Quantitative breast tissue characterization using grating-based x-ray phase-contrast imaging

High-Resolution Phase-Contrast Tomography on Human Collagenous Tissues: A Comprehensive Review

Phase-contrast X-ray imaging is becoming increasingly considered since its first applications, which occurred almost 30 years ago. Particular emphasis was placed on studies that use this technique to investigate soft tissues, which cannot otherwise be investigated at a high resolution and in a three-dimensional manner, using conventional absorption-based settings. Indeed, its consistency and discrimination power in low absorbing samples, unified to being a not destructive analysis, are pushing interests on its utilization from researchers of different specializations, from botany, through zoology, to human physio-pathology research. In this regard, a challenging method for 3D imaging and quantitative analysis of collagenous tissues has spread in recent years: it is based on the unique characteristics of synchrotron radiation phase-contrast microTomography (PhC-microCT). In this review, the focus has been placed on the research based on the exploitation of synchrotron PhC-microCT for the investigation of collagenous tissue physio-pathologies from solely human samples. Collagen tissues' elasto-mechanic role bonds it to the morphology of the site it is extracted from, which could weaken the results coming from animal experimentations. Encouraging outcomes proved this technique to be suitable to access and quantify human collagenous tissues and persuaded different researchers to approach it. A brief mention was also dedicated to the results obtained on collagenous tissues using new and promising high-resolution phase-contrast tomographic laboratory-based setups, which will certainly represent the real step forward in the diffusion of this relatively young imaging technique.

Tri-directional x-ray phase contrast multimodal imaging using one hexagonal mesh modulator

Objective. X-ray phase contrast imaging is a promising technique for future clinical diagnostic as it can provide enhanced contrast in soft tissues compared to traditional x-ray attenuation-contrast imaging. However, the strict requirements on the x-ray coherence and the precise alignment of optical elements limit its applications towards clinical use. To solve this problem, mesh-based x-ray phase contrast imaging method with one hexagonal mesh is proposed for easy alignment and better image visualization.Approach. The mesh produces structured illuminations and the detector captures its distortions to reconstruct the absorption, differential phase contrast (DPC) and dark-field (DF) images of the sample. In this work, we fabricated a hexagonal mesh to simultaneously retrieve DPC and DF signals in three different directions with single shot. A phase retrieval algorithm to obtain artifacts-free phase from DPC images with three different directions is put forward and false color dark-field image is also reconstructed with tri-directional images. Mesh-shifting method based on this hexagonal mesh modulator is also proposed to reconstruct images with better image quality at the expense of increased dose.Main results. In numerical simulations, the proposed hexagonal mesh outperforms the traditional square mesh in image evaluation metrics performance and false color visualization with the same radiation dose. The experimental results demonstrate its feasiblity in real imaging systems and its advantages in quantitive imaging and better visualization. The proposed hexagonal mesh is easy to fabricate and can be successfully applied to x-ray source with it spot size up to 300μm.Significance. This work opens new possibilities for quantitative x-ray non-destructive imaging and may also be instructive for research fields such as x-ray structured illumination microscopy (SIM), x-ray spectral imaging and x-ray phase contrast and dark-field computed tomography (CT).

Stable tissue-mimicking phantoms for longitudinal multimodality imaging studies that incorporate optical, CT, and MRI contrast

Significance

Tissue phantoms that mimic the optical and radiologic properties of human or animal tissue play an important role in the development, characterization, and evaluation of imaging systems. Phantoms that are easily produced and stable for longitudinal studies are highly desirable.

Aim

A new type of long-lasting phantom was developed with commercially available materials and was assessed for fabrication ease, stability, and optical property control. Magnetic resonance imaging (MRI) and x-ray computed tomography (CT) contrast properties were also evaluated.

Approach

A systematic investigation of relationships between concentrations of skin-like pigments and composite optical properties was conducted to realize optical property phantoms in the red and near-infrared (NIR) wavelength range that also offered contrast for CT and MRI.

Results

Phantom fabrication time was < 1    h and did not involve any heating or cooling processes. Changes in optical properties were < 2 % over a 12-month period. Phantom optical and spectral features were similar to human soft tissue over the red to NIR wavelength ranges. Pigments used in the study also had CT and MRI contrasts for multimodality imaging studies.

Conclusions

The phantoms described here mimic optical properties of soft tissue and are suitable for multimodality imaging studies involving CT or MRI without adding secondary contrast agents.

Heterogeneous breast phantom for computed tomography and magnetic resonance imaging

In this article, a heterogeneous multimodal anthropomorphic breast phantom with carcinoma is introduced to meet the response of the natural breast tissue when imaged using ionizing and non-ionizing machines. The skin, adipose, fibroglandular, pectoral muscle, and carcinoma tissue were mimicked. A T1-weighted breast magnetic resonance image with BI-RADS I tissue segmentation was used for molds creation. The tissue-mimicking materials (TMMs) were tailored in terms of their elemental composition weight fractions and their response to ionization radiation parameters. These are the mass attenuation coefficient (MAC), electron density (ne) and effective atomic number (Zeff). The behaviour of the TMMs, when exposed to a wide range of ionization radiation energy, was investigated analytically and numerically using X-COM. The achieved results showed an excellent agreement with the corresponding properties of the natural breast elemental compositions as reported by the International Commission on Radiation Units and Measurements (ICRU). The MAC of the TMMs and the ICRU-based breast tissue were found to be consistent. The maximum percentage of error in ne and Zeff amounts to only 2.93% and 5.76%, respectively. For non-ionizing imaging, the TMMs were characterized in term of T1 and T2 relaxation times. Using our preclinical MRI unit, the TMMs relaxation times were measured and compared to the natural tissue. The fabricated phantom was validated experimentally using CT, MRI, and Mammographic machines. The achieved images of the TMMs were in alignment with the real tissue in terms of CT HU values and grayscale colors. T1W and T2W images on MRI revealed the expected contrast between TMMs as in natural tissue.

X-ray Dark-Field Imaging for Improved Contrast in Historical Handwritten Literature

If ancient documents are too fragile to be opened, X-ray imaging can be used to recover the content non-destructively. As an extension to conventional attenuation imaging, dark-field imaging provides access to microscopic structural object information, which can be especially advantageous for materials with weak attenuation contrast, such as certain metal-free inks in paper. With cotton paper and different self-made inks based on authentic recipes, we produced test samples for attenuation and dark-field imaging at a metal-jet X-ray source. The resulting images show letters written in metal-free ink that were recovered via grating-based dark-field imaging. Without the need for synchrotron-like beam quality, these results set the ground for a mobile dark-field imaging setup that could be brought to a library for document scanning, avoiding long transport routes for valuable historic documents.

Phase and dark-field imaging with mesh-based structured illumination and polycapillary optics

PURPOSE

X-ray phase and dark-field (DF) imaging have been shown to improve the diagnostic capabilities of X-ray systems. However, these methods have found limited clinical use due to the need for multiple precision gratings with limited field of view or requirements on X-ray coherence that may not be easily translated to clinical practice. This work aims to develop a practicable X-ray phase and DF imaging system that could be translated and practiced in the clinic.

METHODS

This work employs a conventional source to create structured illumination with a simple wire mesh. A mesh-shifting algorithm is used to allow wider Fourier windowing to enhance resolution. Deconvolution of the source spot width and camera resolution improves accuracy. Polycapillary optics are employed to enhance coherence. The effects of incorporating optics with two different focal lengths are compared. Information apparent in enhanced absorption images, phase images, and DF images of fat embedded phantoms were compared and subjected to a limited receiver operator characteristic (ROC) study. The DF images of the moist and dry porous object (sponges) were compared.

RESULTS

The mesh-based phase and DF imaging system constructs images with three different information types: scatter-free absorption images, differential phase images, and scatter magnitude/DF images, simultaneously from the same original image. The polycapillary optic enhances the coherence of the beam. The deblurring technique corrects the phase signal error due to geometrical blur and the limitation of the camera modulation transfer function (MTF) and removes image artifacts to improve the resolution in a single shot. The mesh-shifting method allows the use of a wider Fourier processing window, which gives even higher resolution, at the expense of an increased dose. The limited ROC study confirms the efficacy of the system over the conventional system. DF images of moist and dry porous object show the significance of the system in the imaging of lung infections.

CONCLUSION

The mesh-based X-ray phase and DF imaging system is an inexpensive and easy setup in terms of alignment and data acquisition and can produce phase and DF images in a single shot with wide field of view. The system shows significant potential for use in diagnostic imaging in a clinical setting.

Quantitative X-ray phase contrast computed tomography with grating interferometry : Biomedical applications of quantitative X-ray grating-based phase contrast computed tomography

The ability of biomedical imaging data to be of quantitative nature is getting increasingly important with the ongoing developments in data science. In contrast to conventional attenuation-based X-ray imaging, grating-based phase contrast computed tomography (GBPC-CT) is a phase contrast micro-CT imaging technique that can provide high soft tissue contrast at high spatial resolution. While there is a variety of different phase contrast imaging techniques, GBPC-CT can be applied with laboratory X-ray sources and enables quantitative determination of electron density and effective atomic number. In this review article, we present quantitative GBPC-CT with the focus on biomedical applications.

Development and preclinical evaluation of a patient-specific high energy x-ray phase sensitive breast tomosynthesis system

BACKGROUND

This article reports the first x-ray phase sensitive breast tomosynthesis (PBT) system that is aimed for direct translation to clinical practice for the diagnosis of breast cancer.

PURPOSE

To report the preclinical evaluation and comparison of the newly built PBT system with a conventional digital breast tomosynthesis (DBT) system.

METHODS AND MATERIALS

The PBT system is developed based on a comprehensive inline phase contrast theoretical model. The system consists of a polyenergetic microfocus x-ray source and a flat panel detector mounted on an arm that is attached to a rotating gantry. It acquires nine projections over a 15° angular span in a stop-and-shoot manner. A dedicated phase retrieval algorithm is integrated with a filtered back-projection method that reconstructs tomographic slices. The American College of Radiology (ACR) accreditation phantom, a contrast detail (CD) phantom and mastectomy tissue samples were imaged at the same glandular dose levels by both the PBT and a standard of care DBT system for image quality characterizations and comparisons.

RESULTS

The PBT imaging scores with the ACR phantom are in good to excellent range and meet the quality assurance criteria set by the Mammography Quality Standard Act. The CD phantom image comparison and associated statistical analyses from two-alternative forced-choice reader studies confirm the improvement offered by the PBT system in terms of contrast resolution, spatial resolution, and conspicuity. The artifact spread function (ASF) analyses revealed a sizable lateral spread of metal artifacts in PBT slices as compared to DBT slices. Signal-to-noise ratio values for various inserts of the ACR and CD phantoms further validated the superiority of the PBT system. Mastectomy sample images acquired by the PBT system showed a superior depiction of microcalcifications vs the DBT system.

CONCLUSION

The PBT imaging technology can be clinically employed for improving the accuracy of breast cancer screening and diagnosis.

Propagation-Based Phase-Contrast CT of the Breast Demonstrates Higher Quality Than Conventional Absorption-Based CT Even at Lower Radiation Dose

RATIONALE AND OBJECTIVES

Propagation-based phase-contrast CT (PB-CT) is an advanced X-ray imaging technology that exploits both refraction and absorption of the transmitted X-ray beam. This study was aimed at optimizing the experimental conditions of PB-CT for breast cancer imaging and examined its performance relative to conventional absorption-based CT (AB-CT) in terms of image quality and radiation dose.

MATERIALS AND METHODS

Surgically excised breast mastectomy specimens (n = 12) were scanned using both PB-CT and AB-CT techniques under varying imaging conditions. To evaluate the radiological image quality, visual grading characteristics (VGC) analysis was used in which 11 breast specialist radiologists compared the overall image quality of PB-CT images with respect to the corresponding AB-CT images. The area under the VGC curve was calculated to measure the differences between PB-CT and AB-CT images.

RESULTS

The highest radiological quality was obtained for PB-CT images using a 32 keV energy X-ray beam and by applying the Homogeneous Transport of Intensity Equation phase retrieval with the value of its parameter γ set to one-half of the theoretically optimal value for the given materials. Using these optimized conditions, the image quality of PB-CT images obtained at 4 mGy and 2 mGy mean glandular dose was significantly higher than AB-CT images at 4 mGy (AUC_VGC = 0.901, p = 0.001 and AUC_VGC = 0.819, p = 0.011, respectively).

CONCLUSION

PB-CT achieves a higher radiological image quality compared to AB-CT even at a considerably lower mean glandular dose. Successful translation of the PB-CT technique for breast cancer imaging can potentially result in improved breast cancer diagnosis.

Modeling of an X-ray grating-based imaging interferometer using ray tracing

X-ray imaging by means of a grating-based Talbot-Lau interferometer has become an important tool for a wide variety of application areas such as security, medical and materials analysis. Imaging modalities include attenuation, differential phase contrast, and visibility contrast (or so-called dark field). We have developed a novel modeling approach based on ray tracing with commercially available software (Zemax OpticStudio) that yields image projections for all three modalities. The results compare favorably with experimental findings. Our polychromatic ray-based model accommodates realistic 3-D CAD objects with tailored materials properties and also allows for both surface and bulk scattering. As such, the model can simulate imaging of complicated objects as well as assist in a physical understanding of experimental projection details.

Evaluation of the Weighted Mean X-ray Energy for an Imaging System Via Propagation-Based Phase-Contrast Imaging

For imaging events of extremely short duration, like shock waves or explosions, it is necessary to be able to image the object with a single-shot exposure. A suitable setup is given by a laser-induced X-ray source such as the one that can be found at GSI (Helmholtzzentrum für Schwerionenforschung GmbH) in Darmstadt (Society for Heavy Ion Research), Germany. There, it is possible to direct a pulse from the high-energy laser Petawatt High Energy Laser for Heavy Ion eXperiments (PHELIX) on a tungsten wire to generate a picosecond polychromatic X-ray pulse, called backlighter. For grating-based single-shot phase-contrast imaging of shock waves or exploding wires, it is important to know the weighted mean energy of the X-ray spectrum for choosing a suitable setup. In propagation-based phase-contrast imaging the knowledge of the weighted mean energy is necessary to be able to reconstruct quantitative phase images of unknown objects. Hence, we developed a method to evaluate the weighted mean energy of the X-ray backlighter spectrum using propagation-based phase-contrast images. In a first step wave-field simulations are performed to verify the results. Furthermore, our evaluation is cross-checked with monochromatic synchrotron measurements with known energy at Diamond Light Source (DLS, Didcot, UK) for proof of concepts.

Quantitative analysis of a micro array anode structured target for hard x-ray grating interferometry

Talbot-Lau interferometry (TLI) provides additional contrast modes for x-ray imaging that are complementary to conventional absorption radiography. TLI is particularly interesting because it is one of the few practical methods for realizing phase contrast with x-rays that is compatible with large-spot high power x-ray sources. A novel micro array anode structured target (MAAST) x-ray source offers several advantages for TLI over the conventional combination of an extended x-ray source coupled with an absorption grating including higher flux and larger field of view, and these advantages become more pronounced for x-ray energies in excess of 30 keV. A Monte Carlo simulation was performed to determine the optimal parameters for a MAAST source for use with TLI. It was found that the both spatial distribution of x-ray production and the number of x-ray produced in the MAAST have a strong dependence on the incidence angle of the electron beam.

Design optimization of a periodic microstructured array anode for hard x-ray grating interferometry

Talbot-Lau grating interferometer (TLGI) has great advantages in x-ray imaging contrasts, especially for low-Z materials, over conventional absorption contrast. A microstructured array anode target (MAAT) source offers significantly higher imaging throughput than the combination of an extended x-ray source paired with an absorption grating (also known as source grating). The performance of the MAAT source can be optimized with respect to the areal density, dimensions, and choice of material for the microstructured metal inserts (MMI) and the substrate in which they are embedded. In this paper, we analyze the x-ray generation efficiency per incident electron, relative fraction of x-rays generated by MMI and substrate, x-ray spectrum, and angular distribution via Monte Carlo simulation. Based on the simulation results, the optimal parameters are obtained for a MAAT with incident electron energies from 30 keV to 120 keV. The corresponding temperature distribution within the MAAT is also simulated for the optimal set of the parameters via finite element analysis. As demonstrated by the thermal analysis data, the maximum allowable electron-beam power loading was derived that allows a stable operation of the transmission MAAT.

Contrast-to-noise ratios and thickness-normalized, ventilation-dependent signal levels in dark-field and conventional in vivo thorax radiographs of two pigs

Lung tissue causes significant small-angle X-ray scattering, which can be visualized with grating-based X-ray dark-field imaging. Structural lung diseases alter alveolar microstructure, which often causes a dark-field signal decrease. The imaging method provides benefits for diagnosis of such diseases in small-animal models, and was successfully used on porcine and human lungs in a fringe-scanning setup. Micro- and macroscopic changes occur in the lung during breathing, but their individual effects on the dark-field signal are unknown. However, this information is important for quantitative medical evaluation of dark-field thorax radiographs. To estimate the effect of these changes on the dark-field signal during a clinical examination, we acquired in vivo dark-field chest radiographs of two pigs at three ventilation pressures. Pigs were used due to the high degree of similarity between porcine and human lungs. To analyze lung expansion separately, we acquired CT scans of both pigs at comparable posture and ventilation pressures. Segmentation, masking, and forward-projection of the CT datasets yielded maps of lung thickness and logarithmic lung attenuation signal in registration with the dark-field radiographs. Upon correlating this data, we discovered approximately linear relationships between the logarithmic dark-field signal and both projected quantities for all scans. Increasing ventilation pressure strongly decreased dark-field extinction coefficients, whereas the ratio of lung dark-field and attenuation signal changed only slightly. Furthermore, we investigated ratios of dark-field and attenuation noise levels at realistic signal levels via calculations and phantom measurements. Dark-field contrast-to-noise ratio (CNR) per lung height was 5 to 10% of the same quantity in attenuation. We conclude that better CNR performance in the dark-field modality is typically due to greater anatomical noise in the conventional radiograph. Given the high physiological similarity of human and porcine lungs, the presented thickness-normalized, ventilation-dependent values allow estimation of dark-field activity of human lungs of variable size and inspiration, which facilitates the design of suitable clinical imaging setups.

3D grating-based X-ray phase-contrast computed tomography for high-resolution quantitative assessment of cartilage: An experimental feasibility study with 3T MRI, 7T MRI and biomechanical correlation

Objective

Aim of this study was, to demonstrate the feasibility of high-resolution grating-based X-ray phase-contrast computed tomography (PCCT) for quantitative assessment of cartilage.

Materials and methods

In an experimental setup, 12 osteochondral samples were harvested from n = 6 bovine knees (n = 2 each). From each knee, one cartilage sample was degraded using 2.5% Trypsin. In addition to PCCT and biomechanical cartilage stiffness measurements, 3T and 7T MRI was performed including MSME SE T2 and ME GE T2* mapping sequences for relaxationtime measurements. Paired t-tests and receiver operating characteristics (ROC) curves were used for statistical analyses.

Results

PCCT provided high-resolution images for improved morphological cartilage evaluation as compared to 3T and 7T MRI. Quantitative analyses revealed significant differences between the superficial and the deep cartilage layer for T2 mapping as well as for PCCT (P<0.05). No significant difference was detected for PCCT between healthy and degraded samples (P>0.05). MRI and stiffness measurements showed significant differences between healthy and degraded osteochondral samples. Accuracy in the prediction of cartilage degradation was excellent for MRI and biomechanical analyses.

Conclusion

In conclusion, high-resolution grating-based X-ray PCCT cartilage imaging is feasible. In addition to MRI and biomechanical analyses it provides complementary, water content independent, information for improved morphological and quantitative characterization of articular cartilage ultrastructure.

Assessment of intraductal carcinoma in situ (DCIS) using grating-based X-ray phase-contrast CT at conventional X-ray sources: An experimental ex-vivo study

BACKGROUND

The extent of intraductal carcinoma in situ (DCIS) is commonly underestimated due to the discontinuous growth and lack of microcalcifications. Specimen radiography has been established to reduce the rate of re-excision. However, the predictive value for margin assessment with conventional specimen radiography for DCIS is low. In this study we assessed the potential of grating-based phase-contrast computed tomography (GBPC-CT) at conventional X-ray sources for specimen tomography of DCIS containing samples.

MATERIALS AND METHODS

GBPC-CT was performed on four ex-vivo breast specimens containing DCIS and invasive carcinoma of non-specific type. Phase-contrast and absorption-based datasets were manually matched with corresponding histological slices as the standard of reference.

RESULTS

Matching of CT images and histology was successful. GBPC-CT showed an improved soft tissue contrast compared to absorption-based images revealing more histological details in the same sections. Non-calcifying DCIS exceeding the invasive tumor could be correlated to areas of dilated bright ducts around the tumor.

CONCLUSIONS

GBPC-CT imaging at conventional X-ray sources offers improved depiction quality for the imaging of breast tissue samples compared to absorption-based imaging, allows the identification of diagnostically relevant tissue details, and provides full three-dimensional assessment of sample margins.

Quantitative characterization of ex vivo breast tissue via x-ray phase-contrast tomography

BACKGROUND

Grating-based X-ray phase-contrast imaging (GPCI) has received growing interests in recent years due to its high capability of visualizing soft tissue. Breast imaging is one of the most promising candidates for the first clinical application of this imaging modality.

OBJECTIVE

In this work, quantitative breast tissue characterization based on GPCI computed tomography (CT) is investigated with a laboratory X-ray tube through a comparison between attenuation-based CT images and phase-contrast CT images.

METHODS

The Hounsfield units (HU) scale was introduced to phase-contrast images due to its wide application in clinical medicine. In this work, instead of water, plastic cylinders composed of polyethylene terephthalate (PET) was treated as the calibration material. An alternative test-retest reliability (TRR) was presented to evaluate the repeatability of GPCI. Comparison between attenuation-based CT imaging and GPCI CT imaging was operated with the use of statistical analysis methods like histograms and receiver operating characteristic (ROC) curves.

RESULTS

The determined mean TRR related to cylinders is slightly larger in phase-contrast imaging (0.93) than that in attenuation-based imaging (0.89). With respect to distinguishing breast tissues, the AUC (area under curve) values of ROC curves of phase-contrast images are higher than that of attenuation-based images.

CONCLUSIONS

An ex vivo study of GPCI shows that it is a stable imaging modality for visualizing the breast tissue with good repeatability, and that it could be of potential for the diagnosis of breast cancer as well.

High resolution laboratory grating-based X-ray phase-contrast CT

The conventional form of computed tomography using X-ray attenuation without any contrast agents is of limited use for the characterization of soft tissue in many fields of medical and biological studies. Grating-based phase-contrast computed tomography (gbPC-CT) is a promising alternative imaging method solving the low soft tissue contrast without the need of any contrast agent. While highly sensitive measurements are possible using conventional X-ray sources the spatial resolution does often not fulfill the requirements for specific imaging tasks, such as visualization of pathologies. The focus of this study is the increase in spatial resolution without loss of sensitivity. To overcome this limitation a super-resolution reconstruction based on sub-pixel shifts involving a deconvolution of the image data during each iteration is applied. In our study we achieve an effective pixel size of 28 μm with a conventional rotating anode tube and a photon-counting detector. We also demonstrate that the method can upgrade existing setups to measure tomographies with higher resolution. The results show the increase in resolution at high sensitivity and with the ability to make quantitative measurements. The combination of sparse sampling and statistical iterative reconstruction may be used to reduce the total measurement time. In conclusion, we present high-quality and high-resolution tomographic images of biological samples to demonstrate the experimental feasibility of super-resolution reconstruction.

X-ray dark-field imaging of the human lung-A feasibility study on a deceased body

Disorders of the lungs such as chronic obstructive pulmonary disease (COPD) are a major cause of chronic morbidity and mortality and the third leading cause of death in the world. The absence of sensitive diagnostic tests for early disease stages of COPD results in under-diagnosis of this treatable disease in an estimated 60–85% of the patients. In recent years a grating-based approach to X-ray dark-field contrast imaging has shown to be very sensitive for the detection and quantification of pulmonary emphysema in small animal models. However, translation of this technique to imaging systems suitable for humans remains challenging and has not yet been reported. In this manuscript, we present the first X-ray dark-field images of in-situ human lungs in a deceased body, demonstrating the feasibility of X-ray dark-field chest radiography on a human scale. Results were correlated with findings of computed tomography imaging and autopsy. The performance of the experimental radiography setup allows acquisition of multi-contrast chest X-ray images within clinical boundary conditions, including radiation dose. Upcoming clinical studies will have to demonstrate that this technology has the potential to improve early diagnosis of COPD and pulmonary diseases in general.

Quantitative characterization and diagnosis via hard X-ray phase-contrast microtomography

Nondestructive three-dimensional (3D) micromorphological imaging technique is essential for hepatic alveolar echinococcosis (HAE) disease to determine its damage level and early diagnosis, assess relative drug therapy and optimize treatment strategies. However, the existing morphological researches of HAE mainly depend on the conventional CT, MRI, or ultrasound in hospitals, unfortunately confronting with the common limit of imaging resolution and sensitivity, especially for tiny or early HAE lesions. Now we presented a phase-retrieval-based synchrotron X-ray phase computed tomography (PR-XPCT) with striking contrast-to-noise ratio and high-density resolution to visualize the HAE nondestructive 3D structures and quantitatively segment different pathological characteristics of HAE lesions without staining process at the micrometer scale. Our experimental results of the HAE rat models at early and developed pathological stages and albendazole liposome (L-ABZ) therapeutic feeding models successfully exhibited the different HAE pathological 3D morphological and microstructural characteristics with excellent contrast and high resolution, demonstrating its availability and superiority. Moreover, we achieved the quantitative statistics and analysis of the pathological changes of HAE lesions at different stages and L-ABZ therapeutic evaluation, helpful to understanding the development and drug treatment of HAE disease. The PR-XPCT-based quantitative segmentation and characterization has a great potential in detection and analysis of soft tissue pathological changes, such as different tumors.

Qualitative and Quantitative Evaluation of Structural Myocardial Alterations by Grating-Based Phase-Contrast Computed Tomography

OBJECTIVES

Grating-based phase-contrast computed tomography (gb-PCCT) relies on x-ray refraction instead of absorption to generate high-contrast images in biological soft tissue. The aim of this study was to evaluate the potential of gb-PCCT for the depiction of structural changes in heart disease.

MATERIALS AND METHODS

Four human heart specimens from patients with hypertensive disease, ischemic disease, dilated heart disease, and cardiac lipomatosis were examined. The gb-PCCT setup consisted of an x-ray tube (40 kV, 70 mA), grating-interferometer, and detector, and allowed simultaneous acquisition of phase- and absorption-contrast data. With histopathology as the standard of reference, myocardium (MC), fibrotic scar (FS), interstitial fibrosis (IF), and fatty tissue (FT) were visually and quantitatively evaluated. Systematic differences in absorption- and phase-contrast Hounsfield units (HUabs and HUp) were assessed.

RESULTS

Thirteen corresponding cross-sections were included, and MC, FS, IF, and FT were found in 13 (100%), 4 (30.8%), 7 (53.8%), and 13 (100%) cross-sections, respectively. Mean HUp/HUabs were 52.5/54.1, 86.6/69.7, 62.4/62.3, and -38.6/-258.9 for MC, FS, IF, and FT, respectively. An overlap in HUabs was observed for MC and IF (P = 0.84) but not for HUp (P < 0.01). Contrast-to-noise ratios were significantly higher in phase- than in absorption-contrast for MC/FT (35.4 vs 7.8; P < 0.01) and for MC/FS (12.3 vs 0.2; P < 0.01).

CONCLUSIONS

Given its superior soft tissue contrast, gb-PCCT is able to depict structural changes in different cardiomyopathies, which can currently not be obtained by x-ray absorption-based imaging methods. If current technical limitations can be overcome, gb-PCCT may evolve as a powerful tool for the anatomical assessment of cardiomyopathy.

Accurate effective atomic number determination with polychromatic grating-based phase-contrast computed tomography

The demand for quantitative medical imaging is increasing in the ongoing digitalization. Conventional computed tomography (CT) is energy-dependent and therefore of limited comparability. In contrast, dual-energy CT (DECT) allows for the determination of absolute image contrast quantities, namely the electron density and the effective atomic number, and is already established in clinical radiology and radiation therapy. Grating-based phase-contrast computed tomography (GBPC-CT) is an experimental X-ray technique that also allows for the measurement of the electron density and the effective atomic number. However, the determination of both quantities is challenging when dealing with polychromatic GBPC-CT setups. In this paper, we present how to calculate the effective atomic numbers with a polychromatic, laboratory GBPC-CT setup operating between 35 and 50\,kVp. First, we investigated the accuracy of the measurement of the attenuation coefficients and electron densities. For this, we performed a calibration using the concept of effective energy. With the reliable experimental quantitative values, we were able to evaluate the effective atomic numbers of the investigated materials using a method previously shown with monochromatic X-ray radiation. In detail, we first calculated the ratio of the electron density and attenuation coefficient, which were experimentally determined with our polychromatic GBPC-CT setup. Second, we compared this ratio with tabulated total attenuation cross sections from literature values to determine the effective atomic numbers. Thus, we were able to calculate two physical absolute quantities -- the electron density and effective atomic number -- that are in general independent of the specific experimental conditions like the X-ray beam spectrum or the setup design.

Tilted grating phase-contrast computed tomography using statistical iterative reconstruction

Grating-based phase-contrast computed tomography (GBPC-CT) enables increased soft tissue differentiation, but often suffers from streak artifacts when performing high-sensitivity GBPC-CT of biomedical samples. Current GBPC-CT setups consist of one-dimensional gratings and hence allow to measure only the differential phase-contrast (DPC) signal perpendicular to the direction of the grating lines. Having access to the full two-dimensional DPC signal can strongly reduce streak artefacts showing up as characteristic horizontal lines in the reconstructed images. GBPC-CT with gratings tilted by 45° around the optical axis, combining opposed projections, and reconstructing with filtered backprojection is one method to retrieve the full three-dimensional DPC signal. This approach improves the quality of the tomographic data as already demonstrated at a synchrotron facility. However, additional processing and interpolation is necessary, and the approach fails when dealing with cone-beam geometry setups. In this work, we employ the tilted grating configuration with a laboratory GBPC-CT setup with cone-beam geometry and use statistical iterative reconstruction (SIR) with a forward model accounting for diagonal grating alignment. Our results show a strong reduction of streak artefacts and significant increase in image quality. In contrast to the prior approach our proposed method can be used in a laboratory environment due to its cone-beam compatibility.

A dedicated breast-PET/CT scanner: Evaluation of basic performance characteristics

PURPOSE

Application of advanced imaging techniques, such as PET and x ray CT, can potentially improve detection of breast cancer. Unfortunately, both modalities have challenges in the detection of some lesions. The combination of the two techniques, however, could potentially lead to an overall improvement in diagnostic breast imaging. The purpose of this investigation is to test the basic performance of a new dedicated breast-PET/CT.

METHODS

The PET component consists of a rotating pair of detectors. Its performance was evaluated using the NEMA NU4-2008 protocols. The CT component utilizes a pulsed x ray source and flat panel detector mounted on the same gantry as the PET scanner. Its performance was assessed using specialized phantoms. The radiation dose to a breast during CT imaging was explored by the measurement of free-in-air kerma and air kerma measured at the center of a 16 cm-diameter PMMA cylinder. Finally, the combined capabilities of the system were demonstrated by imaging of a micro-hot-rod phantom.

RESULTS

Overall, performance of the PET component is comparable to many pre-clinical and other dedicated breast-PET scanners. Its spatial resolution is 2.2 mm, 5 mm from the center of the scanner using images created with the single-sliced-filtered-backprojection algorithm. Peak NECR is 24.6 kcps; peak sensitivity is 1.36%; the scatter fraction is 27%. Spatial resolution of the CT scanner is 1.1 lp/mm at 10% MTF. The free-in-air kerma is 2.33 mGy, while the PMMA-air kerma is 1.24 mGy. Finally, combined imaging of a micro-hot-rod phantom illustrated the potential utility of the dual-modality images produced by the system.

CONCLUSION

The basic performance characteristics of a new dedicated breast-PET/CT scanner are good, demonstrating that its performance is similar to current dedicated PET and CT scanners. The potential value of this system is the capability to produce combined duality-modality images that could improve detection of breast disease. The next stage in development of this system is testing with more advanced phantoms and human subjects.

[X‑ray Phase Contrast : Principles, potential and advances in clinical translation]

More than 100 years ago Max von Laue in Munich discovered that X‑rays can be interpreted not only as X‑ray quanta in a particle picture, but also show a wave character. This property has been used for a long time in basic research (e.g. in crystallography for determining the structure of proteins), but so far has had no application in medical imaging. In the last 10 years, however, very impressive technological progress could be made in preclinical research, which also makes the utilization of the wave character of X‑ray light possible for medical imaging. These novel radiography procedures, so-called phase-contrast and dark-field imaging, have a great potential for a pronounced improvement in X‑ray imaging and therefore, also the diagnosis of important diseases. This article describes the basic principles of these novel procedures, summarizes the preclinical research results already achieved exemplified by various organs and shows the potential for future clinical utilization in radiography and computed tomography.

Ex Vivo Assessment of Coronary Atherosclerotic Plaque by Grating-Based Phase-Contrast Computed Tomography: Correlation With Optical Coherence Tomography

OBJECTIVES

The aim of this study was to determine the diagnostic accuracy of grating-based phase-contrast computed tomography (gb-PCCT) to classify and quantify coronary vessel characteristics in comparison with optical coherence tomography (OCT) and histopathology in an ex vivo setting.

MATERIALS AND METHODS

After excision from 5 heart specimens, 15 human coronary arteries underwent gb-PCCT examination using an experimental imaging setup consisting of a rotating molybdenum anode x-ray tube, a Talbot-Lau grating interferometer, and a single photon counting detector. Subsequently, all vessels were imaged by OCT and histopathologically processed. Optical coherence tomography, gb-PCCT, and histopathology images were manually matched using anatomical landmarks. Optical coherence tomography and gb-PCCT were reviewed by 2 independent observers blinded to histopathology. Vessel, lumen, and plaque area were measured, and plaque characteristics (lipid rich, calcified, and fibrous) were determined for each section. Measures of diagnostic accuracy were derived, applying histopathology as the standard of reference.

RESULTS

Of a total of 286 assessed cross sections, 241 corresponding sections were included in the statistical analysis. Quantitative measures derived from gb-PCCT were significantly higher than from OCT (P < 0.001) and were strongly correlated with histopathology (Pearson r ≥0.85 for gb-PCCT and ≥0.61 for OCT, respectively). Results of Bland-Altman analysis demonstrated smaller mean differences between OCT and histopathology than for gb-PCCT and histopathology. Limits of agreement were narrower for gb-PCCT with regard to lumen area, for OCT with regard to plaque area, and were comparable with regard to vessel area. Based on histopathology, 228/241 (94.6%) sections were classified as fibrous, calcified, or lipid rich. The diagnostic accuracy of gb-PCCT was excellent for the detection of all plaque components (sensitivity, ≥0.95; specificity, ≥0.94), whereas the results for OCT showed sensitivities of ≥0.73 and specificities of ≥0.66.

CONCLUSIONS

In this ex vivo setting, gb-PCCT provides excellent results in the assessment of coronary atherosclerotic plaque characteristics and vessel dimensions in comparison to OCT and histopathology. Thus, the technique may serve as adjunct nondestructive modality for advanced plaque characterization in an experimental setting.

Revising the lower statistical limit of x-ray grating-based phase-contrast computed tomography

Phase-contrast x-ray computed tomography (PCCT) is currently investigated as an interesting extension of conventional CT, providing high soft-tissue contrast even if examining weakly absorbing specimen. Until now, the potential for dose reduction was thought to be limited compared to attenuation CT, since meaningful phase retrieval fails for scans with very low photon counts when using the conventional phase retrieval method via phase stepping. In this work, we examine the statistical behaviour of the reverse projection method, an alternative phase retrieval approach and compare the results to the conventional phase retrieval technique. We investigate the noise levels in the projections as well as the image quality and quantitative accuracy of the reconstructed tomographic volumes. The results of our study show that this method performs better in a low-dose scenario than the conventional phase retrieval approach, resulting in lower noise levels, enhanced image quality and more accurate quantitative values. Overall, we demonstrate that the lower statistical limit of the phase stepping procedure as proposed by recent literature does not apply to this alternative phase retrieval technique. However, further development is necessary to overcome experimental challenges posed by this method which would enable mainstream or even clinical application of PCCT.

Dark-field imaging in coronary atherosclerosis

OBJECTIVES

Dark-field imaging based on small angle X-ray scattering has been shown to be highly sensitive for microcalcifications, e.g. in breast tissue. We hypothesized (i) that high signal areas in dark-field imaging of atherosclerotic plaque are associated with microcalcifications and (ii) that dark-field imaging is more sensitive for microcalcifications than attenuation-based imaging.

METHODS

Fifteen coronary artery specimens were examined at an experimental set-up consisting of X-ray tube (40kV), grating-interferometer and detector. Tomographic dark-field-, attenuation-, and phase-contrast data were simultaneously acquired. Histopathology served as standard of reference. To explore the potential of dark field imaging in a full-body CT system, simulations were carried out with spherical calcifications of different sizes to simulate small and intermediate microcalcifications.

RESULTS

Microcalcifications were present in 10/10 (100%) cross-sections with high dark-field signal and without evidence of calcifications in attenuation- or phase contrast. In positive controls with high signal areas in all three modalities, 10/10 (100%) cross-sections showed macrocalcifications. In negative controls without high signal areas, no calcifications were detected. Simulations showed that the microcalcifications generate substantially higher dark-field than attenuation signal.

CONCLUSIONS

Dark-field imaging is highly sensitive for microcalcifications in coronary atherosclerotic plaque and might provide complementary information in the assessment of plaque instability.

Qualitative and Quantitative Imaging Evaluation of Renal Cell Carcinoma Subtypes with Grating-based X-ray Phase-contrast CT

Current clinical imaging methods face limitations in the detection and correct characterization of different subtypes of renal cell carcinoma (RCC), while these are important for therapy and prognosis. The present study evaluates the potential of grating-based X-ray phase-contrast computed tomography (gbPC-CT) for visualization and characterization of human RCC subtypes. The imaging results for 23 ex vivo formalin-fixed human kidney specimens obtained with phase-contrast CT were compared to the results of the absorption-based CT (gbCT), clinical CT and a 3T MRI and validated using histology. Regions of interest were placed on each specimen for quantitative evaluation. Qualitative and quantitative gbPC-CT imaging could significantly discriminate between normal kidney cortex (54 ± 4 HUp) and clear cell (42 ± 10), papillary (43 ± 6) and chromophobe RCCs (39 ± 7), p < 0.05 respectively. The sensitivity for detection of tumor areas was 100%, 50% and 40% for gbPC-CT, gbCT and clinical CT, respectively. RCC architecture like fibrous strands, pseudocapsules, necrosis or hyalinization was depicted clearly in gbPC-CT and was not equally well visualized in gbCT, clinical CT and MRI. The results show that gbPC-CT enables improved discrimination of normal kidney parenchyma and tumorous tissues as well as different soft-tissue components of RCCs without the use of contrast media.

Ex vivo characterization of pathologic fluids with quantitative phase-contrast computed tomography

PURPOSE

X-ray phase-contrast imaging (PCI) provides additional information beyond absorption characteristics by detecting the phase shift of the X-ray beam passing through material. The grating-based system works with standard polychromatic X-ray sources, promising a possible clinical implementation. PCI has been shown to provide additional information in soft-tissue samples. The aim of this study was to determine if ex vivo quantitative phase-contrast computed tomography (PCCT) may differentiate between pathologic fluid collections.

MATERIALS AND METHODS

PCCT was performed with the grating interferometry method. A protein serial dilution, human blood samples and 17 clinical samples of pathologic fluid retentions were imaged and correlated with clinical chemistry measurements. Conventional and phase-contrast tomography images were reconstructed. Phase-contrast Hounsfield Units (HUp) were used for quantitative analysis analogously to conventional HU. The imaging was analyzed using overall means, ROI values as well as whole-volume-histograms and vertical gradients. Contrast to noise ratios were calculated between different probes and between imaging methods.

RESULTS

HUp showed a very good linear correlation with protein concentration in vitro. In clinical samples, HUp correlated rather well with cell count and triglyceride content. PCI was better than absorption imaging at differentiating protein concentrations in the protein samples as well as at differentiating blood plasma from cellular components. PCI also allowed for differentiation of watery samples (such as lymphoceles) from pus.

CONCLUSION

Phase-contrast computed tomography is a promising tool for the differentiation of pathologic fluids that appear homogenous with conventional attenuation imaging.

X-ray phase-contrast computed tomography of human coronary arteries

OBJECTIVE

The objective of this study was to assess the potential of grating-based phase-contrast computed tomography (gb-PCCT) for the detection and characterization of human coronary artery disease in an experimental ex vivo validation study.

MATERIALS AND METHODS

The study was approved by the institutional review board, and informed consent was obtained from all patients. Specimens were examined using a conventional low-coherence x-ray tube (40 kV) and a Talbot-Lau grating interferometer. Histopathologic assessment was used as the standard of reference. Signal characteristics of calcified, fibrous (FIB), and lipid-rich (LIP) tissue were visually and quantitatively assessed by phase-contrast Hounsfield units (HU). Conventional absorption-based HU values were also measured. Conservative measurements of diagnostic accuracy for the detection and differentiation of plaque components as well as quantitative measurements of vessel dimensions were obtained, and receiver operating characteristic curve analysis for plaque differentiation was performed.

RESULTS

A total of 15 coronary arteries from 5 subjects were available for analysis (386 sections). Calcified, FIB, and LIP displayed distinct gb-PCCT signal criteria. The diagnostic accuracy of gb-PCCT was high with sensitivity, specificity, and negative and positive predictive values of 0.89 or greater for all plaque components with good interrater agreement (к ≥ 0.88). In addition, quantitative measurements of vessel dimensions in gb-PCCT were strongly correlated with measurements obtained from histopathology (Pearson R ≥ 0.86). Finally, phase-contrast Hounsfield units were superior to conventional HU in differentiating FIB and LIP (receiver operating characteristic analysis, 0.86 vs. 0.77, respectively; P < 0.05).

CONCLUSIONS

In an ex vivo setting, gb-PCCT provides improved differentiation and quantification of coronary atherosclerotic plaque and may thus serve as a tool for nondestructive histopathology.

Helical X-ray phase-contrast computed tomography without phase stepping

X-ray phase-contrast computed tomography (PCCT) using grating interferometry provides enhanced soft-tissue contrast. The possibility to use standard polychromatic laboratory sources enables an implementation into a clinical setting. Thus, PCCT has gained significant attention in recent years. However, phase-contrast CT scans still require significantly increased measurement times in comparison to conventional attenuation-based CT imaging. This is mainly due to a time-consuming stepping of a grating, which is necessary for an accurate retrieval of the phase information. In this paper, we demonstrate a novel scan technique, which directly allows the determination of the phase signal without a phase-stepping procedure. The presented work is based on moiré fringe scanning, which allows fast data acquisition in radiographic applications such as mammography or in-line product analysis. Here, we demonstrate its extension to tomography enabling a continuous helical sample rotation as routinely performed in clinical CT systems. Compared to standard phase-stepping techniques, the proposed helical fringe-scanning procedure enables faster measurements, an extended field of view and relaxes the stability requirements of the system, since the gratings remain stationary. Finally, our approach exceeds previously introduced methods by not relying on spatial interpolation to acquire the phase-contrast signal.

Experimental Realisation of High-sensitivity Laboratory X-ray Grating-based Phase-contrast Computed Tomography

The possibility to perform high-sensitivity X-ray phase-contrast imaging with laboratory grating-based phase-contrast computed tomography (gbPC-CT) setups is of great interest for a broad range of high-resolution biomedical applications. However, achieving high sensitivity with laboratory gbPC-CT setups still poses a challenge because several factors such as the reduced flux, the polychromaticity of the spectrum, and the limited coherence of the X-ray source reduce the performance of laboratory gbPC-CT in comparison to gbPC-CT at synchrotron facilities. In this work, we present our laboratory X-ray Talbot-Lau interferometry setup operating at 40 kVp and describe how we achieve the high sensitivity yet unrivalled by any other laboratory X-ray phase-contrast technique. We provide the angular sensitivity expressed via the minimum resolvable refraction angle both in theory and experiment, and compare our data with other differential phase-contrast setups. Furthermore, we show that the good stability of our high-sensitivity setup allows for tomographic scans, by which even the electron density can be retrieved quantitatively as has been demonstrated in several preclinical studies.

Quantitative Three-Dimensional Imaging of Lipid, Protein, and Water Contents via X-Ray Phase-Contrast Tomography

X-ray phase-contrast computed tomography is an emerging imaging technology with powerful capabilities for three-dimensional (3D) visualization of weakly absorbing objects such as biological soft tissues. This technique is an extension of existing X-ray applications because conventional attenuation-contrast images are simultaneously acquired. The complementary information provided by both the contrast modalities suggests that enhanced material characterization is possible when performing combined data analysis. In this study, we describe how protein, lipid, and water concentrations in each 3D voxel can be quantified by vector decomposition. Experimental results of dairy products, porcine fat and rind, and different human soft tissue types are presented. The results demonstrate the potential of phase-contrast imaging as a new analysis tool. The 3D representations of protein, lipid, and water contents open up new opportunities in the fields of biology, medicine, and food science.

Increasing the field of view in grating based X-ray phase contrast imaging using stitched gratings

Grating based X-ray differential phase contrast imaging (DPCI) allows for high contrast imaging of materials with similar absorption characteristics. In the last years' publications, small animals or parts of the human body like breast, hand, joints or blood vessels have been studied. Larger objects could not be investigated due to the restricted field of view limited by the available grating area. In this paper, we report on a new stitching method to increase the grating area significantly: individual gratings are merged on a carrier substrate. Whereas the grating fabrication process is based on the LIGA technology (X-ray lithography and electroplating) different cutting and joining methods have been evaluated. First imaging results using a 2×2 stitched analyzer grating in a Talbot-Lau interferometer have been generated using a conventional polychromatic X-ray source. The image quality and analysis confirm the high potential of the stitching method to increase the field of view considerably.

Computer vision tools to optimize reconstruction parameters in x-ray in-line phase tomography

In this article, a set of three computer vision tools, including scale invariant feature transform (SIFT), a measure of focus, and a measure based on tractography are demonstrated to be useful in replacing the eye of the expert in the optimization of the reconstruction parameters in x-ray in-line phase tomography. We demonstrate how these computer vision tools can be used to inject priors on the shape and scale of the object to be reconstructed. This is illustrated with the Paganin single intensity image phase retrieval algorithm in heterogeneous soft tissues of biomedical interest, where the selection of the reconstruction parameters was previously made from visual inspection or physical assumptions on the composition of the sample.

AHA classification of coronary and carotid atherosclerotic plaques by grating-based phase-contrast computed tomography

OBJECTIVES

To evaluate the potential of grating-based phase-contrast computed-tomography (gb-PCCT) to classify human carotid and coronary atherosclerotic plaques according to modified American Heart Association (AHA) criteria.

METHODS

Experiments were carried out at a laboratory-based set-up consisting of X-ray tube (40 kVp), grating-interferometer and detector. Eighteen human carotid and coronary artery specimens were examined. Histopathology served as the standard of reference. Vessel cross-sections were classified as AHA lesion type I/II, III, IV/V, VI, VII or VIII plaques by two independent reviewers blinded to histopathology. Conservative measurements of diagnostic accuracies for the detection and differentiation of plaque types were evaluated.

RESULTS

A total of 127 corresponding gb-PCCT/histopathology sections were analyzed. Based on histopathology, lesion type I/II was present in 12 (9.5 %), III in 18 (14.2 %), IV/V in 38 (29.9 %), VI in 16 (12.6 %), VII in 34 (26.8 %) and VIII in 9 (7.0 %) cross-sections. Sensitivity, specificity and positive and negative predictive value were ≥0.88 for most analyzed plaque types with a good level of agreement (Cohen's kappa = 0.90). Overall, results were better in carotid (kappa = 0.97) than in coronary arteries (kappa = 0.85). Inter-observer agreement was high with kappa = 0.85, p < 0.0001.

CONCLUSIONS

These results indicate that gb-PCCT can reliably classify atherosclerotic plaques according to modified AHA criteria with excellent agreement to histopathology.

KEY POINTS

• Different atherosclerotic plaque types display distinct morphological features in phase-contrast CT. • Phase-contrast CT can detect and differentiate AHA plaque types. • Calcifications caused streak artefacts and reduced sensitivity in type VI lesions. • Overall agreement was higher in carotid than in coronary arteries.

Phase-Contrast Hounsfield Units of Fixated and Non-Fixated Soft-Tissue Samples

X-ray phase-contrast imaging is a novel technology that achieves high soft-tissue contrast. Although its clinical impact is still under investigation, the technique may potentially improve clinical diagnostics. In conventional attenuation-based X-ray computed tomography, radiological diagnostics are quantified by Hounsfield units. Corresponding Hounsfield units for phase-contrast imaging have been recently introduced, enabling a setup-independent comparison and standardized interpretation of imaging results. Thus far, the experimental values of few tissue types have been reported; these values have been determined from fixated tissue samples. This study presents phase-contrast Hounsfield units for various types of non-fixated human soft tissues. A large variety of tissue specimens ranging from adipose, muscle and connective tissues to liver, kidney and pancreas tissues were imaged by a grating interferometer with a rotating-anode X-ray tube and a photon-counting detector. Furthermore, we investigated the effects of formalin fixation on the quantitative phase-contrast imaging results.

Ex Vivo Perfusion-Simulation Measurements of Microbubbles as a Scattering Contrast Agent for Grating-Based X-Ray Dark-Field Imaging

The investigation of dedicated contrast agents for x-ray dark-field imaging, which exploits small-angle scattering at microstructures for contrast generation, is of strong interest in analogy to the common clinical use of high-atomic number contrast media in conventional attenuation-based imaging, since dark-field imaging has proven to provide complementary information. Therefore, agents consisting of gas bubbles, as used in ultrasound imaging for example, are of particular interest. In this work, we investigate an experimental contrast agent based on microbubbles consisting of a polyvinyl-alcohol shell with an iron oxide coating, which was originally developed for multimodal imaging and drug delivery. Its performance as a possible contrast medium for small-animal angiography was examined using a mouse carcass to realistically consider attenuating and scattering background signal. Subtraction images of dark field, phase contrast and attenuation were acquired for a concentration series of 100%, 10% and 1.3% to mimic different stages of dilution in the contrast agent in the blood vessel system. The images were compared to the gold-standard iodine-based contrast agent Solutrast, showing a good contrast improvement by microbubbles in dark-field imaging. This study proves the feasibility of microbubble-based dark-field contrast-enhancement in presence of scattering and attenuating mouse body structures like bone and fur. Therefore, it suggests a strong potential of the use of polymer-based microbubbles for small-animal dark-field angiography.

Quantitative imaging using high-energy X-ray phase-contrast CT with a 70 kVp polychromatic X-ray spectrum

Imaging of large and dense objects with grating-based X-ray phase-contrast computed tomography requires high X-ray photon energy and large fields of view. It has become increasingly possible due to the improvements in the grating manufacturing processes. Using a high-energy X-ray phase-contrast CT setup with a large (10 cm in diameter) analyzer grating and operated at an acceleration tube voltage of 70 kVp, we investigate the complementarity of both attenuation and phase contrast modalities with materials of various atomic numbers (Z). We confirm experimentally that for low-Z materials, phase contrast yields no additional information content over attenuation images, yet it provides increased contrast-to-noise ratios (CNRs). The complementarity of both signals can be seen again with increasing Z of the materials and a more comprehensive material characterization is thus possible. Imaging of a part of a human cervical spine with intervertebral discs surrounded by bones and various soft tissue types showcases the benefit of high-energy X-ray phase-contrast system. Phase-contrast reconstruction reveals the internal structure of the discs and makes the boundary between the disc annulus and nucleus pulposus visible. Despite the fact that it still remains challenging to develop a high-energy grating interferometer with a broad polychromatic source with satisfactory optical performance, improved image quality for phase contrast as compared to attenuation contrast can be obtained and new exciting applications foreseen.

Energy-resolved visibility analysis of grating interferometers operated at polychromatic X-ray sources

Grating interferometry has been successfully adapted at standard X-ray tubes and is a promising candidate for a broad use of phase-contrast imaging in medical diagnostics or industrial testing. The achievable image quality using this technique is mainly dependent on the interferometer performance with the interferometric visibility as crucial parameter. The presented study deals with experimental investigations of the spectral dependence of the visibility in order to understand the interaction between the single contributing energies. Especially for the choice which type of setup has to be preferred using a polychromatic source, this knowledge is highly relevant. Our results affirm previous findings from theoretical investigations but also show that measurements of the spectral contributions to the visibility are necessary to fully characterize and optimize a grating interferometer and cannot be replaced by only relying on simulated data up to now.

Large-angle x-ray scatter in Talbot-Lau interferometry for breast imaging

Monte Carlo simulations were used to investigate large-angle x-ray scatter at design energy of 25 keV during small field of view (9.6 cm × 5 cm) differential phase contrast imaging of the breast using Talbot-Lau interferometry. Homogenous, adipose and fibroglandular breasts of uniform thickness ranging from 2 to 8 cm encompassing the field of view were modeled. Theoretically determined transmission efficiencies of the gratings were used to validate the Monte Carlo simulations, followed by simulations to determine the x-ray scatter reaching the detector. The recorded x-ray scatter was classified into x-ray photons that underwent at least one Compton interaction (incoherent scatter) and Rayleigh interaction alone (coherent scatter) for further analysis. Monte Carlo based estimates of transmission efficiencies showed good correspondence [Formula: see text] with theoretical estimates. Scatter-to-primary ratio increased with increasing breast thickness, ranging from 0.11 to 0.22 for 2-8 cm thick adipose breasts and from 0.12 to 0.28 for 2-8 cm thick fibroglandular breasts. The analyzer grating reduced incoherent scatter by ~18% for 2 cm thick adipose breast and by ~35% for 8 cm thick fibroglandular breast. Coherent scatter was the dominant contributor to the total scatter. Coherent-to-incoherent scatter ratio ranged from 2.2 to 3.1 for 2-8 cm thick adipose breasts and from 2.7 to 3.4 for 2-8 cm thick fibroglandular breasts.

Micro-CT of rodents: state-of-the-art and future perspectives

Micron-scale computed tomography (micro-CT) is an essential tool for phenotyping and for elucidating diseases and their therapies. This work is focused on preclinical micro-CT imaging, reviewing relevant principles, technologies, and applications. Commonly, micro-CT provides high-resolution anatomic information, either on its own or in conjunction with lower-resolution functional imaging modalities such as positron emission tomography (PET) and single-photon emission computed tomography (SPECT). More recently, however, advanced applications of micro-CT produce functional information by translating clinical applications to model systems (e.g., measuring cardiac functional metrics) and by pioneering new ones (e.g. measuring tumor vascular permeability with nanoparticle contrast agents). The primary limitations of micro-CT imaging are the associated radiation dose and relatively poor soft tissue contrast. We review several image reconstruction strategies based on iterative, statistical, and gradient sparsity regularization, demonstrating that high image quality is achievable with low radiation dose given ever more powerful computational resources. We also review two contrast mechanisms under intense development. The first is spectral contrast for quantitative material discrimination in combination with passive or actively targeted nanoparticle contrast agents. The second is phase contrast which measures refraction in biological tissues for improved contrast and potentially reduced radiation dose relative to standard absorption imaging. These technological advancements promise to develop micro-CT into a commonplace, functional and even molecular imaging modality.

FMT-PCCT: hybrid fluorescence molecular tomography-x-ray phase-contrast CT imaging of mouse models

The implementation of hybrid fluorescence molecular tomography (FMT) and X-ray computed tomography (CT) has been shown to be a necessary development, not only for combining anatomical with functional and molecular contrast, but also for generating optical images of high accuracy. FMT affords highly sensitive 3-D imaging of fluorescence bio-distribution, but in stand-alone form it offers images of low resolution. It was shown that FMT accuracy significantly improves by considering anatomical priors from CT. Conversely, CT generally suffers from low soft tissue contrast. Therefore utilization of CT data as prior information in FMT inversion is challenging when different internal organs are not clearly differentiated. Instead, we combined herein FMT with emerging X-ray phase-contrast CT (PCCT). PCCT relies on phase shift differences in tissue to achieve soft tissue contrast superior to conventional CT. We demonstrate for the first time FMT-PCCT imaging of different animal models, where FMT and PCCT scans were performed in vivo and ex vivo, respectively. The results show that FMT-PCCT expands the potential of FMT in imaging lesions with otherwise low or no CT contrast, while retaining the cost benefits of CT and simplicity of hybrid device realizations. The results point to the most accurate FMT performance to date.

Visualizing typical features of breast fibroadenomas using phase-contrast CT: an ex-vivo study

Background

Fibroadenoma is the most common benign solid breast lesion type and a very common cause for histologic assessment. To justify a conservative therapy, a highly specific discrimination between fibroadenomas and other breast lesions is crucial. Phase-contrast imaging offers improved soft-tissue contrast and differentiability of fine structures combined with the potential of 3-dimensional imaging. In this study we assessed the potential of grating-based phase-contrast CT imaging for visualizing diagnostically relevant features of fibroadenomas.

Materials and Methods

Grating-based phase-contrast CT was performed on six ex-vivo formalin-fixed breast specimens containing a fibroadenoma and three samples containing benign changes that resemble fibroadenomas using Talbot Lau interferometry and a polychromatic X-ray source. Phase-contrast and simultaneously acquired absorption-based 3D-datasets were manually matched with corresponding histological slices. The visibility of diagnostically valuable features was assessed in comparison with histology as the gold-standard.

Results

In all cases, matching of grating-based phase-contrast CT images and histology was successfully completed. Grating-based phase-contrast CT showed greatly improved differentiation of fine structures and provided accurate depiction of strands of fibrous tissue within the fibroadenomas as well as of the diagnostically valuable dilated, branched ductuli of the fibroadenomas. A clear demarcation of tumor boundaries in all cases was provided by phase- but not absorption-contrast CT.

Conclusions

Pending successful translation of the technology to a clinical setting and considerable reduction of the required dose, the data presented here suggest that grating-based phase-contrast CT may be used as a supplementary non-invasive diagnostic tool in breast diagnostics. Phase-contrast CT may thus contribute to the reduction of false positive findings and reduce the recall and core biopsy rate in population-based screening. Phase-contrast CT may further be used to assist during histopathological workup, offering a 3D view of the tumor and helping to identify diagnostically valuable tissue sections within large tumors.