indicates the potential of this imaging approach for reducing artifacts and improving image quality.Significance.This study demonstrates the feasibility of prospective physiological gating with CNT x-ray sources in a stationary gantry setup for cardiac imaging. This approach could potentially alleviate the need for beta blocker administration during cardiac CT scans, thereby increasing the flexibility of the imaging system and enabling the imaging of a wider variety of patient cardiac conditions.

X-ray source arrays for volumetric imaging during radiotherapy treatment

This work presents a novel hardware configuration for radiotherapy systems to enable fast 3D X-ray imaging before and during treatment delivery. Standard external beam radiotherapy linear accelerators (linacs) have a single X-ray source and detector located at ± 90° from the treatment beam respectively. The entire system can be rotated around the patient acquiring multiple 2D X-ray images to create a 3D cone-beam Computed Tomography (CBCT) image before treatment delivery to ensure the tumour and surrounding organs align with the treatment plan. Scanning with a single source is slow relative to patient respiration or breath holds and cannot be performed during treatment delivery, limiting treatment delivery accuracy in the presence of patient motion and excluding some patients from concentrated treatment plans that would be otherwise expected to have improved outcomes. This simulation study investigated whether recent advances in carbon nanotube (CNT) field emission source arrays, high frame rate (60 Hz) flat panel detectors and compressed sensing reconstruction algorithms could circumvent imaging limitations of current linacs. We investigated a novel hardware configuration incorporating source arrays and high frame rate detectors into an otherwise standard linac. We investigated four potential pre-treatment scan protocols that could be achieved in a 17 s breath hold or 2-10 1 s breath holds. Finally, we demonstrated for the first time volumetric X-ray imaging during treatment delivery by using source arrays, high frame rate detectors and compressed sensing. Image quality was assessed quantitatively over the CBCT geometric field of view as well as across each axis through the tumour centroid. Our results demonstrate that source array imaging enables larger volumes to be imaged with acquisitions as short as 1 s albeit with reduced image quality arising from lower photon flux and shorter imaging arcs.

High-Performance Cold Cathode X-ray Tubes Using a Carbon Nanotube Field Electron Emitter

A cold cathode X-ray tube was fabricated using a carbon nanotube (CNT) field electron emitter made by a free-standing CNT film which is composed of a highly packed CNT network. A lot of CNT bundles with a sharp tip are vertically aligned at the edge of the thin CNT film with a length of 10 mm and a thickness of 7 μm. The cold cathode X-ray tube using the CNT field emitter presents an extremely high tube current density of 152 A/cm² (corresponding to tube current of 106.4 mA), the electron beam transmittance of 95.2% and a small focal spot size (FSS) of 0.5 mm. In addition, the cold cathode X-ray tube also shows stable lifetime during 100 000 shots. High emission current density of the cold cathode X-ray tube is mainly attributed to a lot of electron emission sites at an edge of the CNT film. The small FSS is caused by an ensemble of the CNT field electron emitter made by a free-standing thin CNT film and the optimized curve-shape elliptical focusing lens. Based on obtained results, the cold cathode X-ray tube can be widely used for various X-ray applications such as medical diagnosis systems and security check systems in the future.

Investigation of the Pulsing Characteristic of a Carbon Nanotube Emitter

The carbon nanotube (CNT) field emitter is suitable for the high frequency pulsing of X-ray. Pulsing reduces 49% of the dose in grid-controlled fluoroscopy and improves the image of moving objects. Various structures and manufacturing processes are being studied. However, more studies on the dynamic characteristic of a pulsing CNT and its application are needed. In this study, the combined dynamics including the field emission, MOSFET, and modified gate driver for MOSFET have been analyzed. In this configuration, between the cathode of the tube and ground, there is a MOSFET switch that turns the tube current on/off and a shunt resistor that measures the tube current. Due to the high impedance of the vacuum between the gate and cathode of the tube, about 85% of the gate voltage is still exerted between the Gate and cathode of the tube during the off-state of the MOSFET. Therefore, space charges are built during the off-state and then released at the beginning of the on-state of the MOSFET. The modified gate driver structure for MOSFET that we propose in this paper can limit the amount of current flow through the cathode. Tube current (boosted current) can be accurately controlled through a modified gate driver structure. Combining the boosted current and pulse control of MOSFET, the dynamic current performance of a CNT tube can be enhanced and the average tube current or dose can be accurately controlled. Experiments, simulation, and analysis have been conducted to study the combined dynamics and its applications.

Current Understanding of Water Properties inside Carbon Nanotubes

Confined water inside carbon nanotubes (CNTs) has attracted a lot of attention in recent years, amassing as a result a very large number of dedicated studies, both theoretical and experimental. This exceptional scientific interest can be understood in terms of the exotic properties of nanoconfined water, as well as the vast array of possible applications of CNTs in a wide range of fields stretching from geology to medicine and biology. This review presents an overreaching narrative of the properties of water in CNTs, based mostly on results from systematic nuclear magnetic resonance (NMR) and molecular dynamics (MD) studies, which together allow the untangling and explanation of many seemingly contradictory results present in the literature. Further, we identify still-debatable issues and open problems, as well as avenues for future studies, both theoretical and experimental.

Recent advances in liposome formulations for breast cancer therapeutics

Among many nanoparticle-based delivery platforms, liposomes have been particularly successful with many formulations passed into clinical applications. They are well-established and effective gene and/or drug delivery systems, widely used in cancer therapy including breast cancer. In this review we discuss liposome design with the targeting feature and triggering functions. We also summarise the recent progress (since 2014) in liposome-based therapeutics for breast cancer including chemotherapy and gene therapy. We finally identify some challenges on the liposome technology development for the future clinical translation.

Densely sampled spectral modulation for x-ray CT using a stationary modulator with flying focal spot: a conceptual and feasibility study of scatter and spectral correction

PURPOSE

Modulation of the x-ray source in computed tomography (CT) by a designated filter to achieve a desired distribution of photon flux has been greatly advanced in recent years. In this work, we present a densely sampled spectral modulation (DSSM) as a promising low-cost solution to quantitative CT imaging in the presence of scatter. By leveraging a special stationary filter (namely a spectral modulator) and a flying focal spot, DSSM features a strong correlation in the scatter distributions across focal spot positions and sees no substantial projection sparsity or misalignment in data sampling, making it possible to simultaneously correct for scatter and spectral effects in a unified framework.

METHODS

The concept of DSSM is first introduced, followed by an analysis of the design and benefits of using the stationary spectral modulator with a flying focal spot (SMFFS) that dramatically changes the data sampling and its associated data processing. With an assumption that the scatter distributions across focal spot positions have strong correlation, a scatter estimation and spectral correction algorithm from DSSM is then developed, where a dual-energy modulator along with two flying focal spot positions is of interest. Finally, a phantom study on a tabletop cone-beam CT system is conducted to understand the feasibility of DSSM by SMFFS, using a copper modulator and by moving the x-ray tube position in the X direction to mimic the flying focal spot.

RESULTS

Based on our analytical analysis of the DSSM by SMFFS, the misalignment of low- and high-energy projection rays can be reduced by a factor of more than 10 when compared with a stationary modulator only. With respect to modulator design, metal materials such as copper, molybdenum, silver, and tin could be good candidates in terms of energy separation at a given attenuation of photon flux. Physical experiments using a Catphan phantom as well as an anthropomorphic chest phantom demonstrate the effectiveness of DSSM by SMFFS with much better CT number accuracy and less image artifacts. The root mean squared error was reduced from 297.9 to 6.5 Hounsfield units (HU) for the Catphan phantom and from 409.3 to 39.2 HU for the chest phantom.

CONCLUSIONS

The concept of DSSM using a SMFFS is proposed. Phantom results on its scatter estimation and spectral correction performance validate our main ideas and key assumptions, demonstrating its potential and feasibility for quantitative CT imaging.

Physical characterization of a novel wireless DRX Plus 3543C using both a carbon nano tube (CNT) mobile x-ray system and a traditional x-ray system

This work aims to characterize the novel DRX Plus 3543C detector in terms of detective quantum efficiency (DQE) using both a mobile x-ray system called Carestream DRX Revolution Nano and a traditional x-ray system (Carestream DRX Evolution). We used the commercial system DRX Revolution Nano, equipped with a new x-ray source based on CNT technology and field emission (FE) as the electron emitter (cathode). An innovative aspect of this device is its intrinsic selection of the focal spot size. We tested the system using three IEC-specified beam qualities (RQA3, 5 and 7) in terms of modulation transfer function (MTF), normalized noise power spectra (NNPS) and DQE as defined in the IEC 62220-1-1:2015. We compared the results obtained using DRX Revolution Nano and DRX Evolution with correlation and with Bland-Altman plots to study their agreement. RQA3 MTF is slightly lower than the RQA5 and 7 curves between 0.5 and 2.5 cycles mm^-1. We measured MTF values of about 0.6 at 1 lp mm^-1 and about 0.28 lp mm^-1 at 2 lp mm^-1. The NNPS curves show a decreasing trend with the energy regarding the DRX Revolution Nano. On the other hand, the DRX Evolution NNPS curve at RQA3 is greater than the one at RQA5, but the one at RQA5 is less than the one at RQA7. The DQE(0) ranged between about 0.82 (DRX Evolution at RQA3) and 0.54 (DRX Evolution at RQA7). As expected, the squared Pearson's correlation coefficients between the two x-ray tubes were always in an optimal agreement, and Bland-Altman plots confirmed a substantial equivalence between the two physical characterizations of the wireless detector. In conclusion, we can show that the dynamic focal selection of the system equipped with CNT does not play a substantial role in image quality compared to a traditional system in terms of physical characterisation of the detector in our measurement conditions.

The effects of functionalization of carbon nanotubes on toxicological parameters in mice

Carbon nanotubes (CNTs) have emerged as a new class of multifunctional nanoparticles in biomedicine, but their multiple in vivo effects remain unclear. Also, the impact of various functionalization types and duration of exposures are still unidentified. Herein, we report a complete toxicological study to evaluate the effects of single- and multiwalled carbon nanotubes (SWCNTs and MWCNTs) with either amine or carboxylic acid (COOH) surface functional groups. The results showed that significant oxidative stress and the subsequent cell apoptosis could be resulted in both acute and, mainly, in chronic intravenous administrations. Also, male reproductive parameters were altered during these exposures. The amino-functionalized CNTs had more toxic properties compared with the COOH functionalized group, and also, in some groups, the multiwalled nanotubes were more active in eliciting cytotoxicity than the single-walled nanotubes. Interestingly, the SWCNTs-COOH had the least alterations in most of the parameters. Evidently, it is concluded that the toxicity of CNTs in specific organs can be minimized through particular surface functionalizations.

Carbon nanotubes: An effective platform for biomedical electronics

Cylindrical fullerenes (or carbon nanotubes (CNTs)) have been extensively investigated as potential sensor platforms due to effective and practical manipulation of their physical and chemical properties by functionalization/doping with chemical groups suitable for novel nanocarrier systems. CNTs play a significant role in biomedical applications due to rapid development of synthetic methods, structural integration, surface area-controlled heteroatom doping, and electrical conductivity. This review article comprehensively summarized recent trends in biomedical science and technologies utilizing a promising nanomaterial of CNTs in disease diagnosis and therapeutics, based on their biocompatibility and significance in drug delivery, implants, and bio imaging. Biocompatibility of CNTs is essential for designing effective and practical electronic applications in the biomedical field particularly due to their growing potential in the delivery of anticancer agents. Furthermore, functionalized CNTs have been shown to exhibit advanced electrochemical properties, responsible for functioning of numerous oxidase and dehydrogenase based amperometric biosensors. Finally, faster signal transduction by CNTs allows charge transfer between underlying electrode and redox centres of biomolecules (enzymes).

Initial Clinical Experience with Stationary Digital Breast Tomosynthesis

RATIONALE AND OBJECTIVES

A linear array of carbon nanotube-enabled x-ray sources allows for stationary digital breast tomosynthesis (sDBT), during which projection views are collected without the need to move the x-ray tube. This work presents our initial clinical experience with a first-generation sDBT device.

MATERIALS AND METHODS

Following informed consent, women with a "suspicious abnormality" (Breast Imaging Reporting and Data System 4), discovered by digital mammography and awaiting biopsy, were also imaged by the first generation sDBT. Four radiologists participated in this paired-image study, completing questionnaires while interpreting the mammograms and sDBT image stacks. Areas under the receiver operating characteristic curve were used to measure reader performance (likelihood of correctly identifying malignancy based on pathology as ground truth), while a multivariate analysis assessed preference, as readers compared one modality to the next when interpreting diagnostically important image features.

RESULTS

Findings from 43 women were available for analysis, in whom 12 cases of malignancy were identified by pathology. The mean areas under the receiver operating characteristic curve was significantly higher (p < 0.05) for sDBT than mammography for all breast density categories and breast thicknesses. Additionally, readers preferred sDBT over mammography when evaluating mass margins and shape, architectural distortion, and asymmetry, but preferred mammography when characterizing microcalcifications.

CONCLUSION

Readers preferred sDBT over mammography when interpreting soft-tissue breast features and were diagnostically more accurate using images generated by sDBT in a Breast Imaging Reporting and Data System 4 population. However, the findings also demonstrated the need to improve microcalcification conspicuity, which is guiding both technological and image-processing design changes in future sDBT devices.

An Overview of the Recent Progress in the Synthesis and Applications of Carbon Nanotubes

Carbon nanotubes (CNTs) are known as nano-architectured allotropes of carbon, having graphene sheets that are wrapped forming a cylindrical shape. Rolling of graphene sheets in different ways makes CNTs either metals or narrow-band semiconductors. Over the years, researchers have devoted much attention to understanding the intriguing properties CNTs. They exhibit some unusual properties like a high degree of stiffness, a large length-to-diameter ratio, and exceptional resilience, and for this reason, they are used in a variety of applications. These properties can be manipulated by controlling the diameter, chirality, wall nature, and length of CNTs which are in turn, synthesis procedure-dependent. In this review article, various synthesis methods for the production of CNTs are thoroughly elaborated. Several characterization methods are also described in the paper. The applications of CNTs in various technologically important fields are discussed in detail. Finally, future prospects of CNTs are outlined in view of their commercial applications.

Design and Simulation Study of a CNT-Based Multisource Cubical CT System for Dynamic Objects

The purpose of this paper is to design and simulate a new computed tomography (CT) system with a high temporal resolution for dynamic objects. We propose a multisource cubical CT (MCCT) system with X-ray tubes and detectors installed on a cube. Carbon nanotube- (CNT-) based X-ray focal spots are distributed on the twelve edges of the cube. The distribution of X-ray focal spots and detectors completely avoids mechanical movements to scan an object under inspection. CNTs are excellent electron field emitters because the use of a "cold" cathode makes it possible to fabricate a cathode with multiple electron emission points, and the CNT-based X-ray focal spots possess little response time and programmable emission. The proposed rotation-free MCCT system can acquire a high scanning speed when using a high frame rate detector. A three-dimensional (3D) reconstruction algorithm with tensor framelet-based L0-norm (TF-L0) minimization is developed for the simulation study of the MCCT. Simulation experiment results demonstrate the feasibility of the MCCT system.

Carbon Nanotube Field Emitters Synthesized on Metal Alloy Substrate by PECVD for Customized Compact Field Emission Devices to Be Used in X-Ray Source Applications

In this study, a simple, efficient, and economical process is reported for the direct synthesis of carbon nanotube (CNT) field emitters on metal alloy. Given that CNT field emitters can be customized with ease for compact and cold field emission devices, they are promising replacements for thermionic emitters in widely accessible X-ray source electron guns. High performance CNT emitter samples were prepared in optimized plasma conditions through the plasma-enhanced chemical vapor deposition (PECVD) process and subsequently characterized by using a scanning electron microscope, tunneling electron microscope, and Raman spectroscopy. For the cathode current, field emission (FE) characteristics with respective turn on (1 μA/cm²) and threshold (1 mA/cm²) field of 2.84 and 4.05 V/μm were obtained. For a field of 5.24 V/μm, maximum current density of 7 mA/cm² was achieved and a field enhancement factor β of 2838 was calculated. In addition, the CNT emitters sustained a current density of 6.7 mA/cm² for 420 min under a field of 5.2 V/μm, confirming good operational stability. Finally, an X-ray generated image of an integrated circuit was taken using the compact field emission device developed herein.

Phantom-based study exploring the effects of different scatter correction approaches on the reconstructed images generated by contrast-enhanced stationary digital breast tomosynthesis

Stationary digital breast tomosynthesis (sDBT) is an emerging technology in which the single rotating x-ray tube is replaced by a fixed array of multiple carbon nanotube-enabled sources, providing a higher spatial and temporal resolution. As such, sDBT offers a promising platform for contrast-enhanced (CE) imaging. However, given the minimal enhancement above background with standard operational tube settings and iodine dosing, CE breast imaging requires additional acquisition steps to isolate the iodine signal, using either temporal or dual energy subtraction (TS or DES) protocols. Also, correcting for factors that limit contrast is critical, and scatter and noise pose unique challenges during tomosynthesis. This phantom-based study of CE sDBT compared different postacquisition scatter correction approaches on the quality of the reconstructed image slices. Beam-pass collimation was used to sample scatter indirectly, from which an interpolated scatter map was obtained for each projection image. Scatter-corrected projections provided the information for reconstruction. Comparison between the application of different scatter maps demonstrated the significant effect that processing has on the contrast-to-noise ratio and feature detectability ([Formula: see text]) in the final displayed images and emphasized the critical importance of scatter correction during DES.

Direct Synthesis of Carbon Nanotube Field Emitters on Metal Substrate for Open-Type X-ray Source in Medical Imaging

We report the design, fabrication and characterization of a carbon nanotube enabled open-type X-ray system for medical imaging. We directly grew the carbon nanotubes used as electron emitter for electron gun on a non-polished raw metallic rectangular-rounded substrate with an area of 0.1377 cm² through a plasma enhanced chemical vapor deposition system. The stable field emission properties with triode electrodes after electrical aging treatment showed an anode emission current of 0.63 mA at a gate field of 7.51 V/μm. The 4.5-inch cubic shape open type X-ray system was developed consisting of an X-ray aperture, a vacuum part, an anode high voltage part, and a field emission electron gun including three electrodes with focusing, gate and cathode electrodes. Using this system, we obtained high-resolution X-ray images accelerated at 42–70 kV voltage by digital switching control between emitter and ground electrode.