A software platform for phase contrast x-ray breast imaging research

Virtual dosimetry study with three cone-beam breast computed tomography scanners using a fast GPU-based Monte Carlo code

Objective. To compare the dosimetric performance of three cone-beam breast computed tomography (BCT) scanners, using real-time Monte Carlo-based dose estimates obtained with the virtual clinical trials (VCT)-BREAST graphical processing unit (GPU)-accelerated platform dedicated to VCT in breast imaging. Approach. A GPU-based Monte Carlo (MC) code was developed for replicatingin silicothe geometric, x-ray spectra and detector setups adopted, respectively, in two research scanners and one commercial BCT scanner, adopting 80 kV, 60 kV and 49 kV tube voltage, respectively. Our cohort of virtual breasts included 16 anthropomorphic voxelized breast phantoms from a publicly available dataset. For each virtual patient, we simulated exams on the three scanners, up to a nominal simulated mean glandular dose of 5 mGy (primary photons launched, in the order of 1011-1012per scan). Simulated 3D dose maps (recorded for skin, adipose and glandular tissues) were compared for the same phantom, on the three scanners. MC simulations were implemented on a single NVIDIA GeForce RTX 3090 graphics card.Main results.Using the spread of the dose distribution as a figure of merit, we showed that, in the investigated phantoms, the glandular dose is more uniform within less dense breasts, and it is more uniformly distributed for scans at 80 kV and 60 kV, than at 49 kV. A realistic virtual study of each breast phantom was completed in about 3.0 h with less than 1% statistical uncertainty, with 109primary photons processed in 3.6 s computing time.Significance. We reported the first dosimetric study of the VCT-BREAST platform, a fast MC simulation tool for real-time virtual dosimetry and imaging trials in BCT, investigating the dose delivery performance of three clinical BCT scanners. This tool can be adopted to investigate also the effects on the 3D dose distribution produced by changes in the geometrical and spectrum characteristics of a cone-beam BCT scanner.

Virtual grating approach for Monte Carlo simulations of edge illumination-based x-ray phase contrast imaging

The design of new x-ray phase contrast imaging setups often relies on Monte Carlo simulations for prospective parameter studies. Monte Carlo simulations are known to be accurate but time consuming, leading to long simulation times, especially when many parameter variations are required. This is certainly the case for imaging methods relying on absorbing masks or gratings, with various tunable properties, such as pitch, aperture size, and thickness. In this work, we present the virtual grating approach to overcome this limitation. By replacing the gratings in the simulation with virtual gratings, the parameters of the gratings can be changed after the simulation, thereby significantly reducing the overall simulation time. The method is validated by comparison to explicit grating simulations, followed by representative demonstration cases.

Radiomics software for breast imaging optimization and simulation studies

BACKGROUND AND OBJECTIVE

The development, control and optimisation of new x-ray breast imaging modalities could benefit from a quantitative assessment of the resulting image textures. The aim of this work was to develop a software tool for routine radiomics applications in breast imaging, which will also be available upon request.

METHODS

The tool (developed in MATLAB) allows image reading, selection of Regions of Interest (ROI), analysis and comparison. Requirements towards the tool also included convenient handling of common medical and simulated images, building and providing a library of commonly applied algorithms and a friendly graphical user interface. Initial set of features and analyses have been selected after a literature search. Being open, the tool can be extended, if necessary.

RESULTS

The tool allows semi-automatic extracting of ROIs, calculating and processing a total of 23 different metrics or features in 2D images and/or in 3D image volumes. Computations of the features were verified against computations with other software packages performed with test images. Two case studies illustrate the applicability of the tool - (i) features on a series of 2D 'left' and 'right' CC mammograms acquired on a Siemens Inspiration system were computed and compared, and (ii) evaluation of the suitability of newly proposed and developed breast phantoms for x-ray-based imaging based on reference values from clinical mammography images. Obtained results could steer the further development of the physical breast phantoms.

CONCLUSIONS

A new image analysis toolbox was realized and can now be used in a multitude of radiomics applications, on both clinical and test images.

In Silico Phase-Contrast X-Ray Imaging of Anthropomorphic Voxel-Based Phantoms

Propagation-based phase-contrast X-ray imaging is an emerging technique that can improve dose efficiency in clinical imaging. In silico tools are key to understanding the fundamental imaging mechanisms and develop new applications. Here, due to the coherent nature of the phase-contrast effects, tools based on wave propagation (WP) are preferred over Monte Carlo (MC) based methods. WP simulations require very high wave-front sampling which typically limits simulations to small idealized objects. Virtual anthropomorphic voxel-based phantoms are typically provided with a resolution lower than imposed sampling requirements and, thus, cannot be directly translated for use in WP simulations. In the present paper we propose a general strategy to enable the use of these phantoms for WP simulations. The strategy is based on upsampling in the 3D domain followed by projection resulting in high-resolution maps of the projected thickness for each phantom material. These maps can then be efficiently used for simulations of Fresnel diffraction to generate in silico phase-contrast X-ray images. We demonstrate the strategy on an anthropomorphic breast phantom to simulate propagation-based phase-contrast mammography using a laboratory micro-focus X-ray source.

A Brief Review on Breast Carcinoma and Deliberation on Current Non Invasive Imaging Techniques for Detection

BACKGROUND

Breast carcinoma is a life threatening disease that accounts for 25.1% of all carcinoma among women worldwide. Early detection of the disease enhances the chance for survival.

DISCUSSION

This paper presents comprehensive report on breast carcinoma disease and its modalities available for detection and diagnosis, as it delves into the screening and detection modalities with special focus placed on the non-invasive techniques and its recent advancement work done, as well as a proposal on a novel method for the application of early breast carcinoma detection.

CONCLUSION

This paper aims to serve as a foundation guidance for the reader to attain bird's eye understanding on breast carcinoma disease and its current non-invasive modalities.

Towards Monte Carlo simulation of X-ray phase contrast using GATE

We describe the first developments towards a Monte Carlo X-ray phase contrast imaging simulator for the medical imaging and radiotherapy simulation software GATE. Phase contrast imaging is an imaging modality taking advantage of the phase shift of X-rays. This modality produces images with a higher sensitivity than conventional, attenuation based imaging. As the first developments towards Monte Carlo phase contrast simulation, we implemented a Monte Carlo process for the refraction and total reflection of X-rays, as well as an analytical wave optics approach for generating Fresnel diffraction patterns. The implementation is validated against data acquired using a laboratory X-ray tomography system. The overall agreement between the simulations and the data is encouraging, which motivates further development of Monte Carlo based simulation of X-ray phase contrast imaging. These developments have been released in GATE version 8.2.

Evaluation of texture features at staging liver fibrosis based on phase contrast X-ray imaging

BACKGROUND

The purpose of this study is to explore the potential of phase contrast imaging to detect fibrotic progress in its early stage; to investigate the feasibility of texture features for quantified diagnosis of liver fibrosis; and to evaluate the performance of back propagation (BP) neural net classifier for characterization and classification of liver fibrosis.

METHODS

Fibrous mouse liver samples were imaged by X-ray phase contrast imaging, nine texture measures based on gray-level co-occurrence matrix were calculated and the feasibility of texture features in the characterization and discrimination of liver fibrosis at early stages was investigated. Furthermore, 36 or 18 features were applied to the input of BP classifier; the classification performance was evaluated using receiver operating characteristic curve.

RESULTS

The phase contrast images displayed a vary degree of texture pattern from normal to severe fibrosis stages. The BP classifier could distinguish liver fibrosis among normal, mild, moderate and severe stages; the average accuracy was 95.1% for 36 features, and 91.1% for 18 features.

CONCLUSION

The study shows that early stages of liver fibrosis can be discriminated by the morphological features on the phase contrast images. BP network model based on combination of texture features is demonstrated effective for staging liver fibrosis.

Phase-contrast imaging with a compact x-ray light source: system design

X-ray phase-contrast imaging (XPCI) overcomes the problem of low contrast between different soft tissues achieved in conventional x-ray imaging by introducing x-ray phase as an additional contrast mechanism. This work describes a compact x-ray light source (CXLS) and compares, via simulations, the high quality XPCI results that can be produced from this source to those produced using a microfocus x-ray source. The simulation framework is first validated using an image acquired with a microfocus-source, propagation-based XPCI (PB-XPCI) system. The phase contrast for a water sphere simulating a simple cyst submersed in muscle is evaluated and the evolution of PB-XPCI signal as the object to detector distance is increased is demonstrated. The proposed design of a PB-XPCI system using the CXLS is described and simulated images of a coronary artery compared between CXLS and microfocus source PB-XPCI systems. To generate images with similar noise levels, a microfocus source would require a 3000 times longer exposure than would the CXLS. We conclude that CXLS technology has the potential to provide high-quality XPCI in a medical environment using extremely short exposure times relative to microfocus source approaches.

Evaluation of the BreastSimulator software platform for breast tomography

The aim of this work was the evaluation of the software BreastSimulator, a breast x-ray imaging simulation software, as a tool for the creation of 3D uncompressed breast digital models and for the simulation and the optimization of computed tomography (CT) scanners dedicated to the breast. Eight 3D digital breast phantoms were created with glandular fractions in the range 10%-35%. The models are characterised by different sizes and modelled realistic anatomical features. X-ray CT projections were simulated for a dedicated cone-beam CT scanner and reconstructed with the FDK algorithm. X-ray projection images were simulated for 5 mono-energetic (27, 32, 35, 43 and 51 keV) and 3 poly-energetic x-ray spectra typically employed in current CT scanners dedicated to the breast (49, 60, or 80 kVp). Clinical CT images acquired from two different clinical breast CT scanners were used for comparison purposes. The quantitative evaluation included calculation of the power-law exponent, β, from simulated and real breast tomograms, based on the power spectrum fitted with a function of the spatial frequency, f, of the form S(f)  =  α/f   ^β . The breast models were validated by comparison against clinical breast CT and published data. We found that the calculated β coefficients were close to that of clinical CT data from a dedicated breast CT scanner and reported data in the literature. In evaluating the software package BreastSimulator to generate breast models suitable for use with breast CT imaging, we found that the breast phantoms produced with the software tool can reproduce the anatomical structure of real breasts, as evaluated by calculating the β exponent from the power spectral analysis of simulated images. As such, this research tool might contribute considerably to the further development, testing and optimisation of breast CT imaging techniques.

Dynamic Mechanical Interactions Between Neighboring Airspaces Determine Cyclic Opening and Closure in Injured Lung

OBJECTIVES

Positive pressure ventilation exposes the lung to mechanical stresses that can exacerbate injury. The exact mechanism of this pathologic process remains elusive. The goal of this study was to describe recruitment/derecruitment at acinar length scales over short-time frames and test the hypothesis that mechanical interdependence between neighboring lung units determines the spatial and temporal distributions of recruitment/derecruitment, using a computational model.

DESIGN

Experimental animal study.

SETTING

International synchrotron radiation laboratory.

SUBJECTS

Four anesthetized rabbits, ventilated in pressure controlled mode.

INTERVENTIONS

The lung was consecutively imaged at ~ 1.5-minute intervals using phase-contrast synchrotron imaging, at positive end-expiratory pressures of 12, 9, 6, 3, and 0 cm H2O before and after lavage and mechanical ventilation induced injury. The extent and spatial distribution of recruitment/derecruitment was analyzed by subtracting subsequent images. In a realistic lung structure, we implemented a mechanistic model in which each unit has individual pressures and speeds of opening and closing. Derecruited and recruited lung fractions (Fderecruited, Frecruited) were computed based on the comparison of the aerated volumes at successive time points.

MEASUREMENTS AND MAIN RESULTS

Alternative recruitment/derecruitment occurred in neighboring alveoli over short-time scales in all tested positive end-expiratory pressure levels and despite stable pressure controlled mode. The computational model reproduced this behavior only when parenchymal interdependence between neighboring acini was accounted for. Simulations closely mimicked the experimental magnitude of Fderecruited and Frecruited when mechanical interdependence was included, while its exclusion gave Frecruited values of zero at positive end-expiratory pressure greater than or equal to 3 cm H2O.

CONCLUSIONS

These findings give further insight into the microscopic behavior of the injured lung and provide a means of testing protective-ventilation strategies to prevent recruitment/derecruitment and subsequent lung damage.

In-line phase-contrast breast tomosynthesis: a phantom feasibility study at a synchrotron radiation facility

The major objective is to adopt, apply and test developed in-house algorithms for volumetric breast reconstructions from projection images, obtained in in-line phase-contrast mode. Four angular sets, each consisting of 17 projection images obtained from four physical phantoms, were acquired at beamline ID17, European Synchroton Radiation Facility, Grenoble, France. The tomosynthesis arc was  ±32°. The physical phantoms differed in complexity of texture and introduced features of interest. Three of the used phantoms were in-house developed, and made of epoxy resin, polymethyl-methacrylate and paraffin wax, while the fourth phantom was the CIRS BR3D. The projection images had a pixel size of 47 µm  ×  47 µm. Tomosynthesis images were reconstructed with standard shift-and-add (SAA) and filtered backprojection (FBP) algorithms. It was found that the edge enhancement observed in planar x-ray images is preserved in tomosynthesis images from both phantoms with homogeneous and highly heterogeneous backgrounds. In case of BR3D, it was found that features not visible in the planar case were well outlined in the tomosynthesis slices. In addition, the edge enhancement index calculated for features of interest was found to be much higher in tomosynthesis images reconstructed with FBP than in planar images and tomosynthesis images reconstructed with SAA. The comparison between images reconstructed by the two reconstruction algorithms shows an advantage for the FBP method in terms of better edge enhancement. Phase-contrast breast tomosynthesis realized in in-line mode benefits the detection of suspicious areas in mammography images by adding the edge enhancement effect to the reconstructed slices.