1
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Partridge T, Wolfson P, Jiang J, Massimi L, Astolfo A, Djurabekova N, Savvidis S, Jones CJM, Hagen CK, Millard E, Shorrock W, Waltham RM, Haig IG, Bate D, Ho KMA, Mc Bain H, Wilson A, Hogan A, Delaney H, Liyadipita A, Levine AP, Dawas K, Mohammadi B, Qureshi YA, Chouhan MD, Taylor SA, Mughal M, Munro PRT, Endrizzi M, Novelli M, Lovat LB, Olivo A. T staging esophageal tumors with x rays. OPTICA 2024; 11:569-576. [PMID: 39006164 PMCID: PMC11239146 DOI: 10.1364/optica.501948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 03/05/2024] [Accepted: 04/07/2024] [Indexed: 07/16/2024]
Abstract
With histopathology results typically taking several days, the ability to stage tumors during interventions could provide a step change in various cancer interventions. X-ray technology has advanced significantly in recent years with the introduction of phase-based imaging methods. These have been adapted for use in standard labs rather than specialized facilities such as synchrotrons, and approaches that enable fast 3D scans with conventional x-ray sources have been developed. This opens the possibility to produce 3D images with enhanced soft tissue contrast at a level of detail comparable to histopathology, in times sufficiently short to be compatible with use during surgical interventions. In this paper we discuss the application of one such approach to human esophagi obtained from esophagectomy interventions. We demonstrate that the image quality is sufficiently high to enable tumor T staging based on the x-ray datasets alone. Alongside detection of involved margins with potentially life-saving implications, staging tumors intra-operatively has the potential to change patient pathways, facilitating optimization of therapeutic interventions during the procedure itself. Besides a prospective intra-operative use, the availability of high-quality 3D images of entire esophageal tumors can support histopathological characterization, from enabling "right slice first time" approaches to understanding the histopathology in the full 3D context of the surrounding tumor environment.
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Affiliation(s)
- T. Partridge
- Department of Medical Physics and Biomedical Engineering, University College London, London WC1E 6BT, UK
| | - P. Wolfson
- Department of Medical Physics and Biomedical Engineering, University College London, London WC1E 6BT, UK
- Division of Surgery and Interventional Science, UCL, London WC1E 6BT, UK
| | - J. Jiang
- Department of Medical Physics and Biomedical Engineering, University College London, London WC1E 6BT, UK
- Current address: Advanced Photon Source, Argonne National Laboratory, Lemont, Illinois 60439, USA
| | - L. Massimi
- Department of Medical Physics and Biomedical Engineering, University College London, London WC1E 6BT, UK
| | - A. Astolfo
- Department of Medical Physics and Biomedical Engineering, University College London, London WC1E 6BT, UK
- Nikon X-Tek Systems Ltd., Tring, Herts HP23 4JX, UK
| | - N. Djurabekova
- Department of Computer Science, UCL, London WC1E 6BT, UK
| | - S. Savvidis
- Department of Medical Physics and Biomedical Engineering, University College London, London WC1E 6BT, UK
| | - C. J. Maughan Jones
- Department of Medical Physics and Biomedical Engineering, University College London, London WC1E 6BT, UK
| | - C. K. Hagen
- Department of Medical Physics and Biomedical Engineering, University College London, London WC1E 6BT, UK
| | - E. Millard
- Nikon X-Tek Systems Ltd., Tring, Herts HP23 4JX, UK
| | - W. Shorrock
- Nikon X-Tek Systems Ltd., Tring, Herts HP23 4JX, UK
| | | | - I. G. Haig
- Nikon X-Tek Systems Ltd., Tring, Herts HP23 4JX, UK
| | - D. Bate
- Department of Medical Physics and Biomedical Engineering, University College London, London WC1E 6BT, UK
- Nikon X-Tek Systems Ltd., Tring, Herts HP23 4JX, UK
| | - K. M. A. Ho
- Division of Surgery and Interventional Science, UCL, London WC1E 6BT, UK
| | - H. Mc Bain
- Division of Surgery and Interventional Science, UCL, London WC1E 6BT, UK
| | - A. Wilson
- Division of Surgery and Interventional Science, UCL, London WC1E 6BT, UK
| | - A. Hogan
- Division of Surgery and Interventional Science, UCL, London WC1E 6BT, UK
| | - H. Delaney
- Department of Histopathology, UCL, London WC1E 6BT, UK
| | - A. Liyadipita
- Department of Histopathology, UCL, London WC1E 6BT, UK
| | - A. P. Levine
- Department of Histopathology, UCL, London WC1E 6BT, UK
| | - K. Dawas
- Department of Upper Gastro-Intestinal Surgery, UCLH, London NW1 2BU, UK
| | - B. Mohammadi
- Department of Upper Gastro-Intestinal Surgery, UCLH, London NW1 2BU, UK
| | - Y. A. Qureshi
- Department of Upper Gastro-Intestinal Surgery, UCLH, London NW1 2BU, UK
| | - M. D. Chouhan
- Center for Medical Imaging, Division of Medicine, UCL, London WC1E 6BT, UK
- Princess Alexandra Hospital Medical Imaging Department, Brisbane, Queensland, Australia
- University of Queensland Medical School, Saint Lucia, Queensland, Australia
| | - S. A. Taylor
- Center for Medical Imaging, Division of Medicine, UCL, London WC1E 6BT, UK
| | - M. Mughal
- Department of Upper Gastro-Intestinal Surgery, UCLH, London NW1 2BU, UK
| | - P. R. T. Munro
- Department of Medical Physics and Biomedical Engineering, University College London, London WC1E 6BT, UK
| | - M. Endrizzi
- Department of Medical Physics and Biomedical Engineering, University College London, London WC1E 6BT, UK
| | - M. Novelli
- Research Department of Pathology, Cancer Institute, UCLH, London NW1 2BU, UK
| | - L. B. Lovat
- Division of Surgery and Interventional Science, UCL, London WC1E 6BT, UK
| | - A. Olivo
- Department of Medical Physics and Biomedical Engineering, University College London, London WC1E 6BT, UK
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2
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Zalis ME, Slutzman JE. Technical and Administrative Advances to Promote Sustainable Radiology. J Am Coll Radiol 2024; 21:274-279. [PMID: 38048966 DOI: 10.1016/j.jacr.2023.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 11/30/2023] [Accepted: 12/01/2023] [Indexed: 12/06/2023]
Abstract
Climate change mandates that we take steps to understand and mitigate the negative environmental consequences of the practice of health care, so that health care advances sustainably. In this article, the authors review and discuss a sample of technical and administrative advances required to align the practice of radiology with principles of environmental sustainability.
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Affiliation(s)
- Michael E Zalis
- Director, Mass General Brigham Radiology Center for Sustainability, Boston, Massachusetts; Divisions of Cardiovascular and Interventional Radiology, Department of Radiology, Mass General Hospital, Boston, Massachusetts.
| | - Jonathan E Slutzman
- Director, Mass General Center for the Environment and Health, Massachusetts General Hospital, Boston, Massachusetts; Department of Emergency Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
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3
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Furlani M, Riberti N, Gatto ML, Giuliani A. High-Resolution Phase-Contrast Tomography on Human Collagenous Tissues: A Comprehensive Review. Tomography 2023; 9:2116-2133. [PMID: 38133070 PMCID: PMC10748183 DOI: 10.3390/tomography9060166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 11/07/2023] [Accepted: 11/22/2023] [Indexed: 12/23/2023] Open
Abstract
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.
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Affiliation(s)
- Michele Furlani
- Department DISCO, Università Politecnica delle Marche, Via Brecce Bianche 12, 60131 Ancona, Italy;
| | - Nicole Riberti
- Neuroscience Imaging and Clinical Sciences Department, University of Chieti-Pescara, 66100 Chieti, Italy;
| | - Maria Laura Gatto
- Department DIISM, Università Politecnica delle Marche, Via Brecce Bianche 12, 60131 Ancona, Italy;
| | - Alessandra Giuliani
- Department DISCO, Università Politecnica delle Marche, Via Brecce Bianche 12, 60131 Ancona, Italy;
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4
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Arana Peña LM, Donato S, Bonazza D, Brombal L, Martellani F, Arfelli F, Tromba G, Longo R. Multiscale X-ray phase-contrast tomography: From breast CT to micro-CT for virtual histology. Phys Med 2023; 112:102640. [PMID: 37441823 DOI: 10.1016/j.ejmp.2023.102640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 05/31/2023] [Accepted: 07/04/2023] [Indexed: 07/15/2023] Open
Abstract
Phase-contrast imaging techniques address the issue of poor soft-tissue contrast encountered in traditional X-ray imaging. This can be accomplished with the propagation-based phase-contrast technique by employing a coherent photon beam, which is available at synchrotron facilities, as well as long sample-to-detector distances. This study demonstrates the optimization of propagation-based phase-contrast computed tomography (CT) techniques for multiscale X-ray imaging of the breast at the Elettra synchrotron facility (Trieste, Italy). Two whole breast mastectomy samples were acquired with propagation-based breast-CT using a monochromatic synchrotron beam at a pixel size of 60 µm. Paraffin-embedded blocks sampled from the same tissues were scanned with propagation-based micro-CT imaging using a polychromatic synchrotron beam at a pixel size of 4 µm. Images of both methodologies and of the same sample were spatially registered. The resulting images showed the transition from whole breast imaging with propagation-based breast-CT methodology to virtual histology with propagation-based micro-CT imaging of the same sample. Additionally, conventional histological images were matched to virtual histology images. Phase-contrast images offer a high resolution with low noise, which allows for a highly precise match between virtual and conventional histology. Furthermore, those techniques allow a clear discernment of breast structures, lesions, and microcalcifications, being a promising clinically-compatible tool for breast imaging in a multiscale approach, to either assist in the detection of cancer in full volume breast samples or to complement structure identification in paraffin-embedded breast tissue samples.
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Affiliation(s)
- L M Arana Peña
- Department of Physics, University of Trieste, Via Alfonso Valerio 2, Trieste I-34127, Italy; INFN Division of Trieste, 34127 Trieste, Italy; Elettra-Sincrotrone Trieste, SS 14 Km 163,5, AREA Science Park, 34149 Basovizza, (Trieste), Italy
| | - S Donato
- Department of Physics and STAR Lab, University of Calabria, Via P. Bucci 31C, Rende, (CS), I-87036, Italy; INFN Division of Frascati, Via E. Fermi 54, Frascati I-00044, Italy.
| | - D Bonazza
- Unit of Surgical Pathology, Cattinara Hospital, Azienda Sanitaria Universitaria Giuliana Isontina (ASUGI), Strada di Fiume, 447, Trieste I-34149, Italy
| | - L Brombal
- Department of Physics, University of Trieste, Via Alfonso Valerio 2, Trieste I-34127, Italy; INFN Division of Trieste, 34127 Trieste, Italy
| | - F Martellani
- Unit of Surgical Pathology, Cattinara Hospital, Azienda Sanitaria Universitaria Giuliana Isontina (ASUGI), Strada di Fiume, 447, Trieste I-34149, Italy
| | - F Arfelli
- Department of Physics, University of Trieste, Via Alfonso Valerio 2, Trieste I-34127, Italy; INFN Division of Trieste, 34127 Trieste, Italy
| | - G Tromba
- Elettra-Sincrotrone Trieste, SS 14 Km 163,5, AREA Science Park, 34149 Basovizza, (Trieste), Italy
| | - R Longo
- Department of Physics, University of Trieste, Via Alfonso Valerio 2, Trieste I-34127, Italy; INFN Division of Trieste, 34127 Trieste, Italy
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5
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Polikarpov M, Vila-Comamala J, Wang Z, Pereira A, van Gogh S, Gasser C, Jefimovs K, Romano L, Varga Z, Lång K, Schmeltz M, Tessarini S, Rawlik M, Jermann E, Lewis S, Yun W, Stampanoni M. Towards virtual histology with X-ray grating interferometry. Sci Rep 2023; 13:9049. [PMID: 37270642 DOI: 10.1038/s41598-023-35854-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 05/24/2023] [Indexed: 06/05/2023] Open
Abstract
Breast cancer is the most common type of cancer worldwide. Diagnosing breast cancer relies on clinical examination, imaging and biopsy. A core-needle biopsy enables a morphological and biochemical characterization of the cancer and is considered the gold standard for breast cancer diagnosis. A histopathological examination uses high-resolution microscopes with outstanding contrast in the 2D plane, but the spatial resolution in the third, Z-direction, is reduced. In the present paper, we propose two high-resolution table-top systems for phase-contrast X-ray tomography of soft-tissue samples. The first system implements a classical Talbot-Lau interferometer and allows to perform ex-vivo imaging of human breast samples with a voxel size of 5.57 μm. The second system with a comparable voxel size relies on a Sigray MAAST X-ray source with structured anode. For the first time, we demonstrate the applicability of the latter to perform X-ray imaging of human breast specimens with ductal carcinoma in-situ. We assessed image quality of both setups and compared it to histology. We showed that both setups made it possible to target internal features of breast specimens with better resolution and contrast than previously achieved, demonstrating that grating-based phase-contrast X-ray CT could be a complementary tool for clinical histopathology.
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Affiliation(s)
- M Polikarpov
- Swiss Light Source, Paul Scherrer Institut, 5232, Villigen-PSI, Switzerland.
- Institute for Biomedical Engineering, ETH Zurich, 8092, Zurich, Switzerland.
| | - J Vila-Comamala
- Swiss Light Source, Paul Scherrer Institut, 5232, Villigen-PSI, Switzerland
| | - Z Wang
- Swiss Light Source, Paul Scherrer Institut, 5232, Villigen-PSI, Switzerland
- Institute for Biomedical Engineering, ETH Zurich, 8092, Zurich, Switzerland
- Department of Engineering Physics, Tsinghua University, Haidian District, Beijing, 100080, China
| | - A Pereira
- Swiss Light Source, Paul Scherrer Institut, 5232, Villigen-PSI, Switzerland
- Institute for Biomedical Engineering, ETH Zurich, 8092, Zurich, Switzerland
| | - S van Gogh
- Swiss Light Source, Paul Scherrer Institut, 5232, Villigen-PSI, Switzerland
- Institute for Biomedical Engineering, ETH Zurich, 8092, Zurich, Switzerland
| | - C Gasser
- Institute for Biomedical Engineering, ETH Zurich, 8092, Zurich, Switzerland
| | - K Jefimovs
- Swiss Light Source, Paul Scherrer Institut, 5232, Villigen-PSI, Switzerland
| | - L Romano
- Swiss Light Source, Paul Scherrer Institut, 5232, Villigen-PSI, Switzerland
- Institute for Biomedical Engineering, ETH Zurich, 8092, Zurich, Switzerland
| | - Z Varga
- Department of Pathology and Molecular Pathology, University Hospital Zürich, 8091, Zurich, Switzerland
| | - K Lång
- Department of Diagnostic Radiology, Translational Medicine, Lund University, Lund, Sweden
- Unilabs Mammography Unit, Skåne University Hospital, Malmö, Sweden
| | - M Schmeltz
- Swiss Light Source, Paul Scherrer Institut, 5232, Villigen-PSI, Switzerland
| | - S Tessarini
- Swiss Light Source, Paul Scherrer Institut, 5232, Villigen-PSI, Switzerland
- Institute for Biomedical Engineering, ETH Zurich, 8092, Zurich, Switzerland
| | - M Rawlik
- Swiss Light Source, Paul Scherrer Institut, 5232, Villigen-PSI, Switzerland
- Institute for Biomedical Engineering, ETH Zurich, 8092, Zurich, Switzerland
| | | | - S Lewis
- Sigray Inc., Concord, CA, 94520, USA
| | - W Yun
- Sigray Inc., Concord, CA, 94520, USA
| | - M Stampanoni
- Swiss Light Source, Paul Scherrer Institut, 5232, Villigen-PSI, Switzerland
- Institute for Biomedical Engineering, ETH Zurich, 8092, Zurich, Switzerland
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6
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Duan X, Li N, Cooper DML, Ding XF, Chen X, Zhu N. Low-density tissue scaffold imaging by synchrotron radiation propagation-based imaging computed tomography with helical acquisition mode. JOURNAL OF SYNCHROTRON RADIATION 2023; 30:417-429. [PMID: 36891855 PMCID: PMC10000810 DOI: 10.1107/s1600577523000772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 01/29/2023] [Indexed: 06/18/2023]
Abstract
Visualization of low-density tissue scaffolds made from hydrogels is important yet challenging in tissue engineering and regenerative medicine (TERM). For this, synchrotron radiation propagation-based imaging computed tomography (SR-PBI-CT) has great potential, but is limited due to the ring artifacts commonly observed in SR-PBI-CT images. To address this issue, this study focuses on the integration of SR-PBI-CT and helical acquisition mode (i.e. SR-PBI-HCT) to visualize hydrogel scaffolds. The influence of key imaging parameters on the image quality of hydrogel scaffolds was investigated, including the helical pitch (p), photon energy (E) and the number of acquisition projections per rotation/revolution (Np), and, on this basis, those parameters were optimized to improve image quality and to reduce noise level and artifacts. The results illustrate that SR-PBI-HCT imaging shows impressive advantages in avoiding ring artifacts with p = 1.5, E = 30 keV and Np = 500 for the visualization of hydrogel scaffolds in vitro. Furthermore, the results also demonstrate that hydrogel scaffolds can be visualized using SR-PBI-HCT with good contrast while at a low radiation dose, i.e. 342 mGy (voxel size of 26 µm, suitable for in vivo imaging). This paper presents a systematic study on hydrogel scaffold imaging using SR-PBI-HCT and the results reveal that SR-PBI-HCT is a powerful tool for visualizing and characterizing low-density scaffolds with a high image quality in vitro. This work represents a significant advance toward the non-invasive in vivo visualization and characterization of hydrogel scaffolds at a suitable radiation dose.
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Affiliation(s)
- Xiaoman Duan
- Division of Biomedical Engineering, College of Engineering, University of Saskatchewan, Saskatoon, SK S7N 5A9, Canada
| | - Naitao Li
- Division of Biomedical Engineering, College of Engineering, University of Saskatchewan, Saskatoon, SK S7N 5A9, Canada
| | - David M. L. Cooper
- Department of Anatomy, Physiology and Pharmacology, College of Medicine, University of Saskatchewan, Saskatoon, SK S7N 5A9, Canada
| | - Xiao Fan Ding
- Division of Biomedical Engineering, College of Engineering, University of Saskatchewan, Saskatoon, SK S7N 5A9, Canada
| | - Xiongbiao Chen
- Division of Biomedical Engineering, College of Engineering, University of Saskatchewan, Saskatoon, SK S7N 5A9, Canada
- Department of Mechanical Engineering, College of Engineering, University of Saskatchewan, Saskatoon, SK S7N 5A9, Canada
| | - Ning Zhu
- Division of Biomedical Engineering, College of Engineering, University of Saskatchewan, Saskatoon, SK S7N 5A9, Canada
- Department of Chemical and Biological Engineering, College of Engineering, University of Saskatchewan, Saskatoon, SK S7N 5A9, Canada
- Canadian Light Source, Saskatoon, SK S7N 2V3, Canada
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7
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Fajardo LL, Hillis SL, Zheng B, Wong MD, Ghani MU, Omoumi FH, Li Y, Jenkins P, Peterson ME, Wu X, Liu H. A Pilot Study to Assess the Performance of Phase-Sensitive Breast Tomosynthesis. Radiology 2023; 306:e213198. [PMID: 36165790 PMCID: PMC9885338 DOI: 10.1148/radiol.213198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 07/22/2022] [Accepted: 08/09/2022] [Indexed: 01/26/2023]
Abstract
Background A new modality, phase-sensitive breast tomosynthesis (PBT), may have similar diagnostic performance to conventional breast tomosynthesis but with a reduced radiation dose. Purpose To perform a pilot study of the performance of a novel PBT system compared with conventional digital breast tomosynthesis (DBT) in patients undergoing additional diagnostic imaging workup for breast lesions. Materials and Methods In a prospective study from June 2020 to March 2021, participants with suspicious breast lesions detected at screening DBT or MRI were recruited for additional PBT imaging before additional diagnostic workup or biopsy. In this pilot study, nine radiologists independently evaluated image quality and assessed the likelihood of lesion malignancy by retrospectively evaluating DBT and PBT images in two separate reading sessions. Image quality was rated subjectively using a Likert scale from 1 to 5. Areas under the receiver operating characteristic curve (AUCs) were used to compare the lesion classification (malignant vs benign) performance of the radiologists. Results Images in 50 patients (mean age, 56 years ± 12 [SD]; 49 women) with 52 evaluable lesions (28 malignant) were assessed. For image appearance and general feature visibility, DBT images had a higher total mean image quality score (3.8) than PBT images (2.9), with P < .002 for each comparison. For classification of lesions as benign or malignant, the AUCs were 0.74 for both PBT and DBT. PBT images were acquired at a 24% mean radiation dose reduction (mean, 1.78 mGy vs 2.34 mGy for DBT; P < .001). Conclusion The phase-sensitive breast tomosynthesis system had a 24% lower mean radiation dose compared with digital breast tomosynthesis, although with lower image quality. Diagnostic performance of the system remains to be determined in larger studies. © RSNA, 2022 Online supplemental material is available for this article. See also the editorial by Gao and Moy in this issue.
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Affiliation(s)
- Laurie L. Fajardo
- From the Department of Radiology and Imaging Sciences, University of
Utah, Salt Lake City, Utah (L.L.F., P.J., M.E.P.); Departments of Radiology and
Biostatistics, University of Iowa, Iowa City, Iowa (S.L.H.); Advanced Medical
Imaging Center and School of Electrical and Computer Engineering, University of
Oklahoma, Norman, OK 73019 (B.Z., M.D.W., M.U.G., F.H.O., Y.L., H.L.); and
Department of Radiology, University of Alabama at Birmingham, Birmingham, Ala
(X.W.)
| | - Stephen L. Hillis
- From the Department of Radiology and Imaging Sciences, University of
Utah, Salt Lake City, Utah (L.L.F., P.J., M.E.P.); Departments of Radiology and
Biostatistics, University of Iowa, Iowa City, Iowa (S.L.H.); Advanced Medical
Imaging Center and School of Electrical and Computer Engineering, University of
Oklahoma, Norman, OK 73019 (B.Z., M.D.W., M.U.G., F.H.O., Y.L., H.L.); and
Department of Radiology, University of Alabama at Birmingham, Birmingham, Ala
(X.W.)
| | - Bin Zheng
- From the Department of Radiology and Imaging Sciences, University of
Utah, Salt Lake City, Utah (L.L.F., P.J., M.E.P.); Departments of Radiology and
Biostatistics, University of Iowa, Iowa City, Iowa (S.L.H.); Advanced Medical
Imaging Center and School of Electrical and Computer Engineering, University of
Oklahoma, Norman, OK 73019 (B.Z., M.D.W., M.U.G., F.H.O., Y.L., H.L.); and
Department of Radiology, University of Alabama at Birmingham, Birmingham, Ala
(X.W.)
| | - Molly Donovan Wong
- From the Department of Radiology and Imaging Sciences, University of
Utah, Salt Lake City, Utah (L.L.F., P.J., M.E.P.); Departments of Radiology and
Biostatistics, University of Iowa, Iowa City, Iowa (S.L.H.); Advanced Medical
Imaging Center and School of Electrical and Computer Engineering, University of
Oklahoma, Norman, OK 73019 (B.Z., M.D.W., M.U.G., F.H.O., Y.L., H.L.); and
Department of Radiology, University of Alabama at Birmingham, Birmingham, Ala
(X.W.)
| | - Muhammad U. Ghani
- From the Department of Radiology and Imaging Sciences, University of
Utah, Salt Lake City, Utah (L.L.F., P.J., M.E.P.); Departments of Radiology and
Biostatistics, University of Iowa, Iowa City, Iowa (S.L.H.); Advanced Medical
Imaging Center and School of Electrical and Computer Engineering, University of
Oklahoma, Norman, OK 73019 (B.Z., M.D.W., M.U.G., F.H.O., Y.L., H.L.); and
Department of Radiology, University of Alabama at Birmingham, Birmingham, Ala
(X.W.)
| | - Farid H. Omoumi
- From the Department of Radiology and Imaging Sciences, University of
Utah, Salt Lake City, Utah (L.L.F., P.J., M.E.P.); Departments of Radiology and
Biostatistics, University of Iowa, Iowa City, Iowa (S.L.H.); Advanced Medical
Imaging Center and School of Electrical and Computer Engineering, University of
Oklahoma, Norman, OK 73019 (B.Z., M.D.W., M.U.G., F.H.O., Y.L., H.L.); and
Department of Radiology, University of Alabama at Birmingham, Birmingham, Ala
(X.W.)
| | - Yuhua Li
- From the Department of Radiology and Imaging Sciences, University of
Utah, Salt Lake City, Utah (L.L.F., P.J., M.E.P.); Departments of Radiology and
Biostatistics, University of Iowa, Iowa City, Iowa (S.L.H.); Advanced Medical
Imaging Center and School of Electrical and Computer Engineering, University of
Oklahoma, Norman, OK 73019 (B.Z., M.D.W., M.U.G., F.H.O., Y.L., H.L.); and
Department of Radiology, University of Alabama at Birmingham, Birmingham, Ala
(X.W.)
| | - Peter Jenkins
- From the Department of Radiology and Imaging Sciences, University of
Utah, Salt Lake City, Utah (L.L.F., P.J., M.E.P.); Departments of Radiology and
Biostatistics, University of Iowa, Iowa City, Iowa (S.L.H.); Advanced Medical
Imaging Center and School of Electrical and Computer Engineering, University of
Oklahoma, Norman, OK 73019 (B.Z., M.D.W., M.U.G., F.H.O., Y.L., H.L.); and
Department of Radiology, University of Alabama at Birmingham, Birmingham, Ala
(X.W.)
| | - Michael E. Peterson
- From the Department of Radiology and Imaging Sciences, University of
Utah, Salt Lake City, Utah (L.L.F., P.J., M.E.P.); Departments of Radiology and
Biostatistics, University of Iowa, Iowa City, Iowa (S.L.H.); Advanced Medical
Imaging Center and School of Electrical and Computer Engineering, University of
Oklahoma, Norman, OK 73019 (B.Z., M.D.W., M.U.G., F.H.O., Y.L., H.L.); and
Department of Radiology, University of Alabama at Birmingham, Birmingham, Ala
(X.W.)
| | - Xizeng Wu
- From the Department of Radiology and Imaging Sciences, University of
Utah, Salt Lake City, Utah (L.L.F., P.J., M.E.P.); Departments of Radiology and
Biostatistics, University of Iowa, Iowa City, Iowa (S.L.H.); Advanced Medical
Imaging Center and School of Electrical and Computer Engineering, University of
Oklahoma, Norman, OK 73019 (B.Z., M.D.W., M.U.G., F.H.O., Y.L., H.L.); and
Department of Radiology, University of Alabama at Birmingham, Birmingham, Ala
(X.W.)
| | - Hong Liu
- From the Department of Radiology and Imaging Sciences, University of
Utah, Salt Lake City, Utah (L.L.F., P.J., M.E.P.); Departments of Radiology and
Biostatistics, University of Iowa, Iowa City, Iowa (S.L.H.); Advanced Medical
Imaging Center and School of Electrical and Computer Engineering, University of
Oklahoma, Norman, OK 73019 (B.Z., M.D.W., M.U.G., F.H.O., Y.L., H.L.); and
Department of Radiology, University of Alabama at Birmingham, Birmingham, Ala
(X.W.)
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8
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Gao Y, Moy L. Phase-Sensitive Breast Tomosynthesis May Address Shortcomings of Digital Breast Tomosynthesis. Radiology 2023; 306:e222184. [PMID: 36165798 PMCID: PMC9885346 DOI: 10.1148/radiol.222184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 09/02/2022] [Accepted: 09/07/2022] [Indexed: 01/26/2023]
Affiliation(s)
- Yiming Gao
- From the Department of Radiology, Laura and Isaac Perlmutter Cancer
Center (Y.G., L.M.), Center for Biomedical Imaging (L.M.), and Center for
Advanced Imaging Innovation and Research (L.M.), New York University Grossman
School of Medicine, 160 E 34th St, 3rd Floor, New York, NY 10016
| | - Linda Moy
- From the Department of Radiology, Laura and Isaac Perlmutter Cancer
Center (Y.G., L.M.), Center for Biomedical Imaging (L.M.), and Center for
Advanced Imaging Innovation and Research (L.M.), New York University Grossman
School of Medicine, 160 E 34th St, 3rd Floor, New York, NY 10016
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9
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Savvidis S, Gerli MF, Pellegrini M, Massimi L, Hagen CK, Endrizzi M, Atzeni A, Ogunbiyi OK, Turmaine M, Smith ES, Fagiani C, Selmin G, Urbani L, Durkin N, Shibuya S, De Coppi P, Olivo A. Monitoring tissue engineered constructs and protocols with laboratory-based x-ray phase contrast tomography. Acta Biomater 2022; 141:290-299. [PMID: 35051630 DOI: 10.1016/j.actbio.2022.01.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 12/21/2021] [Accepted: 01/12/2022] [Indexed: 11/01/2022]
Abstract
Tissue engineering (TE) aims to generate bioengineered constructs which can offer a surgical treatment for many conditions involving tissue or organ loss. Construct generation must be guided by suitable assessment tools. However, most current tools (e.g. histology) are destructive, which restricts evaluation to a single-2D anatomical plane, and has no potential for assessing constructs prior to or following their implantation. An alternative can be provided by laboratory-based x-ray phase contrast computed tomography (PC-CT), which enables the extraction of 3D density maps of an organ's anatomy. In this work, we developed a semi-automated image processing pipeline dedicated to the analysis of PC-CT slices of oesophageal constructs. Visual and quantitative (density and morphological) information is extracted on a volumetric basis, enabling a comprehensive evaluation of the regenerated constructs. We believe the presented tools can enable the successful regeneration of patient-specific oesophagus, and bring comparable benefit to a wide range of TE applications. STATEMENT OF SIGNIFICANCE: Phase contrast computed tomography (PC-CT) is an imaging modality which generates high resolution volumetric density maps of biological tissue. In this work, we demonstrate the use of PC-CT as a new tool for guiding the progression of an oesophageal tissue engineering (TE) protocol. Specifically, we developed a semi-automated image-processing pipeline which analyses the oesophageal PC-CT slices, extracting visual and quantitative (density and morphological) information. This information was proven key for performing a comprehensive evaluation of the regenerated constructs, and cannot be obtained through existing assessment tools primarily due to their destructive nature (e.g. histology). This work paves the way for using PC-CT in a wide range of TE applications which can be pivotal for unlocking the potential of this field.
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10
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Mettivier G, di Franco F, Sarno A, Castriconi R, Di Lillo F, Bliznakova K, Russo P. In-Line Phase Contrast Mammography, Phase Contrast Digital Breast Tomosynthesis, and Phase Contrast Breast Computed Tomography With a Dedicated CT Scanner and a Microfocus X-Ray Tube: Experimental Phantom Study. IEEE TRANSACTIONS ON RADIATION AND PLASMA MEDICAL SCIENCES 2021. [DOI: 10.1109/trpms.2020.3003380] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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11
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Ghani MU, Fajardo LL, Omoumi F, Yan A, Jenkins P, Wong M, Li Y, Peterson ME, Callahan EJ, Hillis SL, Zheng B, Wu X, Liu H. A phase sensitive x-ray breast tomosynthesis system: Preliminary patient images with cancer lesions. Phys Med Biol 2021; 66. [PMID: 34633295 DOI: 10.1088/1361-6560/ac2ea6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 10/11/2021] [Indexed: 11/11/2022]
Abstract
Phase-sensitive x-ray imaging continues to attract research for its ability to visualize weakly absorbing details like those often encountered in biology and medicine. We have developed and assembled the first inline-based high-energy phase sensitive breast tomosynthesis (PBT) system, which is currently undergoing patient imaging testing at a clinical site. The PBT system consists of a microfocus polychromatic x-ray source and a direct conversion-based flat panel detector coated with a 1 mm thick amorphous selenium layer allowing a high detective quantum efficiency at high energies. The PBT system scans a compressed breast over 15° with 9 angular projection views. The high-energy scan parameters are carefully selected to ensure similar or lower mean glandular dose levels to the clinical standard of care systems. Phase retrieval and data binning are applied to the phase contrast angular projection views and a filtered back-projection algorithm is used to reconstruct the final images. This article reports the distributions of radiation dose versus thickness of the compressed breasts at 59 and 89 kV and sample PBT images acquired from 3 patients. Preliminary PBT images demonstrate the feasibility of this new imaging modality to acquire breast images at lower radiation dose as compared to the clinical digital breast tomosynthesis system with enhanced lesion characteristics (i.e. lesion spiculation and margins).
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Affiliation(s)
- Muhammad U Ghani
- Advanced Medical Imaging Center and School of Electrical and Computer Engineering, University of Oklahoma, Norman, OK 73019, United States of America
| | - Laurie L Fajardo
- Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, UT 84132, United States of America
| | - Farid Omoumi
- Advanced Medical Imaging Center and School of Electrical and Computer Engineering, University of Oklahoma, Norman, OK 73019, United States of America
| | - Aimin Yan
- Advanced Medical Imaging Center and School of Electrical and Computer Engineering, University of Oklahoma, Norman, OK 73019, United States of America
| | - Peter Jenkins
- Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, UT 84132, United States of America
| | - Molly Wong
- Advanced Medical Imaging Center and School of Electrical and Computer Engineering, University of Oklahoma, Norman, OK 73019, United States of America
| | - Yuhua Li
- Advanced Medical Imaging Center and School of Electrical and Computer Engineering, University of Oklahoma, Norman, OK 73019, United States of America
| | - Michael E Peterson
- Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, UT 84132, United States of America
| | - Edward J Callahan
- Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, UT 84132, United States of America
| | - Stephen L Hillis
- Departments of Radiology and Biostatistics, University of Iowa, Iowa City, IA 52242, United States of America
| | - Bin Zheng
- Advanced Medical Imaging Center and School of Electrical and Computer Engineering, University of Oklahoma, Norman, OK 73019, United States of America
| | - Xizeng Wu
- Department of Radiology, University of Alabama at Birmingham, Birmingham, AL 35249, United States of America
| | - Hong Liu
- Advanced Medical Imaging Center and School of Electrical and Computer Engineering, University of Oklahoma, Norman, OK 73019, United States of America
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12
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Romano M, Bravin DA, Wright DMD, Jacques L, Miettinen DA, Hlushchuk DR, Dinkel J, Bartzsch DS, Laissue JA, Djonov V, Coan DP. X-ray Phase Contrast 3D virtual histology: evaluation of lung alterations after micro-beam irradiation. Int J Radiat Oncol Biol Phys 2021; 112:818-830. [PMID: 34678432 DOI: 10.1016/j.ijrobp.2021.10.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 09/20/2021] [Accepted: 10/05/2021] [Indexed: 12/24/2022]
Abstract
PURPOSE This study provides the first experimental application of multiscale three-dimensional (3D) X-ray Phase Contrast Imaging Computed Tomography (XPCI-CT) virtual histology for the inspection and quantitative assessment of the late stage effects of radio-induced lesions on lungs in a small animal model. METHODS AND MATERIALS Healthy male Fischer rats were irradiated with X-ray standard broad beams and Microbeam Radiation Therapy (MRT), a high dose rate (14 kGy/s), FLASH spatially-fractionated X-ray therapy to avoid the beamlets smearing due to cardiosynchronous movements of the organs during the irradiation. After organ dissection, ex-vivo XPCI-CT was applied to all the samples and the results were quantitatively analysed and correlated to histologic data. RESULTS XPCI-CT enables the 3D visualization of lung tissues with unprecedented contrast and sensitivity allowing alveoli, vessels and bronchi hierarchical visualization. XPCI-CT discriminates in 3D radio-induced lesions such as fibrotic scars, Ca/Fe deposits and, in addition, allows a full-organ accurate quantification of the fibrotic tissue within the irradiated organs. The radiation-induced fibrotic tissue content is less than 10% of the analyzed volume for all the MRT treated organs while it reaches the 34% in the case of irradiations with 50 Gy using a broad beam. CONCLUSIONS XPCI-CT is an effective imaging technique able to provide detailed 3D information for the assessment of lung pathology and treatment efficacy in a small animal model.
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Affiliation(s)
- Mariele Romano
- Faculty of Physics, Ludwig Maximilian University, Am Coulombwall 1, München, Garching, Germany
| | - Dr Alberto Bravin
- European Synchrotron Radiation Facility, 71 Avenue des Martyrs, Grenoble, France, 38000
| | | | - Laurent Jacques
- Faculty of Physics, Ludwig Maximilian University, Am Coulombwall 1, München, Garching, Germany
| | - Dr Arttu Miettinen
- Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland; Swiss Light Source, Paul Scherrer Institut, Villigen, Switzerland
| | - Dr Ruslan Hlushchuk
- Institute of Anatomy, University of Bern, 2 Baltzerstrasse, Bern, Switzerland Department
| | - Julien Dinkel
- Department of Clinical Radiology, Faculty of Medicine, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Dr Stefan Bartzsch
- Department of Radiation Oncology, School of Medicine, Technical University of Munich, Klinikum rechts der Isar, Munich, Germany; Helmholtz Centre Munich, Institute for Radiation Medicine, Munich, Germany
| | - Jean Albert Laissue
- Institute of Anatomy, University of Bern, 2 Baltzerstrasse, Bern, Switzerland Department
| | - Valentin Djonov
- Institute of Anatomy, University of Bern, 2 Baltzerstrasse, Bern, Switzerland Department
| | - Dr Paola Coan
- Faculty of Physics, Ludwig Maximilian University, Am Coulombwall 1, München, Garching, Germany; Department of Clinical Radiology, Faculty of Medicine, Ludwig-Maximilians-Universität München, Munich, Germany.
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13
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Romano M, Bravin A, Mittone A, Eckhardt A, Barbone GE, Sancey L, Dinkel J, Bartzsch S, Ricke J, Alunni-Fabbroni M, Hirner-Eppeneder H, Karpov D, Giannini C, Bunk O, Bouchet A, Ruf V, Giese A, Coan P. A Multi-Scale and Multi-Technique Approach for the Characterization of the Effects of Spatially Fractionated X-ray Radiation Therapies in a Preclinical Model. Cancers (Basel) 2021; 13:cancers13194953. [PMID: 34638437 PMCID: PMC8507698 DOI: 10.3390/cancers13194953] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 09/23/2021] [Accepted: 09/27/2021] [Indexed: 12/15/2022] Open
Abstract
The purpose of this study is to use a multi-technique approach to detect the effects of spatially fractionated X-ray Microbeam (MRT) and Minibeam Radiation Therapy (MB) and to compare them to seamless Broad Beam (BB) irradiation. Healthy- and Glioblastoma (GBM)-bearing male Fischer rats were irradiated in-vivo on the right brain hemisphere with MRT, MB and BB delivering three different doses for each irradiation geometry. Brains were analyzed post mortem by multi-scale X-ray Phase Contrast Imaging-Computed Tomography (XPCI-CT), histology, immunohistochemistry, X-ray Fluorescence (XRF), Small- and Wide-Angle X-ray Scattering (SAXS/WAXS). XPCI-CT discriminates with high sensitivity the effects of MRT, MB and BB irradiations on both healthy and GBM-bearing brains producing a first-time 3D visualization and morphological analysis of the radio-induced lesions, MRT and MB induced tissue ablations, the presence of hyperdense deposits within specific areas of the brain and tumor evolution or regression with respect to the evaluation made few days post-irradiation with an in-vivo magnetic resonance imaging session. Histology, immunohistochemistry, SAXS/WAXS and XRF allowed identification and classification of these deposits as hydroxyapatite crystals with the coexistence of Ca, P and Fe mineralization, and the multi-technique approach enabled the realization, for the first time, of the map of the differential radiosensitivity of the different brain areas treated with MRT and MB. 3D XPCI-CT datasets enabled also the quantification of tumor volumes and Ca/Fe deposits and their full-organ visualization. The multi-scale and multi-technique approach enabled a detailed visualization and classification in 3D of the radio-induced effects on brain tissues bringing new essential information towards the clinical implementation of the MRT and MB radiation therapy techniques.
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Affiliation(s)
- Mariele Romano
- Department of Medical Physics, Faculty of Physics, Ludwig-Maximilians-Universität, Am Coulombwall 1, München, 85748 Garching, Germany; (M.R.); (A.E.); (G.E.B.)
| | - Alberto Bravin
- European Synchrotron Radiation Facility, 71 Avenue des Martyrs, 38000 Grenoble, France; (A.B.); (A.M.); (D.K.)
- Department of Physics, Faculty of Physics, University of Milano-Bicocca, 20126 Milan, Italy
| | - Alberto Mittone
- European Synchrotron Radiation Facility, 71 Avenue des Martyrs, 38000 Grenoble, France; (A.B.); (A.M.); (D.K.)
- CELLS-ALBA Synchrotron, 08290 Cerdanyola del Valles, Spain
| | - Alicia Eckhardt
- Department of Medical Physics, Faculty of Physics, Ludwig-Maximilians-Universität, Am Coulombwall 1, München, 85748 Garching, Germany; (M.R.); (A.E.); (G.E.B.)
| | - Giacomo E. Barbone
- Department of Medical Physics, Faculty of Physics, Ludwig-Maximilians-Universität, Am Coulombwall 1, München, 85748 Garching, Germany; (M.R.); (A.E.); (G.E.B.)
- Department of Radiology, University Hospital, Ludwig-Maximilians-Universität, 81377 Munich, Germany; (J.D.); (J.R.); (M.A.-F.); (H.H.-E.)
| | - Lucie Sancey
- Centre de Recherche UGA/INSERM U1209/CNRS UMR5309, Institute for Advanced Biosciences, 38700 La Tronche, France;
| | - Julien Dinkel
- Department of Radiology, University Hospital, Ludwig-Maximilians-Universität, 81377 Munich, Germany; (J.D.); (J.R.); (M.A.-F.); (H.H.-E.)
| | - Stefan Bartzsch
- Department of Radiation Oncology, School of Medicine, Technical University of Munich, Klinikum Rechts der Isar, 81675 Munich, Germany;
- Department of Radiation Sciences (DRS), Institute of Radiation Medicine (IRM), Helmholtz Zentrum München, 85764 Neuherberg, Germany
| | - Jens Ricke
- Department of Radiology, University Hospital, Ludwig-Maximilians-Universität, 81377 Munich, Germany; (J.D.); (J.R.); (M.A.-F.); (H.H.-E.)
| | - Marianna Alunni-Fabbroni
- Department of Radiology, University Hospital, Ludwig-Maximilians-Universität, 81377 Munich, Germany; (J.D.); (J.R.); (M.A.-F.); (H.H.-E.)
| | - Heidrun Hirner-Eppeneder
- Department of Radiology, University Hospital, Ludwig-Maximilians-Universität, 81377 Munich, Germany; (J.D.); (J.R.); (M.A.-F.); (H.H.-E.)
| | - Dmitry Karpov
- European Synchrotron Radiation Facility, 71 Avenue des Martyrs, 38000 Grenoble, France; (A.B.); (A.M.); (D.K.)
- Swiss Light Source, Paul Scherrer Institute, 5232 Villigen, Switzerland;
| | - Cinzia Giannini
- Institute of Crystallography, National Research Council, 70126 Bari, Italy;
| | - Oliver Bunk
- Swiss Light Source, Paul Scherrer Institute, 5232 Villigen, Switzerland;
| | - Audrey Bouchet
- Inserm U1296 Unit “Radiation: Defense, Health Environment”, 69008 Lyon, France;
| | - Viktoria Ruf
- Center for Neuropathology and Prion Research, Ludwig-Maximilians-Universität, 81377 Munich, Germany; (V.R.); (A.G.)
| | - Armin Giese
- Center for Neuropathology and Prion Research, Ludwig-Maximilians-Universität, 81377 Munich, Germany; (V.R.); (A.G.)
| | - Paola Coan
- Department of Medical Physics, Faculty of Physics, Ludwig-Maximilians-Universität, Am Coulombwall 1, München, 85748 Garching, Germany; (M.R.); (A.E.); (G.E.B.)
- Department of Radiology, University Hospital, Ludwig-Maximilians-Universität, 81377 Munich, Germany; (J.D.); (J.R.); (M.A.-F.); (H.H.-E.)
- Correspondence:
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14
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Wolfson P, Ho KMA, Bassett P, Haidry R, Olivo A, Lovat L, Sami SS. Accuracy of clinical staging for T2N0 oesophageal cancer: systematic review and meta-analysis. Dis Esophagus 2021; 34:6146603. [PMID: 33618359 DOI: 10.1093/dote/doab002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 11/24/2020] [Accepted: 01/03/2021] [Indexed: 12/24/2022]
Abstract
Oesophageal cancer is the sixth commonest cause of overall cancer mortality. Clinical staging utilizes multiple imaging modalities to guide treatment and prognostication. T2N0 oesophageal cancer is a treatment threshold for neoadjuvant therapy. Data on accuracy of current clinical staging tests for this disease subgroup are conflicting. We performed a meta-analysis of all primary studies comparing clinical staging accuracy using multiple imaging modalities (index test) to histopathological staging following oesophagectomy (reference standard) in T2N0 oesophageal cancer. Patients that underwent neoadjuvant therapy were excluded. Electronic databases (MEDLINE, Embase, Cochrane Library) were searched up to September 2019. The primary outcome was diagnostic accuracy of combined T&N clinical staging. Publication date, first recruitment date, number of centers, sample size and geographical location main histological subtype were evaluated as potential sources of heterogeneity. The search strategy identified 1,199 studies. Twenty studies containing 5,213 patients met the inclusion criteria. Combined T&N staging accuracy was 19% (95% CI, 15-24); T staging accuracy was 29% (95% CI, 24-35); percentage of patients with T downstaging was 41% (95% CI, 33-50); percentage of patients with T upstaging was 28% (95% CI, 24-32) and percentage of patients with N upstaging was 34% (95% CI, 30-39). Significant sources of heterogeneity included the number of centers, sample size and study region. T2N0 oesophageal cancer staging remains inaccurate. A significant proportion of patients were downstaged (could have received endotherapy) or upstaged (should have received neoadjuvant chemotherapy). These findings were largely unchanged over the past two decades highlighting an urgent need for more accurate staging tests for this subgroup of patients.
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Affiliation(s)
- Paul Wolfson
- Division of Surgery and Interventional Science, University College London, London, UK.,Department of Gastroenterology, University College Hospital NHS Foundation Trust, London, UK
| | - Kai Man Alexander Ho
- Division of Surgery and Interventional Science, University College London, London, UK.,Department of Gastroenterology, University College Hospital NHS Foundation Trust, London, UK
| | | | - Rehan Haidry
- Division of Surgery and Interventional Science, University College London, London, UK.,Department of Gastroenterology, University College Hospital NHS Foundation Trust, London, UK
| | - Alessandro Olivo
- Department of Medical Physics and Bioengineering, University College London, London, UK
| | - Laurence Lovat
- Division of Surgery and Interventional Science, University College London, London, UK.,Department of Gastroenterology, University College Hospital NHS Foundation Trust, London, UK
| | - Sarmed S Sami
- Division of Surgery and Interventional Science, University College London, London, UK.,Department of Gastroenterology, University College Hospital NHS Foundation Trust, London, UK
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15
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Olivo A. Edge-illumination x-ray phase-contrast imaging. JOURNAL OF PHYSICS. CONDENSED MATTER : AN INSTITUTE OF PHYSICS JOURNAL 2021; 33:363002. [PMID: 34167096 PMCID: PMC8276004 DOI: 10.1088/1361-648x/ac0e6e] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 06/07/2021] [Accepted: 06/24/2021] [Indexed: 05/08/2023]
Abstract
Although early demonstration dates back to the mid-sixties, x-ray phase-contrast imaging (XPCI) became hugely popular in the mid-90s, thanks to the advent of 3rd generation synchrotron facilities. Its ability to reveal object features that had so far been considered invisible to x-rays immediately suggested great potential for applications across the life and the physical sciences, and an increasing number of groups worldwide started experimenting with it. At that time, it looked like a synchrotron facility was strictly necessary to perform XPCI with some degree of efficiency-the only alternative being micro-focal sources, the limited flux of which imposed excessively long exposure times. However, new approaches emerged in the mid-00s that overcame this limitation, and allowed XPCI implementations with conventional, non-micro-focal x-ray sources. One of these approaches showing particular promise for 'real-world' applications is edge-illumination XPCI: this article describes the key steps in its evolution in the context of contemporary developments in XPCI research, and presents its current state-of-the-art, especially in terms of transition towards practical applications.
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Affiliation(s)
- Alessandro Olivo
- Department of Medical Physics and Biomedical Engineering, UCL, London, United Kingdom
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16
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Brombal L, Arana Peña LM, Arfelli F, Longo R, Brun F, Contillo A, Di Lillo F, Tromba G, Di Trapani V, Donato S, Menk RH, Rigon L. Motion artifacts assessment and correction using optical tracking in synchrotron radiation breast CT. Med Phys 2021; 48:5343-5355. [PMID: 34252212 PMCID: PMC9291820 DOI: 10.1002/mp.15084] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 05/12/2021] [Accepted: 06/21/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose The SYRMA‐3D collaboration is setting up a breast computed tomography (bCT) clinical program at the Elettra synchrotron radiation facility in Trieste, Italy. Unlike the few dedicated scanners available at hospitals, synchrotron radiation bCT requires the patient's rotation, which in turn implies a long scan duration (from tens of seconds to few minutes). At the same time, it allows the achievement of high spatial resolution. These features make synchrotron radiation bCT prone to motion artifacts. This article aims at assessing and compensating for motion artifacts through an optical tracking approach. Methods In this study, patients’ movements due to breathing have been first assessed on seven volunteers and then simulated during the CT scans of a breast phantom and a surgical specimen, by adding a periodic oscillatory motion (constant speed, 1 mm amplitude, 12 cycles/minute). CT scans were carried out at 28 keV with a mean glandular dose of 5 mGy. Motion artifacts were evaluated and a correction algorithm based on the optical tracking of fiducial marks was introduced. A quantitative analysis based on the structural similarity (SSIM) index and the normalized mean square error (nMSE) was performed on the reconstructed CT images. Results CT images reconstructed through the optical tracking procedure were found to be as good as the motionless reference image. Moreover, the analysis of SSIM and nMSE demonstrated that an uncorrected motion of the order of the system's point spread function (around 0.1 mm in the present case) can be tolerated. Conclusions Results suggest that a motion correction procedure based on an optical tracking system would be beneficial in synchrotron radiation bCT.
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Affiliation(s)
- Luca Brombal
- Department of Physics, University of Trieste, Trieste, Italy.,Division of Trieste, Istituto Nazionale di Fisica Nucleare, Trieste, Italy
| | - Lucia Mariel Arana Peña
- Department of Physics, University of Trieste, Trieste, Italy.,Division of Trieste, Istituto Nazionale di Fisica Nucleare, Trieste, Italy
| | - Fulvia Arfelli
- Department of Physics, University of Trieste, Trieste, Italy.,Division of Trieste, Istituto Nazionale di Fisica Nucleare, Trieste, Italy
| | - Renata Longo
- Department of Physics, University of Trieste, Trieste, Italy.,Division of Trieste, Istituto Nazionale di Fisica Nucleare, Trieste, Italy
| | - Francesco Brun
- Division of Trieste, Istituto Nazionale di Fisica Nucleare, Trieste, Italy.,Department of Engineering and Architecture, University of Trieste, Trieste, Italy
| | | | | | | | - Vittorio Di Trapani
- Department of Physical sciences, Earth and environment, University of Siena, Siena, Italy.,Division of Pisa, Istituto Nazionale di Fisica Nucleare, Pisa, Italy
| | - Sandro Donato
- Department of Physics, University of Calabria, Arcavacata di Rende, Cosenza, Italy.,Division of Frascati, Istituto Nazionale di Fisca Nucleare, Frascati, Rome, Italy
| | - Ralf Hendrik Menk
- Division of Trieste, Istituto Nazionale di Fisica Nucleare, Trieste, Italy.,Elettra-Sincrotrone Trieste S.C.p.A., Trieste, Italy.,Department of Medical Imaging, University of Saskatchewan, Saskatoon, Canada
| | - Luigi Rigon
- Department of Physics, University of Trieste, Trieste, Italy.,Division of Trieste, Istituto Nazionale di Fisica Nucleare, Trieste, Italy
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17
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Loncaric F, Garcia-Canadilla P, Garcia-Alvarez A, Sanchis L, Prat S, Doltra A, Quintana E, Pereda D, Dejea H, Bonnin A, Sitges M, Bijnens B. Etiology-Discriminative Multimodal Imaging of Left Ventricular Hypertrophy and Synchrotron-Based Assessment of Microstructural Tissue Remodeling. Front Cardiovasc Med 2021; 8:670734. [PMID: 34113664 PMCID: PMC8185228 DOI: 10.3389/fcvm.2021.670734] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 04/07/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Distinguishing the etiology of left ventricular hypertrophy (LVH) is clinically relevant due to patient outcomes and management. Easily obtained, echocardiography-based myocardial deformation patterns may improve standard non-invasive phenotyping, however, the relationship between deformation phenotypes and etiology-related, microstructural cardiac remodeling has not been reported. Synchrotron radiation-based X-ray phase-contrast imaging (X-PCI) can provide high resolution, three-dimensional (3D) information on myocardial microstructure. The aim of this pilot study is to apply a multiscale, multimodality protocol in LVH patients undergoing septal myectomy to visualize in vivo and ex vivo myocardial tissue and relate non-invasive LVH imaging phenotypes to the underlying synchrotron-assessed microstructure. Methods and findings: Three patients (P1-3) undergoing septal myectomy were comprehensively studied. Medical history was collected, and patients were imaged with echocardiography/cardiac magnetic resonance prior to the procedure. Myocardial tissue samples obtained during the myectomy were imaged with X-PCI generating high spatial resolution images (0.65 μm) to assess myocyte organization, 3D connective tissue distribution and vasculature remodeling. Etiology-centered non-invasive imaging phenotypes, based on findings of hypertrophy and late gadolinium enhancement (LGE) distribution, and enriched by speckle-tracking and tissue Doppler echocardiography deformation patterns, identified a clear phenotype of hypertensive heart disease (HTN) in P1, and hypertrophic cardiomyopathy (HCM) in P2/P3. X-PCI showed extensive interstitial fibrosis with normal 3D myocyte and collagen organization in P1. In comparison, in P2/P3, X-PCI showed 3D myocyte and collagen disarray, as well as arterial wall hypertrophy with increased perivascular collagen, compatible with sarcomere-mutation HCM in both patients. The results of this pilot study suggest the association of non-invasive deformation phenotypes with etiology-related myocyte and connective tissue matrix disorganization. A larger patient cohort could enable statistical analysis of group characteristics and the assessment of deformation pattern reproducibility. Conclusion: High-resolution, 3D X-PCI provides novel ways to visualize myocardial remodeling in LVH, and illustrates the correspondence of macrostructural and functional non-invasive phenotypes with invasive microstructural phenotypes, suggesting the potential clinical utility of non-invasive myocardial deformation patterns in phenotyping LVH in everyday clinical practice.
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Affiliation(s)
- Filip Loncaric
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
| | | | - Ana Garcia-Alvarez
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
- Cardiovascular Institute, Hospital Clínic and Universitat de Barcelona, Barcelona, Spain
| | - Laura Sanchis
- Cardiovascular Institute, Hospital Clínic and Universitat de Barcelona, Barcelona, Spain
| | - Susana Prat
- Cardiovascular Institute, Hospital Clínic and Universitat de Barcelona, Barcelona, Spain
| | - Adelina Doltra
- Cardiovascular Institute, Hospital Clínic and Universitat de Barcelona, Barcelona, Spain
| | - Eduard Quintana
- Cardiovascular Institute, Hospital Clínic and Universitat de Barcelona, Barcelona, Spain
| | - Daniel Pereda
- Cardiovascular Institute, Hospital Clínic and Universitat de Barcelona, Barcelona, Spain
| | - Hector Dejea
- Photon Science Department, Paul Scherrer Institut, Villigen, Switzerland
- Eidgenössische Technische Hochschule Zurich, Zurich, Switzerland
| | - Anne Bonnin
- Photon Science Department, Paul Scherrer Institut, Villigen, Switzerland
| | - Marta Sitges
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
- Cardiovascular Institute, Hospital Clínic and Universitat de Barcelona, Barcelona, Spain
- Centro de Investigación en Red de Enfermedades Cardiovasculares (CERCA), Madrid, Spain
| | - Bart Bijnens
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
- Institució Catalana de Recerca i Estudis Avançats, Barcelona, Spain
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18
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Ghani MU, Wu X, Fajardo LL, Jing Z, Wong MD, Zheng B, Omoumi F, Li Y, Yan A, Jenkins P, Hillis SL, Linstroth L, Liu H. Development and preclinical evaluation of a patient-specific high energy x-ray phase sensitive breast tomosynthesis system. Med Phys 2021; 48:2511-2520. [PMID: 33523479 DOI: 10.1002/mp.14743] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 01/19/2021] [Accepted: 01/20/2021] [Indexed: 12/30/2022] Open
Abstract
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.
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Affiliation(s)
- Muhammad U Ghani
- Advanced Medical Imaging Center and School of Electrical and Computer Engineering, University of Oklahoma, Norman, OK, 73019, USA
| | - Xizeng Wu
- Department of Radiology, University of Alabama at Birmingham, Birmingham, AL, 35249, USA
| | - Laurie L Fajardo
- Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, UT, 84132, USA
| | | | - Molly D Wong
- Advanced Medical Imaging Center and School of Electrical and Computer Engineering, University of Oklahoma, Norman, OK, 73019, USA
| | - Bin Zheng
- Advanced Medical Imaging Center and School of Electrical and Computer Engineering, University of Oklahoma, Norman, OK, 73019, USA
| | - Farid Omoumi
- Advanced Medical Imaging Center and School of Electrical and Computer Engineering, University of Oklahoma, Norman, OK, 73019, USA
| | - Yuhua Li
- Advanced Medical Imaging Center and School of Electrical and Computer Engineering, University of Oklahoma, Norman, OK, 73019, USA
| | - Aimin Yan
- Department of Radiology, University of Alabama at Birmingham, Birmingham, AL, 35249, USA
| | - Peter Jenkins
- Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, UT, 84132, USA
| | - Stephen L Hillis
- Department of Radiology and Biostatistics, University of Iowa, Iowa City, IA, 52242, USA
| | - Laura Linstroth
- Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, UT, 84132, USA
| | - Hong Liu
- Advanced Medical Imaging Center and School of Electrical and Computer Engineering, University of Oklahoma, Norman, OK, 73019, USA
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19
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Synchrotron Radiation-Based Refraction-Contrast Tomographic Images Using X-ray Dark-Field Imaging Optics in Human Lung Adenocarcinoma and Histologic Correlations. Diagnostics (Basel) 2021; 11:diagnostics11030487. [PMID: 33801895 PMCID: PMC7999731 DOI: 10.3390/diagnostics11030487] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 03/02/2021] [Accepted: 03/07/2021] [Indexed: 12/25/2022] Open
Abstract
The aim of this study was to evaluate the clinical implication of synchrotron radiation imaging techniques for human lung adenocarcinoma in comparison with pathologic examination. A refraction-based tomographic imaging technique called the X-ray dark-field imaging (XDFI) method was used to obtain computed tomographic images of human lung adenocarcinoma at the beam line at Photon Factory BL 14B at the High Energy Accelerator Research Organization (KEK) in Tsukuba, Japan. Images of normal lung tissue were also obtained using the same methods and reconstructed as 3D images. Both reconstructed images were compared with pathologic examinations from histologic slides which were made with identical samples. Pulmonary alveolar structure including terminal bronchioles, alveolar sacs, and vasculatures could be identified in synchrotron radiation images of normal lung. Hyperplasia of interstitial tissue and dysplasia of alveolar structures were noticed in images of lung adenocarcinoma. Both synchrotron radiation images were considerably correlated with images from histologic slides. Lepidic patterns of cancer tissue were distinguished from the invasive area in synchrotron radiation images of lung adenocarcinoma. Refraction-contrast tomographic techniques using synchrotron radiation could provide high-resolution images of lung adenocarcinoma which are compatible with those from pathologic examinations.
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20
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Solé Cruz E, Mercier A, Suuronen JP, Chaffanjon P, Brun E, Bellier A. Synchrotron phase-contrast imaging applied to the anatomical study of the hand and its vascularization. J Anat 2021; 239:536-543. [PMID: 33686643 PMCID: PMC8273599 DOI: 10.1111/joa.13427] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 10/05/2020] [Accepted: 02/24/2021] [Indexed: 11/27/2022] Open
Abstract
Microscopic anatomical study of the hand requires difficult or destructive dissection techniques for each anatomical structure. Synchrotron phase-contrast imaging (sPCI) allows us to study precisely, at a microscopic resolution and in a nondestructive approach, the soft tissues and bone structures within a single 3D image. Therefore, we aimed to assess the capacity of sPCI to study the arterial anatomy of the hand and digits in human cadavers for anatomical purposes. A non-injected hand from an embalmed body was imaged using sPCI at 21-µm pixel size. The vascularization and innervation of the hands were virtually reconstructed at 84-µm resolution, and the medial neurovascular bundle of the third digit at 21 µm. The thinner-most distal structures were observed and reported. The diameter and thickness of the vascular and neural structures were defined on 2D computed tomographic axial projections, and using a granulometry method coupled to the 3D reconstructions. The vascularization of the hand was visible from the radial and ulnar arteries to the distal digital transverse anastomoses. The thinnest structure observed was the anastomotic arterial network around the proper palmar digital nerve. The latter emerged from the proper palmar digital artery and vascularized the nerve around its whole length and circumference. The perineural arterioles individualizable at this resolution had a diameter of 66-309 µm. In conclusion, sPCI allows both the arterial and neural anatomy of the hand to be studied at the same time, as well as the anatomical interactions between both networks. It facilitates the study of structures that have different sizes, diameters, thickness, and histological origin with great precision, in a noninvasive way, and using a single technique.
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Affiliation(s)
- Eva Solé Cruz
- French Alpes Laboratory of Anatomy, Grenoble Alpes University, Grenoble, France.,Inserm UA7 Strobe, Grenoble Alpes University, Grenoble, France.,ID17 Biomedical Beamline, European Synchrotron Radiation Facility, Grenoble, France
| | - Alexis Mercier
- French Alpes Laboratory of Anatomy, Grenoble Alpes University, Grenoble, France
| | - Jussi-Petteri Suuronen
- Inserm UA7 Strobe, Grenoble Alpes University, Grenoble, France.,ID17 Biomedical Beamline, European Synchrotron Radiation Facility, Grenoble, France
| | - Philippe Chaffanjon
- French Alpes Laboratory of Anatomy, Grenoble Alpes University, Grenoble, France
| | - Emmanuel Brun
- Inserm UA7 Strobe, Grenoble Alpes University, Grenoble, France
| | - Alexandre Bellier
- French Alpes Laboratory of Anatomy, Grenoble Alpes University, Grenoble, France.,Computational Biology and Mathematics, TIMC Laboratory, UMR 5525 CNRS, Grenoble, France
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21
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Massimi L, Suaris T, Hagen CK, Endrizzi M, Munro PRT, Havariyoun G, Hawker PMS, Smit B, Astolfo A, Larkin OJ, Waltham RM, Shah Z, Duffy SW, Nelan RL, Peel A, Jones JL, Haig IG, Bate D, Olivo A. Detection of involved margins in breast specimens with X-ray phase-contrast computed tomography. Sci Rep 2021; 11:3663. [PMID: 33574584 PMCID: PMC7878478 DOI: 10.1038/s41598-021-83330-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 02/01/2021] [Indexed: 01/19/2023] Open
Abstract
Margins of wide local excisions in breast conserving surgery are tested through histology, which can delay results by days and lead to second operations. Detection of margin involvement intraoperatively would allow the removal of additional tissue during the same intervention. X-ray phase contrast imaging (XPCI) provides soft tissue sensitivity superior to conventional X-rays: we propose its use to detect margin involvement intraoperatively. We have developed a system that can perform phase-based computed tomography (CT) scans in minutes, used it to image 101 specimens approximately half of which contained neoplastic lesions, and compared results against those of a commercial system. Histological analysis was carried out on all specimens and used as the gold standard. XPCI-CT showed higher sensitivity (83%, 95% CI 69–92%) than conventional specimen imaging (32%, 95% CI 20–49%) for detection of lesions at margin, and comparable specificity (83%, 95% CI 70–92% vs 86%, 95% CI 73–93%). Within the limits of this study, in particular that specimens obtained from surplus tissue typically contain small lesions which makes detection more difficult for both methods, we believe it likely that the observed increase in sensitivity will lead to a comparable reduction in the number of re-operations.
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Affiliation(s)
- Lorenzo Massimi
- Department of Medical Physics and Biomedical Engineering, University College London, Gower St, London, WC1E 6BT, UK
| | - Tamara Suaris
- St Bartholomew's Hospital, Barts Health NHS Trust, West Smithfields, London, EC1A 7BE, UK
| | - Charlotte K Hagen
- Department of Medical Physics and Biomedical Engineering, University College London, Gower St, London, WC1E 6BT, UK
| | - Marco Endrizzi
- Department of Medical Physics and Biomedical Engineering, University College London, Gower St, London, WC1E 6BT, UK
| | - Peter R T Munro
- Department of Medical Physics and Biomedical Engineering, University College London, Gower St, London, WC1E 6BT, UK
| | - Glafkos Havariyoun
- Department of Medical Physics and Biomedical Engineering, University College London, Gower St, London, WC1E 6BT, UK
| | - P M Sam Hawker
- Nikon X-Tek Systems, Tring Business Centre, Icknield Way, Tring, Hertfordshire, HP23 4JX, UK
| | - Bennie Smit
- Nikon X-Tek Systems, Tring Business Centre, Icknield Way, Tring, Hertfordshire, HP23 4JX, UK
| | - Alberto Astolfo
- Nikon X-Tek Systems, Tring Business Centre, Icknield Way, Tring, Hertfordshire, HP23 4JX, UK
| | - Oliver J Larkin
- Nikon X-Tek Systems, Tring Business Centre, Icknield Way, Tring, Hertfordshire, HP23 4JX, UK
| | - Richard M Waltham
- Nikon X-Tek Systems, Tring Business Centre, Icknield Way, Tring, Hertfordshire, HP23 4JX, UK
| | - Zoheb Shah
- Barts and the London School of Medicine and Dentistry, Queen Mary University of London, Newark St, London, E1 2AT, UK
| | - Stephen W Duffy
- Barts and the London School of Medicine and Dentistry, Queen Mary University of London, Newark St, London, E1 2AT, UK
| | - Rachel L Nelan
- Barts and the London School of Medicine and Dentistry, Queen Mary University of London, Newark St, London, E1 2AT, UK
| | - Anthony Peel
- St Bartholomew's Hospital, Barts Health NHS Trust, West Smithfields, London, EC1A 7BE, UK
| | - J Louise Jones
- St Bartholomew's Hospital, Barts Health NHS Trust, West Smithfields, London, EC1A 7BE, UK.,Barts and the London School of Medicine and Dentistry, Queen Mary University of London, Newark St, London, E1 2AT, UK
| | - Ian G Haig
- Nikon X-Tek Systems, Tring Business Centre, Icknield Way, Tring, Hertfordshire, HP23 4JX, UK
| | - David Bate
- Nikon X-Tek Systems, Tring Business Centre, Icknield Way, Tring, Hertfordshire, HP23 4JX, UK
| | - Alessandro Olivo
- Department of Medical Physics and Biomedical Engineering, University College London, Gower St, London, WC1E 6BT, UK.
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22
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Haggmark I, Shaker K, Hertz HM. In Silico Phase-Contrast X-Ray Imaging of Anthropomorphic Voxel-Based Phantoms. IEEE TRANSACTIONS ON MEDICAL IMAGING 2021; 40:539-548. [PMID: 33055024 DOI: 10.1109/tmi.2020.3031318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
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.
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23
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Barbone GE, Bravin A, Mittone A, Grosu S, Ricke J, Cavaletti G, Djonov V, Coan P. High-Spatial-Resolution Three-dimensional Imaging of Human Spinal Cord and Column Anatomy with Postmortem X-ray Phase-Contrast Micro-CT. Radiology 2021; 298:135-146. [DOI: 10.1148/radiol.2020201622] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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24
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Arce P, Bolst D, Bordage MC, Brown JMC, Cirrone P, Cortés-Giraldo MA, Cutajar D, Cuttone G, Desorgher L, Dondero P, Dotti A, Faddegon B, Fedon C, Guatelli S, Incerti S, Ivanchenko V, Konstantinov D, Kyriakou I, Latyshev G, Le A, Mancini-Terracciano C, Maire M, Mantero A, Novak M, Omachi C, Pandola L, Perales A, Perrot Y, Petringa G, Quesada JM, Ramos-Méndez J, Romano F, Rosenfeld AB, Sarmiento LG, Sakata D, Sasaki T, Sechopoulos I, Simpson EC, Toshito T, Wright DH. Report on G4-Med, a Geant4 benchmarking system for medical physics applications developed by the Geant4 Medical Simulation Benchmarking Group. Med Phys 2021; 48:19-56. [PMID: 32392626 PMCID: PMC8054528 DOI: 10.1002/mp.14226] [Citation(s) in RCA: 72] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Revised: 04/26/2020] [Accepted: 04/30/2020] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Geant4 is a Monte Carlo code extensively used in medical physics for a wide range of applications, such as dosimetry, micro- and nanodosimetry, imaging, radiation protection, and nuclear medicine. Geant4 is continuously evolving, so it is crucial to have a system that benchmarks this Monte Carlo code for medical physics against reference data and to perform regression testing. AIMS To respond to these needs, we developed G4-Med, a benchmarking and regression testing system of Geant4 for medical physics. MATERIALS AND METHODS G4-Med currently includes 18 tests. They range from the benchmarking of fundamental physics quantities to the testing of Monte Carlo simulation setups typical of medical physics applications. Both electromagnetic and hadronic physics processes and models within the prebuilt Geant4 physics lists are tested. The tests included in G4-Med are executed on the CERN computing infrastructure via the use of the geant-val web application, developed at CERN for Geant4 testing. The physical observables can be compared to reference data for benchmarking and to results of previous Geant4 versions for regression testing purposes. RESULTS This paper describes the tests included in G4-Med and shows the results derived from the benchmarking of Geant4 10.5 against reference data. DISCUSSION Our results indicate that the Geant4 electromagnetic physics constructor G4EmStandardPhysics_option4 gives a good agreement with the reference data for all the tests. The QGSP_BIC_HP physics list provided an overall adequate description of the physics involved in hadron therapy, including proton and carbon ion therapy. New tests should be included in the next stage of the project to extend the benchmarking to other physical quantities and application scenarios of interest for medical physics. CONCLUSION The results presented and discussed in this paper will aid users in tailoring physics lists to their particular application.
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Affiliation(s)
| | - D Bolst
- Centre For Medical Radiation Physics, University of Wollongong, Wollongong, Australia
| | - M-C Bordage
- CRCT (INSERM and Paul Sabatier University), Toulouse, France
| | - J M C Brown
- Department of Radiation Science and Technology, Delft University of Technology, Delft, The Netherlands
| | | | | | - D Cutajar
- Centre For Medical Radiation Physics, University of Wollongong, Wollongong, Australia
| | | | - L Desorgher
- Institute of Radiation Physics (IRA), Lausanne University Hospital, Lausanne, Switzerland
| | | | - A Dotti
- SLAC National Accelerator Laboratory, Stanford, CA, USA
| | - B Faddegon
- University of California, San Francisco, CA, USA
| | - C Fedon
- Radboud University Medical Center, Nijmegen, The Netherlands
| | - S Guatelli
- Centre For Medical Radiation Physics, University of Wollongong, Wollongong, Australia
| | - S Incerti
- Université de Bordeaux, CNRS/IN2P3, UMR5797, Centre d'Études Nucléaires de Bordeaux Gradignan, Gradignan, France
| | - V Ivanchenko
- Tomsk State University, Tomsk, Russian Federation
- CERN, Geneva, Switzerland
| | - D Konstantinov
- NRC "Kurchatov Institute" - IHEP, Protvino, Russian Federation
| | - I Kyriakou
- Medical Physics Laboratory, University of Ioannina, Ioannina, Greece
| | - G Latyshev
- NRC "Kurchatov Institute" - IHEP, Protvino, Russian Federation
| | - A Le
- Centre For Medical Radiation Physics, University of Wollongong, Wollongong, Australia
| | | | | | | | | | - C Omachi
- Nagoya Proton Therapy Center, Nagoya, Japan
| | | | - A Perales
- Medical Physics Department of Clínica Universidad de Navarra, Pamplona, Spain
| | - Y Perrot
- IRSN, Fontenay-aux-Roses, France
| | | | | | | | - F Romano
- INFN Catania Section, Catania, Italy
- Medical Physics Department, National Physical Laboratory, Teddington, UK
| | - A B Rosenfeld
- Centre For Medical Radiation Physics, University of Wollongong, Wollongong, Australia
| | | | - D Sakata
- Centre For Medical Radiation Physics, University of Wollongong, Wollongong, Australia
| | | | - I Sechopoulos
- Radboud University Medical Center, Nijmegen, The Netherlands
- Dutch Expert Center for Screening (LRCB), Nijmegen, The Netherlands
| | - E C Simpson
- Department of Nuclear Physics, Research School of Physics, Australian National University, Canberra, Australia
| | - T Toshito
- Nagoya Proton Therapy Center, Nagoya, Japan
| | - D H Wright
- SLAC National Accelerator Laboratory, Stanford, CA, USA
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25
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Tavakoli Taba S, Arhatari BD, Nesterets YI, Gadomkar Z, Mayo SC, Thompson D, Fox J, Kumar B, Prodanovic Z, Hausermann D, Maksimenko A, Hall C, Dimmock M, Pavlov KM, Lockie D, Gity M, Peele A, Quiney HM, Lewis S, Gureyev TE, Brennan PC. Propagation-Based Phase-Contrast CT of the Breast Demonstrates Higher Quality Than Conventional Absorption-Based CT Even at Lower Radiation Dose. Acad Radiol 2021; 28:e20-e26. [PMID: 32035759 DOI: 10.1016/j.acra.2020.01.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 12/31/2019] [Accepted: 01/07/2020] [Indexed: 01/07/2023]
Abstract
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 (AUCVGC = 0.901, p = 0.001 and AUCVGC = 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.
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26
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Omoumi FH, Ghani MU, Wong MD, Li Y, Zheng B, Yan A, Jenkins PA, Wu X, Liu H. The Potential of Utilizing Mid-Energy X-Rays for In-Line Phase Sensitive Breast Cancer Imaging. BIOMEDICAL SPECTROSCOPY AND IMAGING 2020; 9:89-102. [PMID: 34141562 PMCID: PMC8208526 DOI: 10.3233/bsi-200204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
OBJECTIVE The objective of this study is to demonstrate the potential of utilizing mid-energy x-rays for in-line phase-sensitive breast cancer imaging by phantom studies. METHODS The midenergy (50-80kV) in-line phase sensitive imaging prototype was used to acquire images of the contrast-detail mammography (CDMAM) phantom, an ACR accreditation phantom, and an acrylic edge phantom. The low-dose mid-energy phase-sensitive images were acquired at 60 kV with a radiation dose of 0.9 mGy, while the high-energy phase-sensitive images were acquired at 90 kV with a radiation dose of 1.2 mGy. The Phase-Attenuation Duality (PAD) principle for soft tissue was used for the phase retrieval. A blind observer study was conducted and paired-sample T-test were performed to compare the mean differences in the two imaging systems. RESULTS The correct detection ratio for the CDMAM phantom for phase-contrast images acquired by the low-dose mid-energy system was 56.91%, whereas images acquired by the high-energy system correctly revealed only 40.97% of discs. The correct detection ratios were 57.88% and 43.41% for phase-retrieved images acquired by the low-dose mid-energy and high-energy imaging systems, respectively. The reading scores for all three groups of objects in the ACR phantom were higher for the mid energy imaging system as compared to the high-energy system for both phase-contrast and phase- retrieved images. The calculated edge enhancement index (EEI) from the acrylic edge phantom image for the mid-energy system was higher than that calculated for the high-energy imaging system. The quantitative analyses showed a higher Contrast to Noise Ratio (CNR) as well as a higher Figure of Merit (FOM) in images acquired by the low-dose mid-energy imaging system. CONCLUSION The PAD based retrieval method can be applied in mid-energy system without remarkably affecting the image quality, and in fact, it improves the lesion detectability with a patient dose saving of 25%.
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Affiliation(s)
- F H Omoumi
- Advanced Medical Imaging Center and School of Electrical and Computer Engineering, The University of Oklahoma, Norman, OK 73019, U.S.A
| | - M U Ghani
- Advanced Medical Imaging Center and School of Electrical and Computer Engineering, The University of Oklahoma, Norman, OK 73019, U.S.A
| | - M D Wong
- Advanced Medical Imaging Center and School of Electrical and Computer Engineering, The University of Oklahoma, Norman, OK 73019, U.S.A
| | - Y Li
- Advanced Medical Imaging Center and School of Electrical and Computer Engineering, The University of Oklahoma, Norman, OK 73019, U.S.A
| | - B Zheng
- Advanced Medical Imaging Center and School of Electrical and Computer Engineering, The University of Oklahoma, Norman, OK 73019, U.S.A
| | - A Yan
- Department of Radiology, The University of Alabama at Birmingham, AL 35249, U.S.A
| | - P A Jenkins
- Department of Radiology and Imaging Science, The University of Utah School of Medicine, Salt Lake- City, UT 74132, U.S.A
| | - X Wu
- Department of Radiology, The University of Alabama at Birmingham, AL 35249, U.S.A
| | - H Liu
- Advanced Medical Imaging Center and School of Electrical and Computer Engineering, The University of Oklahoma, Norman, OK 73019, U.S.A
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Ton N, Goncin U, Panahifar A, Chapman D, Wiebe S, Machtaler S. Developing a Microbubble-Based Contrast Agent for Synchrotron In-Line Phase Contrast Imaging. IEEE Trans Biomed Eng 2020; 68:1527-1535. [PMID: 33232220 DOI: 10.1109/tbme.2020.3040079] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE X-ray phase contrast imaging generates contrast from refraction of X-rays, enhancing soft tissue contrast compared to conventional absorption-based imaging. Our goal is to develop a contrast agent for X-ray in-line phase contrast imaging (PCI) based on ultrasound microbubbles (MBs), by assessing size, shell material, and concentration. METHODS Polydisperse perfluorobutane-core lipid-shelled MBs were synthesized and size separated into five groups between 1 and 10 μm. We generated two size populations of polyvinyl-alcohol (PVA)-MBs, 2-3 μm and 3-4 μm, whose shells were either coated or integrated with iron oxide nanoparticles (SPIONs). Microbubbles were then embedded in agar at three concentrations: 5 × 107, 5 × 106 and 5 × 105 MBs/ml. In-line phase contrast imaging was performed at the Canadian Light Source with filtered white beam micro-computed tomography. Phase contrast intensity was measured by both counting detectable MBs, and comparing mean pixel values (MPV) in minimum and maximum intensity projections of the overall samples. RESULTS Individual lipid-MBs 6-10 μm, lipid-MBs 4-6 μm and PVA-MBs coated with SPIONs were detectable at each concentration. At the highest concentration, lipid-MBs 6-10 μm and 4-6 μm showed an overall increase in positive contrast, whereas at a moderate concentration, only lipid-MBs 6-10 μm displayed an increase. Negative contrast was also observed from two largest lipid-MBs at high concentration. CONCLUSION These data indicate that lipid-MBs larger than 4 μm are candidates for PCI, and 5 × 106 MBs/ml may be the lowest concentration suitable for generating visible phase contrast in vivo. SIGNIFICANCE Identifying a suitable MB for PCI may facilitate future clinical translation.
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Momose A. X-ray phase imaging reaching clinical uses. Phys Med 2020; 79:93-102. [PMID: 33212423 DOI: 10.1016/j.ejmp.2020.11.003] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 10/20/2020] [Accepted: 11/01/2020] [Indexed: 02/01/2023] Open
Abstract
X-ray phase imaging that uses the phenomena of X-ray refraction and scattering to generate image contrast has the potential to overcome the drawback of conventional X-ray radiography in observing biological soft tissues. After its dawn at synchrotron radiation facilities 30 years ago, the development of X-ray phase imaging is expanding to hospitals by grating-based phase-imaging approaches available with a conventional X-ray tube. In this review, after introducing the physical advantages and methodological details of X-ray phase imaging, recent trials of instrumentation in hospitals for diagnoses of rheumatoid arthritis and chronic obstructive pulmonary disease are introduced.
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Affiliation(s)
- Atsushi Momose
- Institute of Multidisciplinary Research for Advanced Materials, Tohoku University, 2-1-1 Katahira, Aoba-ku, Sendai 980-8577, Japan.
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Recent advances in X-ray imaging of breast tissue: From two- to three-dimensional imaging. Phys Med 2020; 79:69-79. [PMID: 33171371 DOI: 10.1016/j.ejmp.2020.10.025] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Revised: 10/13/2020] [Accepted: 10/24/2020] [Indexed: 11/20/2022] Open
Abstract
Breast cancer is a globally widespread disease whose detection has already been significantly improved by the introduction of screening programs. Nevertheless, mammography suffers from low soft tissue contrast and the superposition of diagnostically relevant anatomical structures as well as from low values for sensitivity and specificity especially for dense breast tissue. In recent years, two techniques for X-ray breast imaging have been developed that bring advances for the early detection of breast cancer. Grating-based phase-contrast mammography is a new imaging technique that is able to provide three image modalities simultaneously (absorption-contrast, phase-contrast and dark-field signal). Thus, an enhanced detection and delineation of cancerous structures in the phase-contrast image and an improved visualization and characterization of microcalcifications in the dark-field image is possible. Furthermore, latest studies about this approach show that dose-compatible imaging with polychromatic X-ray sources is feasible. In order to additionally overcome the limitations of projection-based imaging, efforts were also made towards the development of breast computed tomography (BCT), which recently led to the first clinical installation of an absorption-based BCT system. Further research combining the benefits of both imaging technologies is currently in progress. This review article summarizes the latest advances in phase-contrast imaging for the female breast (projection-based and three-dimensional view) with special focus on possible clinical implementations in the future.
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Dejea H, Bonnin A, Cook AC, Garcia-Canadilla P. Cardiac multi-scale investigation of the right and left ventricle ex vivo: a review. Cardiovasc Diagn Ther 2020; 10:1701-1717. [PMID: 33224784 DOI: 10.21037/cdt-20-269] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
The heart is a complex multi-scale system composed of components integrated at the subcellular, cellular, tissue and organ levels. The myocytes, the contractile elements of the heart, form a complex three-dimensional (3D) network which enables propagation of the electrical signal that triggers the contraction to efficiently pump blood towards the whole body. Cardiovascular diseases (CVDs), a major cause of mortality in developed countries, often lead to cardiovascular remodeling affecting cardiac structure and function at all scales, from myocytes and their surrounding collagen matrix to the 3D organization of the whole heart. As yet, there is no consensus as to how the myocytes are arranged and packed within their connective tissue matrix, nor how best to image them at multiple scales. Cardiovascular imaging is routinely used to investigate cardiac structure and function as well as for the evaluation of cardiac remodeling in CVDs. For a complete understanding of the relationship between structural remodeling and cardiac dysfunction in CVDs, multi-scale imaging approaches are necessary to achieve a detailed description of ventricular architecture along with cardiac function. In this context, ventricular architecture has been extensively studied using a wide variety of imaging techniques: ultrasound (US), optical coherence tomography (OCT), microscopy (confocal, episcopic, light sheet, polarized light), magnetic resonance imaging (MRI), micro-computed tomography (micro-CT) and, more recently, synchrotron X-ray phase contrast imaging (SR X-PCI). Each of these techniques have their own set of strengths and weaknesses, relating to sample size, preparation, resolution, 2D/3D capabilities, use of contrast agents and possibility of performing together with in vivo studies. Therefore, the combination of different imaging techniques to investigate the same sample, thus taking advantage of the strengths of each method, could help us to extract the maximum information about ventricular architecture and function. In this review, we provide an overview of available and emerging cardiovascular imaging techniques for assessing myocardial architecture ex vivo and discuss their utility in being able to quantify cardiac remodeling, in CVDs, from myocyte to whole organ.
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Affiliation(s)
- Hector Dejea
- Paul Scherrer Institut, Villigen PSI, Villigen, Switzerland.,Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland
| | - Anne Bonnin
- Paul Scherrer Institut, Villigen PSI, Villigen, Switzerland
| | - Andrew C Cook
- Institute of Cardiovascular Science, University College London, London, UK
| | - Patricia Garcia-Canadilla
- Institute of Cardiovascular Science, University College London, London, UK.,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
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Huang W, Lu J, Tang R, Wu Z, Wang Q, Ding X, Wang Z, Chen K. Phase Contrast Imaging Based Microbubble Monitoring of Radiofrequency Ablation: An ex vivo Study. Front Oncol 2020; 10:1709. [PMID: 32984051 PMCID: PMC7477093 DOI: 10.3389/fonc.2020.01709] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2019] [Accepted: 07/30/2020] [Indexed: 01/15/2023] Open
Abstract
Background To explore the potential of synchrotron radiation (SR) phase contrast imaging (PCI) for real-time microbubble formation monitoring during radiofrequency ablation (RFA). Methods RFA was performed on ex vivo porcine muscle tissue using unipolar and multi-tined expandable electrodes. Images of microbubble formation in the samples were captured by both SR PCI and absorption contrast imaging. The synchronous ablation temperature was recorded. Each RFA electrode type group contained 6 samples. Ablation size was assessed by histologic examination. Results Microbubble formation during RFA could be visualized by SR PCI. The diameter of the microbubbles revealed on the image ranged from tens of microns to several millimeters, and these microbubbles first appeared at the edge of the RFA electrode when the target region temperature reached approximately 60°C and rapidly extended outwards. The average microbubble range measured on PCI was 17.66 ± 0.74 mm. The average range of coagulation necrosis measured by histological examination was 17.22 ± 0.38 mm. There was no significant difference between them (P > 0.05). The range of microbubbles corresponded to the ablation zone. Conclusion PCI enabled real-time high-resolution visualization of microbubble formation during RFA, indicating a potential for its use in ablation monitoring.
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Affiliation(s)
- Wei Huang
- Department of Radiology, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Jian Lu
- Department of Radiology, Ruijin Hospital/Luwan Branch, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Rongbiao Tang
- Department of Radiology, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Zhiyuan Wu
- Department of Radiology, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Qingbing Wang
- Department of Radiology, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Xiaoyi Ding
- Department of Radiology, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Zhongmin Wang
- Department of Radiology, Ruijin Hospital/Luwan Branch, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Kemin Chen
- Department of Radiology, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
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Emons J, Fasching PA, Wunderle M, Heindl F, Rieger J, Horn F, Pelzer G, Ritter A, Weber T, Radicke M, Polifka I, Wachter DL, Wenkel E, Michel T, Uder M, Hartmann A, Anton G, Beckmann MW, Schulz-Wendtland R, Jud SM. Assessment of the additional clinical potential of X-ray dark-field imaging for breast cancer in a preclinical setup. Ther Adv Med Oncol 2020; 12:1758835920957932. [PMID: 32994806 PMCID: PMC7502853 DOI: 10.1177/1758835920957932] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 08/20/2020] [Indexed: 12/01/2022] Open
Abstract
Background: Mammography can identify calcifications up to 50–100 μm in size as a surrogate parameter for breast cancer or ductal carcinoma in situ (DCIS). Microcalcifications measuring <50 µm are also associated with breast cancer or DCIS and are frequently not detected on mammography, although they can be detected with dark-field imaging. This study examined whether additional breast examination using X-ray dark-field imaging can increase the detection rate of calcifications. Advances in knowledge: (1) evaluation of additional modality of breast imaging; (2) specific evaluation of breast calcifications. Implications for patient care: the addition of X-ray dark-field imaging to conventional mammography could detect additional calcifications. Methods: Talbot–Lau X-ray phase–contrast imaging and X-ray dark-field imaging were used to acquire images of breast specimens. The radiation dosage with the technique is comparable with conventional mammography. Three X-ray gratings with periods of 5–10 µm between the X-ray tube and the flat-panel detector provide three different images in a single sequence: the conventional attenuation image, differential phase image, and dark-field image. The images were read by radiologists. Radiological findings were marked and examined pathologically. The results were described in a descriptive manner. Results: A total of 81 breast specimens were investigated with the two methods; 199 significant structures were processed pathologically, consisting of 123 benign and 76 malignant lesions (DCIS or invasive breast cancer). X-ray dark-field imaging identified 15 additional histologically confirmed carcinoma lesions that were visible but not declared suspicious on digital mammography alone. Another four malignant lesions that were not visible on mammography were exclusively detected with X-ray dark-field imaging. Conclusions: Adding X-ray dark-field imaging to digital mammography increases the detection rate for breast cancer and DCIS associated lesions with micrometer-sized calcifications. The use of X-ray dark-field imaging may be able to provide more accurate and detailed radiological classification of suspicious breast lesions. Adding X-ray dark-field imaging to mammography may be able to increase the detection rate and improve preoperative planning in deciding between mastectomy or breast-conserving therapy, particularly in patients with invasive lobular breast cancer.
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Affiliation(s)
- Julius Emons
- Department of Gynecology and Obstetrics, Friedrich Alexander University of Erlangen-Nuremberg, Erlangen, Bayern, Germany
| | - Peter A Fasching
- Department of Gynecology and Obstetrics, Erlangen University Hospital, Comprehensive Cancer Center Erlangen-EMN, Universitätsstrasse 21-23, Erlangen 91054, Germany
| | - Marius Wunderle
- Department of Gynecology and Obstetrics, Friedrich Alexander University of Erlangen-Nuremberg, Erlangen, Bayern, Germany
| | - Felix Heindl
- Department of Gynecology and Obstetrics, Friedrich Alexander University of Erlangen-Nuremberg, Erlangen, Bayern, Germany
| | - Jens Rieger
- Erlangen Center for Astroparticle Physics, Friedrich Alexander University of Erlangen-Nuremberg, Erlangen, Germany
| | - Florian Horn
- Erlangen Center for Astroparticle Physics, Friedrich Alexander University of Erlangen-Nuremberg, Erlangen, Germany
| | - Georg Pelzer
- Erlangen Center for Astroparticle Physics, Friedrich Alexander University of Erlangen-Nuremberg, Erlangen, Germany
| | - Andre Ritter
- Erlangen Center for Astroparticle Physics, Friedrich Alexander University of Erlangen-Nuremberg, Erlangen, Germany
| | - Thomas Weber
- Erlangen Center for Astroparticle Physics, Friedrich Alexander University of Erlangen-Nuremberg, Erlangen, Germany
| | | | - Iris Polifka
- Institute of Pathology, Erlangen University Hospital, Erlangen, Germany
| | - David L Wachter
- Institute of Pathology, Erlangen University Hospital, Erlangen, Germany
| | - Evelyn Wenkel
- Institute of Diagnostic Radiology, Erlangen University Hospital, Erlangen, Bayern, Germany
| | - Thilo Michel
- Erlangen Center for Astroparticle Physics, Friedrich Alexander University of Erlangen-Nuremberg, Erlangen, Germany
| | - Michael Uder
- Institute of Diagnostic Radiology, Erlangen University Hospital, Erlangen, Bayern, Germany
| | - Arndt Hartmann
- Institute of Pathology, Erlangen University Hospital, Erlangen, Germany
| | - Gisela Anton
- Erlangen Center for Astroparticle Physics, Friedrich Alexander University of Erlangen-Nuremberg, Erlangen, Germany
| | - Matthias W Beckmann
- Department of Gynecology and Obstetrics, Friedrich Alexander University of Erlangen-Nuremberg, Erlangen, Bayern, Germany
| | | | - Sebastian M Jud
- Department of Gynecology and Obstetrics, Friedrich Alexander University of Erlangen-Nuremberg, Erlangen, Bayern, Germany
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Günther B, Gradl R, Jud C, Eggl E, Huang J, Kulpe S, Achterhold K, Gleich B, Dierolf M, Pfeiffer F. The versatile X-ray beamline of the Munich Compact Light Source: design, instrumentation and applications. JOURNAL OF SYNCHROTRON RADIATION 2020; 27:1395-1414. [PMID: 32876618 PMCID: PMC7467334 DOI: 10.1107/s1600577520008309] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Accepted: 06/22/2020] [Indexed: 05/08/2023]
Abstract
Inverse Compton scattering provides means to generate low-divergence partially coherent quasi-monochromatic, i.e. synchrotron-like, X-ray radiation on a laboratory scale. This enables the transfer of synchrotron techniques into university or industrial environments. Here, the Munich Compact Light Source is presented, which is such a compact synchrotron radiation facility based on an inverse Compton X-ray source (ICS). The recent improvements of the ICS are reported first and then the various experimental techniques which are most suited to the ICS installed at the Technical University of Munich are reviewed. For the latter, a multipurpose X-ray application beamline with two end-stations was designed. The beamline's design and geometry are presented in detail including the different set-ups as well as the available detector options. Application examples of the classes of experiments that can be performed are summarized afterwards. Among them are dynamic in vivo respiratory imaging, propagation-based phase-contrast imaging, grating-based phase-contrast imaging, X-ray microtomography, K-edge subtraction imaging and X-ray spectroscopy. Finally, plans to upgrade the beamline in order to enhance its capabilities are discussed.
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Affiliation(s)
- Benedikt Günther
- Department of Physics, Technical University of Munich, James-Franck-Straße 1, 85748 Garching, Germany
- Munich School of BioEngineering, Technical University of Munich, Boltzmannstraße 11, 85748 Garching, Germany
| | - Regine Gradl
- Department of Physics, Technical University of Munich, James-Franck-Straße 1, 85748 Garching, Germany
- Munich School of BioEngineering, Technical University of Munich, Boltzmannstraße 11, 85748 Garching, Germany
| | - Christoph Jud
- Department of Physics, Technical University of Munich, James-Franck-Straße 1, 85748 Garching, Germany
- Munich School of BioEngineering, Technical University of Munich, Boltzmannstraße 11, 85748 Garching, Germany
| | - Elena Eggl
- Department of Physics, Technical University of Munich, James-Franck-Straße 1, 85748 Garching, Germany
- Munich School of BioEngineering, Technical University of Munich, Boltzmannstraße 11, 85748 Garching, Germany
| | - Juanjuan Huang
- Department of Physics, Technical University of Munich, James-Franck-Straße 1, 85748 Garching, Germany
- Munich School of BioEngineering, Technical University of Munich, Boltzmannstraße 11, 85748 Garching, Germany
| | - Stephanie Kulpe
- Department of Physics, Technical University of Munich, James-Franck-Straße 1, 85748 Garching, Germany
- Munich School of BioEngineering, Technical University of Munich, Boltzmannstraße 11, 85748 Garching, Germany
| | - Klaus Achterhold
- Department of Physics, Technical University of Munich, James-Franck-Straße 1, 85748 Garching, Germany
- Munich School of BioEngineering, Technical University of Munich, Boltzmannstraße 11, 85748 Garching, Germany
| | - Bernhard Gleich
- Munich School of BioEngineering, Technical University of Munich, Boltzmannstraße 11, 85748 Garching, Germany
| | - Martin Dierolf
- Department of Physics, Technical University of Munich, James-Franck-Straße 1, 85748 Garching, Germany
- Munich School of BioEngineering, Technical University of Munich, Boltzmannstraße 11, 85748 Garching, Germany
| | - Franz Pfeiffer
- Department of Physics, Technical University of Munich, James-Franck-Straße 1, 85748 Garching, Germany
- Munich School of BioEngineering, Technical University of Munich, Boltzmannstraße 11, 85748 Garching, Germany
- Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, Technical University of Munich, Ismaninger Straße 22, 81675 Munich, Germany
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BriXS, a new X-ray inverse Compton source for medical applications. Phys Med 2020; 77:127-137. [PMID: 32829101 DOI: 10.1016/j.ejmp.2020.08.013] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 08/03/2020] [Accepted: 08/11/2020] [Indexed: 12/14/2022] Open
Abstract
MariX is a research infrastructure conceived for multi-disciplinary studies, based on a cutting-edge system of combined electron accelerators at the forefront of the world-wide scenario of X-ray sources. The generation of X-rays over a large photon energy range will be enabled by two unique X-ray sources: a Free Electron Laser and an inverse Compton source, called BriXS (Bright compact X-ray Source). The X-ray beam provided by BriXS is expected to have an average energy tunable in the range 20-180 keV and intensities between 1011 and 1013 photon/s within a relative bandwidth ΔE/E=1-10%. These characteristics, together with a very small source size (~20 μm) and a good transverse coherence, will enable a wide range of applications in the bio-medical field. An additional unique feature of BriXS will be the possibility to make a quick switch of the X-ray energy between two values for dual-energy and K-edge subtraction imaging. In this paper, the expected characteristics of BriXS will be presented, with a particular focus on the features of interest to its possible medical applications.
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Mettivier G, Masi M, Arfelli F, Brombal L, Delogu P, Di Lillo F, Donato S, Fedon C, Golosio B, Oliva P, Rigon L, Sarno A, Taibi A, Russo P. Radiochromic film dosimetry in synchrotron radiation breast computed tomography: a phantom study. JOURNAL OF SYNCHROTRON RADIATION 2020; 27:762-771. [PMID: 32381779 PMCID: PMC7285685 DOI: 10.1107/s1600577520001745] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Accepted: 02/07/2020] [Indexed: 06/11/2023]
Abstract
This study relates to the INFN project SYRMA-3D for in vivo phase-contrast breast computed tomography using the SYRMEP synchrotron radiation beamline at the ELETTRA facility in Trieste, Italy. This peculiar imaging technique uses a novel dosimetric approach with respect to the standard clinical procedure. In this study, optimization of the acquisition procedure was evaluated in terms of dose delivered to the breast. An offline dose monitoring method was also investigated using radiochromic film dosimetry. Various irradiation geometries have been investigated for scanning the prone patient's pendant breast, simulated by a 14 cm-diameter polymethylmethacrylate cylindrical phantom containing pieces of calibrated radiochromic film type XR-QA2. Films were inserted mid-plane in the phantom, as well as wrapped around its external surface, and irradiated at 38 keV, with an air kerma value that would produce an estimated mean glandular dose of 5 mGy for a 14 cm-diameter 50% glandular breast. Axial scans were performed over a full rotation or over 180°. The results point out that a scheme adopting a stepped rotation irradiation represents the best geometry to optimize the dose distribution to the breast. The feasibility of using a piece of calibrated radiochromic film wrapped around a suitable holder around the breast to monitor the scan dose offline is demonstrated.
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Affiliation(s)
- Giovanni Mettivier
- Dipartimento di Fisica ‘Ettore Pancini’, Università di Napoli ‘Federico II’, I-80126 Napoli, Italy
- INFN, Sezione di Napoli, I-80126 Napoli, Italy
| | - Marica Masi
- Dipartimento di Fisica ‘Ettore Pancini’, Università di Napoli ‘Federico II’, I-80126 Napoli, Italy
- INFN, Sezione di Napoli, I-80126 Napoli, Italy
| | - Fulvia Arfelli
- Department of Physics, Università di Trieste, I-34127 Trieste, Italy
- Sezione di Trieste, INFN, I-34127 Trieste, Italy
| | - Luca Brombal
- Department of Physics, Università di Trieste, I-34127 Trieste, Italy
- Sezione di Trieste, INFN, I-34127 Trieste, Italy
| | - Pasquale Delogu
- Department of Physical Science, Earth and Environment, Università di Siena, I-53100 Siena, Italy
- Sezione di Pisa, INFN, I-34127 Pisa, Italy
| | - Francesca Di Lillo
- Dipartimento di Fisica ‘Ettore Pancini’, Università di Napoli ‘Federico II’, I-80126 Napoli, Italy
- INFN, Sezione di Napoli, I-80126 Napoli, Italy
- ELETTRA-Sincrotrone Trieste SCpA, Bassovizza, I-34149 Trieste, Italy
| | - Sandro Donato
- Department of Physics, Università di Trieste, I-34127 Trieste, Italy
- Sezione di Trieste, INFN, I-34127 Trieste, Italy
| | - Christian Fedon
- Sezione di Trieste, INFN, I-34127 Trieste, Italy
- Department of Radiology and Nuclear Medicine, Radboud University Medical Center, 6500 HB Nijmegen, The Netherlands
| | - Bruno Golosio
- Department of Physics, Università di Cagliari, I-09042 Cagliari, Italy
- Sezione di Cagliari, INFN, I-09042 Cagliari, Italy
| | - Piernicola Oliva
- Sezione di Cagliari, INFN, I-09042 Cagliari, Italy
- Department of Chemistry and Pharmacy, Università di Sassari, Sassari, Italy
| | - Luigi Rigon
- Department of Physics, Università di Trieste, I-34127 Trieste, Italy
- Sezione di Trieste, INFN, I-34127 Trieste, Italy
| | | | - Angelo Taibi
- Department of Physics and Earth Science, Università di Ferrara, I-44122 Ferrara, Italy
- Sezione di Ferrara, INFN, I-44122 Ferrara, Italy
| | - Paolo Russo
- Dipartimento di Fisica ‘Ettore Pancini’, Università di Napoli ‘Federico II’, I-80126 Napoli, Italy
- INFN, Sezione di Napoli, I-80126 Napoli, Italy
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Heck L, Eggl E, Grandl S, Dierolf M, Jud C, Günther B, Achterhold K, Mayr D, Gleich B, Hellerhoff K, Pfeiffer F, Herzen J. Dose and spatial resolution analysis of grating-based phase-contrast mammography using an inverse Compton x-ray source. J Med Imaging (Bellingham) 2020; 7:023505. [PMID: 32341937 PMCID: PMC7175026 DOI: 10.1117/1.jmi.7.2.023505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Accepted: 04/06/2020] [Indexed: 11/14/2022] Open
Abstract
Purpose: Although the mortality rate of breast cancer was reduced with the introduction of screening mammography, many women undergo unnecessary subsequent examinations due to inconclusive diagnoses. Superposition of anatomical structures especially within dense breasts in conjunction with the inherently low soft tissue contrast of absorption images compromises image quality. This can be overcome by phase-contrast imaging. Approach: We analyze the spatial resolution of grating-based multimodal mammography using a mammographic phantom and one freshly dissected mastectomy specimen at an inverse Compton x-ray source. Here, the focus was on estimating the spatial resolution with the sample in the beam path and discussing benefits and drawbacks of the method used and the estimation of the mean glandular dose. Finally, the possibility of improving the spatial resolution is investigated by comparing monochromatic grating-based mammography with the standard one. Results: The spatial resolution is constant or also higher for the image acquired with monochromatic radiation and the contrast-to-noise ratio (CNR) is higher in our approach while the dose can be reduced by up to 20%. Conclusions: In summary, phase-contrast imaging helps to improve tumor detection by advanced diagnostic image quality. We demonstrate a higher spatial resolution for one mastectomy specimen and increased CNR at an equal or lower dose for the monochromatic measurements.
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Affiliation(s)
- Lisa Heck
- Technical University of Munich, Chair of Biomedical Physics, Munich School of BioEngineering, Department of Physics, Garching, Germany
| | - Elena Eggl
- Technical University of Munich, Chair of Biomedical Physics, Munich School of BioEngineering, Department of Physics, Garching, Germany
| | - Susanne Grandl
- Ludwig Maximilian University of Munich, Institute for Clinical Radiology, Munich, Germany
| | - Martin Dierolf
- Technical University of Munich, Chair of Biomedical Physics, Munich School of BioEngineering, Department of Physics, Garching, Germany
| | - Christoph Jud
- Technical University of Munich, Chair of Biomedical Physics, Munich School of BioEngineering, Department of Physics, Garching, Germany
| | - Benedikt Günther
- Technical University of Munich, Chair of Biomedical Physics, Munich School of BioEngineering, Department of Physics, Garching, Germany
| | - Klaus Achterhold
- Technical University of Munich, Chair of Biomedical Physics, Munich School of BioEngineering, Department of Physics, Garching, Germany
| | - Doris Mayr
- Ludwig Maximilian University of Munich, Institute of Pathology, Munich, Germany
| | - Bernhard Gleich
- Technical University of Munich, Chair of Biomedical Physics, Munich School of BioEngineering, Department of Physics, Garching, Germany
| | - Karin Hellerhoff
- Ludwig Maximilian University of Munich, Institute for Clinical Radiology, Munich, Germany
| | - Franz Pfeiffer
- Technical University of Munich, Chair of Biomedical Physics, Munich School of BioEngineering, Department of Physics, Garching, Germany.,Technical University of Munich, School of Medicine and Klinikum rechts der Isar, Department of Diagnostic and Interventional Radiology, Munich, Germany
| | - Julia Herzen
- Technical University of Munich, Chair of Biomedical Physics, Munich School of BioEngineering, Department of Physics, Garching, Germany
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Rauch T, Rieger J, Pelzer G, Horn F, Erber R, Wunderle M, Emons J, Nabieva N, Fuhrich N, Michel T, Hartmann A, Fasching PA, Anton G. Discrimination analysis of breast calcifications using x-ray dark-field radiography. Med Phys 2020; 47:1813-1826. [PMID: 31977070 DOI: 10.1002/mp.14043] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 11/27/2019] [Accepted: 12/24/2019] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND X-ray dark-field radiography could enhance mammography by providing more information on imaged tissue and microcalcifications. The dark field signal is a measure of small angle scattering and can thus provide additional information on the imaged materials. This information can be useful for material distinction of calcifications and the diagnosis of breast cancer by classifying benign and malign association of these calcifications. METHODS For this study, institutional review board approval was obtained. We present the evaluation of images acquired with interferometric grating-based x-ray imaging of 323 microcalcifications (166 malign and 157 benign associated) in freshly dissected breast tissue and compare the results to the information extracted in follow-up pathological evaluation. The number of imaged calcifications is sufficiently higher than in similar previous studies. Fourteen calcification properties were extracted from the digital images and used as predictors in three different models common in discrimination analysis namely a simple threshold model, a naive Bayes model and a linear regression model, which classify the calcifications as associated with a benign or suspicious finding. Three of these fourteen predictors have been newly defined in this work and are independent from the tissue background surrounding the microcalcifications. Using these predictors no background correction is needed, as in previous works in this field. The new predictors are the length of the first and second principle component of the absorption and dark-field data, as well as the angle between the first principle component and the dark-field axis. We called these predictors data length, data width, and data orientation. RESULTS In fourfold cross-validation malignancy of the imaged tissue was predicted. Models that take only classical absorption predictors into account reached a sensitivity of 53.3% at a specificity of 81.1%. For a combination of predictors that also include dark field information, a sensitivity of 63.2% and specificity of 80.8% were obtained. The included dark field information consisted of the newly introduced parameters, data orientation and data width. CONCLUSIONS While remaining at a similar specificity, the sensitivity, with which a trained model was able to distinguish malign from benign associated calcifications, was increased by 10% on including dark-field information. This suggests grating-based x-ray imaging as a promising clinical imaging method in the field of mammography.
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Affiliation(s)
- Thomas Rauch
- Erlangen Centre for Astroparticle Physics (ECAP), Friedrich-Alexander-University Erlangen-Nuremberg, Erwin-Rommel-Str. 1, D-91058, Erlangen, Germany
| | - Jens Rieger
- Erlangen Centre for Astroparticle Physics (ECAP), Friedrich-Alexander-University Erlangen-Nuremberg, Erwin-Rommel-Str. 1, D-91058, Erlangen, Germany
| | - Georg Pelzer
- Erlangen Centre for Astroparticle Physics (ECAP), Friedrich-Alexander-University Erlangen-Nuremberg, Erwin-Rommel-Str. 1, D-91058, Erlangen, Germany
| | - Florian Horn
- Erlangen Centre for Astroparticle Physics (ECAP), Friedrich-Alexander-University Erlangen-Nuremberg, Erwin-Rommel-Str. 1, D-91058, Erlangen, Germany
| | - Ramona Erber
- Institute of Pathology, Comprehensive Cancer Center Erlangen-EMN, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - Marius Wunderle
- Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-EMN, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - Julius Emons
- Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-EMN, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - Naiba Nabieva
- Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-EMN, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - Nicole Fuhrich
- Institute of Pathology, Comprehensive Cancer Center Erlangen-EMN, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - Thilo Michel
- Erlangen Centre for Astroparticle Physics (ECAP), Friedrich-Alexander-University Erlangen-Nuremberg, Erwin-Rommel-Str. 1, D-91058, Erlangen, Germany
| | - Arndt Hartmann
- Institute of Pathology, Comprehensive Cancer Center Erlangen-EMN, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - Peter A Fasching
- Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-EMN, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - Gisela Anton
- Erlangen Centre for Astroparticle Physics (ECAP), Friedrich-Alexander-University Erlangen-Nuremberg, Erwin-Rommel-Str. 1, D-91058, Erlangen, Germany
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Rougé-Labriet H, Berujon S, Mathieu H, Bohic S, Fayard B, Ravey JN, Robert Y, Gaudin P, Brun E. X-ray Phase Contrast osteo-articular imaging: a pilot study on cadaveric human hands. Sci Rep 2020; 10:1911. [PMID: 32024864 PMCID: PMC7002527 DOI: 10.1038/s41598-020-58168-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Accepted: 01/07/2020] [Indexed: 01/14/2023] Open
Abstract
X-ray Phase Contrast Imaging (PCI) is an emerging modality whose availability in clinics for mammography and lung imaging is expected to materialize within the coming years. In this study, we evaluate the PCI Computed Tomography (PCI-CT) performances with respect to current conventional imaging modalities in the context of osteo-articular disorders diagnosis. X-ray PCI-CT was performed on 3 cadaveric human hands and wrists using a synchrotron beam. Conventional CT, MRI and Ultrasound were also performed on these three samples using routine procedures as well as research protocols. Six radiologists and rheumatologists independently evaluated qualitatively and semi quantitatively the 3D images' quality. Medical interpretations were also made from the images. PCI-CT allows the simultaneous visualization of both the high absorbing and the softer tissues. The 6 reader evaluations characterized PCI-CT as a visualization tool with improved performances for all tissue types (significant p-values), which provides sharper outlines and clearer internal structures than images obtained using conventional modalities. The PCI-CT images contain overall more information, especially at smaller scales with for instance more visible micro-calcifications in our chondrocalcinosis case. Despite a reduced number of samples used, this pilot study highlights the possible medical benefits of PCI for osteo-articular disorders evaluation. Although PCI-CT is not yet available in hospitals, the improved visualization capabilities demonstrated so far and the enhanced tissue measurement quality let suggest strong diagnosis benefits for rheumatology in case of a widespread application of PCI.
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Affiliation(s)
- Hélène Rougé-Labriet
- Novitom SAS, R-D, Grenoble, 38000, France
- Inserm UA7 Strobe, Université Grenoble Alpes, Grenoble, 38000, France
| | | | - Hervé Mathieu
- Université Grenoble Alpes, IRMaGe, Grenoble, 38000, France
| | - Sylvain Bohic
- Inserm UA7 Strobe, Université Grenoble Alpes, Grenoble, 38000, France
- ESRF, the European Synchrotron, Grenoble, 38000, France
| | | | - Jean-Noel Ravey
- Centre Hospitalier Universitaire Grenoble-Alpes, Hopital Sud, Echirolles, 38434, France
| | - Yohann Robert
- Centre Hospitalier Universitaire Grenoble-Alpes, Hopital Sud, Echirolles, 38434, France
| | - Philippe Gaudin
- Centre Hospitalier Universitaire Grenoble-Alpes, Hopital Sud, Echirolles, 38434, France
| | - Emmanuel Brun
- Inserm UA7 Strobe, Université Grenoble Alpes, Grenoble, 38000, France.
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Tavakoli Taba S, Baran P, Nesterets YI, Pacile S, Wienbeck S, Dullin C, Pavlov K, Maksimenko A, Lockie D, Mayo SC, Quiney HM, Dreossi D, Arfelli F, Tromba G, Lewis S, Gureyev TE, Brennan PC. Comparison of propagation-based CT using synchrotron radiation and conventional cone-beam CT for breast imaging. Eur Radiol 2020; 30:2740-2750. [DOI: 10.1007/s00330-019-06567-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Revised: 10/29/2019] [Accepted: 10/31/2019] [Indexed: 01/08/2023]
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40
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Morgan KS, Parsons D, Cmielewski P, McCarron A, Gradl R, Farrow N, Siu K, Takeuchi A, Suzuki Y, Uesugi K, Uesugi M, Yagi N, Hall C, Klein M, Maksimenko A, Stevenson A, Hausermann D, Dierolf M, Pfeiffer F, Donnelley M. Methods for dynamic synchrotron X-ray respiratory imaging in live animals. JOURNAL OF SYNCHROTRON RADIATION 2020; 27:164-175. [PMID: 31868749 PMCID: PMC6927518 DOI: 10.1107/s1600577519014863] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Accepted: 11/04/2019] [Indexed: 05/20/2023]
Abstract
Small-animal physiology studies are typically complicated, but the level of complexity is greatly increased when performing live-animal X-ray imaging studies at synchrotron and compact light sources. This group has extensive experience in these types of studies at the SPring-8 and Australian synchrotrons, as well as the Munich Compact Light Source. These experimental settings produce unique challenges. Experiments are always performed in an isolated radiation enclosure not specifically designed for live-animal imaging. This requires equipment adapted to physiological monitoring and test-substance delivery, as well as shuttering to reduce the radiation dose. Experiment designs must also take into account the fixed location, size and orientation of the X-ray beam. This article describes the techniques developed to overcome the challenges involved in respiratory X-ray imaging of live animals at synchrotrons, now enabling increasingly sophisticated imaging protocols.
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Affiliation(s)
- Kaye Susannah Morgan
- School of Physics and Astronomy, Monash University, Wellington Road, Clayton, VIC 3800, Australia
- Institute for Advanced Study, Technische Universität München, Garching Germany
- Chair of Biomedical Physics and Munich School of BioEngineering, Technische Universität München, 85748 Garching, Germany
| | - David Parsons
- Robinson Research Institute, University of Adelaide, SA 5006, Australia
- Adelaide Medical School, University of Adelaide, SA 5000, Australia
- Respiratory and Sleep Medicine, Women’s and Children’s Hospital, 72 King William Road, North Adelaide, SA 5006, Australia
| | - Patricia Cmielewski
- Robinson Research Institute, University of Adelaide, SA 5006, Australia
- Adelaide Medical School, University of Adelaide, SA 5000, Australia
- Respiratory and Sleep Medicine, Women’s and Children’s Hospital, 72 King William Road, North Adelaide, SA 5006, Australia
| | - Alexandra McCarron
- Robinson Research Institute, University of Adelaide, SA 5006, Australia
- Adelaide Medical School, University of Adelaide, SA 5000, Australia
- Respiratory and Sleep Medicine, Women’s and Children’s Hospital, 72 King William Road, North Adelaide, SA 5006, Australia
| | - Regine Gradl
- Institute for Advanced Study, Technische Universität München, Garching Germany
- Chair of Biomedical Physics and Munich School of BioEngineering, Technische Universität München, 85748 Garching, Germany
| | - Nigel Farrow
- Robinson Research Institute, University of Adelaide, SA 5006, Australia
- Adelaide Medical School, University of Adelaide, SA 5000, Australia
- Respiratory and Sleep Medicine, Women’s and Children’s Hospital, 72 King William Road, North Adelaide, SA 5006, Australia
| | - Karen Siu
- School of Physics and Astronomy, Monash University, Wellington Road, Clayton, VIC 3800, Australia
| | - Akihisa Takeuchi
- SPring-8, Japan Synchrotron Radiation Institute, Kouto, Hyogo, Japan
| | - Yoshio Suzuki
- SPring-8, Japan Synchrotron Radiation Institute, Kouto, Hyogo, Japan
| | - Kentaro Uesugi
- SPring-8, Japan Synchrotron Radiation Institute, Kouto, Hyogo, Japan
| | - Masayuki Uesugi
- SPring-8, Japan Synchrotron Radiation Institute, Kouto, Hyogo, Japan
| | - Naoto Yagi
- SPring-8, Japan Synchrotron Radiation Institute, Kouto, Hyogo, Japan
| | - Chris Hall
- Imaging and Medical Beamline, The Australian Synchrotron – ANSTO, 800 Blackburn Road, Clayton, VIC 3168, Australia
| | - Mitzi Klein
- Imaging and Medical Beamline, The Australian Synchrotron – ANSTO, 800 Blackburn Road, Clayton, VIC 3168, Australia
| | - Anton Maksimenko
- Imaging and Medical Beamline, The Australian Synchrotron – ANSTO, 800 Blackburn Road, Clayton, VIC 3168, Australia
| | - Andrew Stevenson
- Imaging and Medical Beamline, The Australian Synchrotron – ANSTO, 800 Blackburn Road, Clayton, VIC 3168, Australia
| | - Daniel Hausermann
- Imaging and Medical Beamline, The Australian Synchrotron – ANSTO, 800 Blackburn Road, Clayton, VIC 3168, Australia
| | - Martin Dierolf
- Chair of Biomedical Physics and Munich School of BioEngineering, Technische Universität München, 85748 Garching, Germany
| | - Franz Pfeiffer
- Institute for Advanced Study, Technische Universität München, Garching Germany
- Chair of Biomedical Physics and Munich School of BioEngineering, Technische Universität München, 85748 Garching, Germany
| | - Martin Donnelley
- Robinson Research Institute, University of Adelaide, SA 5006, Australia
- Adelaide Medical School, University of Adelaide, SA 5000, Australia
- Respiratory and Sleep Medicine, Women’s and Children’s Hospital, 72 King William Road, North Adelaide, SA 5006, Australia
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41
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Abstract
For the past several decades, synchrotron radiation has been extensively used to measure the spatial distribution and chemical affinity of elements found in trace concentrations (<few μg/g) in animal and human tissues. Intense and highly focused (lateral size of several micrometers) X-ray beams combined with small steps of photon energy tuning (2-3 eV) of synchrotron radiation allowed X-ray fluorescence (XRF) and X-ray absorption spectroscopy (XAS) techniques to nondestructively and simultaneously detect trace elements as well as identify their chemical affinity and speciation in situ, respectively. Although limited by measurement time and radiation damage to the tissue, these techniques are commonly used to obtain two-dimensional and three-dimensional maps of several elements at synchrotron facilities around the world. The spatial distribution and chemistry of the trace elements obtained is then correlated to the targeted anatomical structures and to the biological functions (normal or pathological). For example, synchrotron-based in vitro studies of various human tissues showed significant differences between the normal and pathological distributions of metallic trace elements such as iron, zinc, copper, and lead in relation to human diseases ranging from Parkinson's disease and cancer to osteoporosis and osteoarthritis. Current research effort is aimed at not only measuring the abnormal elemental distributions associated with various diseases, but also indicate or discover possible biological mechanisms that could explain such observations. While a number of studies confirmed and strengthened previous knowledge, others revealed or suggested new possible roles of trace elements or provided a more accurate spatial distribution in relation to the underlying histology. This area of research is at the intersection of several current fundamental and applied scientific inquiries such as metabolomics, medicine, biochemistry, toxicology, food science, health physics, and environmental and public health.
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42
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Brombal L, Arfelli F, Delogu P, Donato S, Mettivier G, Michielsen K, Oliva P, Taibi A, Sechopoulos I, Longo R, Fedon C. Image quality comparison between a phase-contrast synchrotron radiation breast CT and a clinical breast CT: a phantom based study. Sci Rep 2019; 9:17778. [PMID: 31780707 PMCID: PMC6882794 DOI: 10.1038/s41598-019-54131-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2019] [Accepted: 11/04/2019] [Indexed: 11/13/2022] Open
Abstract
In this study we compared the image quality of a synchrotron radiation (SR) breast computed tomography (BCT) system with a clinical BCT in terms of contrast-to-noise ratio (CNR), signal-to-noise ratio (SNR), noise power spectrum (NPS), spatial resolution and detail visibility. A breast phantom consisting of several slabs of breast-adipose equivalent material with different embedded targets (i.e., masses, fibers and calcifications) was used. Phantom images were acquired using a dedicated BCT system installed at the Radboud University Medical Center (Nijmegen, The Netherlands) and the SR BCT system at the SYRMEP beamline of Elettra SR facility (Trieste, Italy) based on a photon-counting detector. Images with the SR setup were acquired mimicking the clinical BCT conditions (i.e., energy of 30 keV and radiation dose of 6.5 mGy). Images were reconstructed with an isotropic cubic voxel of 273 µm for the clinical BCT, while for the SR setup two phase-retrieval (PhR) kernels (referred to as “smooth” and “sharp”) were alternatively applied to each projection before tomographic reconstruction, with voxel size of 57 × 57 × 50 µm3. The CNR for the clinical BCT system can be up to 2-times higher than SR system, while the SNR can be 3-times lower than SR system, when the smooth PhR is used. The peak frequency of the NPS for the SR BCT is 2 to 4-times higher (0.9 mm−1 and 1.4 mm−1 with smooth and sharp PhR, respectively) than the clinical BCT (0.4 mm−1). The spatial resolution (MTF10%) was estimated to be 1.3 lp/mm for the clinical BCT, and 5.0 lp/mm and 6.7 lp/mm for the SR BCT with the smooth and sharp PhR, respectively. The smallest fiber visible in the SR BCT has a diameter of 0.15 mm, while for the clinical BCT is 0.41 mm. Calcification clusters with diameter of 0.13 mm are visible in the SR BCT, while the smallest diameter for the clinical BCT is 0.29 mm. As expected, the image quality of the SR BCT outperforms the clinical BCT system, providing images with higher spatial resolution and SNR, and with finer granularity. Nevertheless, this study assesses the image quality gap quantitatively, giving indications on the benefits associated with SR BCT and providing a benchmarking basis for its clinical implementation. In addition, SR-based studies can provide a gold-standard in terms of achievable image quality, constituting an upper-limit to the potential clinical development of a given technique.
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Affiliation(s)
- Luca Brombal
- Department of Physics, University of Trieste, 34127, Trieste, Italy.,INFN Division of Trieste, 34127, Trieste, Italy
| | - Fulvia Arfelli
- Department of Physics, University of Trieste, 34127, Trieste, Italy.,INFN Division of Trieste, 34127, Trieste, Italy
| | - Pasquale Delogu
- Department of Physical Sciences, Earth and Environment, University of Siena, 53100, Siena, Italy.,INFN Division of Pisa, 56127, Pisa, Italy
| | - Sandro Donato
- Department of Physics, University of Trieste, 34127, Trieste, Italy.,INFN Division of Trieste, 34127, Trieste, Italy
| | - Giovanni Mettivier
- Department of Physics, University of Napoli Federico II, 80126, Fuorigrotta Napoli, Italy.,INFN Division of Napoli, 80126, Fuorigrotta Napoli, Italy
| | - Koen Michielsen
- Department of Radiology and Nuclear Medicine, Radboud University Medical Center, 6500 HB, Nijmegen, The Netherlands
| | - Piernicola Oliva
- Department of Chemistry and Pharmacy, University of Sassari, 07100, Sassari, Italy.,INFN Division of Cagliari, 09042, Monserrato Cagliari, Italy
| | - Angelo Taibi
- Department of Physics and Earth Science, University of Ferrara, 44122, Ferrara, Italy.,INFN Division of Ferrara, 44122, Ferrara, Italy
| | - Ioannis Sechopoulos
- Department of Radiology and Nuclear Medicine, Radboud University Medical Center, 6500 HB, Nijmegen, The Netherlands.,Dutch Expert Center for Screening (LRCB), 6503 GJ, Nijmegen, The Netherlands
| | - Renata Longo
- Department of Physics, University of Trieste, 34127, Trieste, Italy. .,INFN Division of Trieste, 34127, Trieste, Italy.
| | - Christian Fedon
- INFN Division of Trieste, 34127, Trieste, Italy.,Department of Radiology and Nuclear Medicine, Radboud University Medical Center, 6500 HB, Nijmegen, The Netherlands
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43
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Patel PA, Stojanovic J. Diagnosis and Treatment of Renovascular Disease in Children. Semin Roentgenol 2019; 54:367-383. [PMID: 31706370 DOI: 10.1053/j.ro.2019.06.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Premal A Patel
- Interventional Radiology, Radiology Department, Great Ormond Street Hospital for Children, London, United Kingdom.
| | - Jelena Stojanovic
- Renal Unit, Great Ormond Street Hospital for Children, London, United Kingdom
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44
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Pacilè S, Dullin C, Baran P, Tonutti M, Perske C, Fischer U, Albers J, Arfelli F, Dreossi D, Pavlov K, Maksimenko A, Mayo SC, Nesterets YI, Taba ST, Lewis S, Brennan PC, Gureyev TE, Tromba G, Wienbeck S. Free propagation phase-contrast breast CT provides higher image quality than cone-beam breast-CT at low radiation doses: a feasibility study on human mastectomies. Sci Rep 2019; 9:13762. [PMID: 31551475 PMCID: PMC6760215 DOI: 10.1038/s41598-019-50075-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Accepted: 08/22/2019] [Indexed: 12/09/2022] Open
Abstract
In this study we demonstrate the first direct comparison between synchrotron x-ray propagation-based CT (PB-CT) and cone-beam breast-CT (CB-CT) on human mastectomy specimens (N = 12) including different benign and malignant lesions. The image quality and diagnostic power of the obtained data sets were compared and judged by two independent expert radiologists. Two cases are presented in detail in this paper including a comparison with the corresponding histological evaluation. Results indicate that with PB-CT it is possible to increase the level of contrast-to-noise ratio (CNR) keeping the same level of dose used for the CB-CT or achieve the same level of CNR reached by CB-CT at a lower level of dose. In other words, PB-CT can achieve a higher diagnostic potential compared to the commercial breast-CT system while also delivering a considerably lower mean glandular dose. Therefore, we believe that PB-CT technique, if translated to a clinical setting, could have a significant impact in improving breast cancer diagnosis.
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Affiliation(s)
- S Pacilè
- Elettra Sincrotrone Trieste S.C.p.A., Basovizza, Italy. .,Department of Engineering and Architecture, University of Trieste, Trieste, Italy.
| | - C Dullin
- Elettra Sincrotrone Trieste S.C.p.A., Basovizza, Italy.,Institute for Diagnostic and Interventional Radiology, University Medical Center Goettingen, Goettingen, Germany.,Translational Molecular Imaging, Max-Plank-Institute for Experimental Medicine, Goettingen, Germany
| | - P Baran
- ARC Centre of Excellence in Advanced Molecular Imaging, School of Physics, The University of Melbourne, Parkville, Australia
| | - M Tonutti
- Department of Radiology, Academic Hospital of Trieste, Trieste, Italy
| | - C Perske
- Institute for Pathology, University Medical Center Goettingen, Goettingen, Germany
| | - U Fischer
- Diagnostic Breast Center Goettingen, Goettingen, Germany
| | - J Albers
- Institute for Diagnostic and Interventional Radiology, University Medical Center Goettingen, Goettingen, Germany
| | - F Arfelli
- Department of Physics, University of Trieste, Trieste, Italy
| | - D Dreossi
- Elettra Sincrotrone Trieste S.C.p.A., Basovizza, Italy
| | - K Pavlov
- School of Physical and Chemical Sciences, University of Canterbury, Christchurch, New Zealand.,School of Science and Technology, University of New England, Armidale, Australia.,School of Physics and Astronomy, Monash University, Clayton, Australia
| | | | - S C Mayo
- Commonwealth Scientific and Industrial Research Organisation, Clayton, Australia
| | - Y I Nesterets
- Commonwealth Scientific and Industrial Research Organisation, Clayton, Australia.,School of Science and Technology, University of New England, Armidale, Australia
| | - S Tavakoli Taba
- The University of Sydney, BREAST, Faculty of Health Sciences, Lidcombe, New South Wales, Australia
| | - S Lewis
- The University of Sydney, BREAST, Faculty of Health Sciences, Lidcombe, New South Wales, Australia
| | - P C Brennan
- The University of Sydney, BREAST, Faculty of Health Sciences, Lidcombe, New South Wales, Australia
| | - T E Gureyev
- ARC Centre of Excellence in Advanced Molecular Imaging, School of Physics, The University of Melbourne, Parkville, Australia.,School of Science and Technology, University of New England, Armidale, Australia.,School of Physics and Astronomy, Monash University, Clayton, Australia.,The University of Sydney, BREAST, Faculty of Health Sciences, Lidcombe, New South Wales, Australia
| | - G Tromba
- Elettra Sincrotrone Trieste S.C.p.A., Basovizza, Italy
| | - S Wienbeck
- Institute for Diagnostic and Interventional Radiology, University Medical Center Goettingen, Goettingen, Germany
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45
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Optimization of the energy for Breast monochromatic absorption X-ray Computed Tomography. Sci Rep 2019; 9:13135. [PMID: 31511550 PMCID: PMC6739417 DOI: 10.1038/s41598-019-49351-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Accepted: 08/22/2019] [Indexed: 11/09/2022] Open
Abstract
The limits of mammography have led to an increasing interest on possible alternatives such as the breast Computed Tomography (bCT). The common goal of all X-ray imaging techniques is to achieve the optimal contrast resolution, measured through the Contrast to Noise Ratio (CNR), while minimizing the radiological risks, quantified by the dose. Both dose and CNR depend on the energy and the intensity of the X-rays employed for the specific imaging technique. Some attempts to determine an optimal energy for bCT have suggested the range 22 keV-34 keV, some others instead suggested the range 50 keV-60 keV depending on the parameters considered in the study. Recent experimental works, based on the use of monochromatic radiation and breast specimens, show that energies around 32 keV give better image quality respect to setups based on higher energies. In this paper we report a systematic study aiming at defining the range of energies that maximizes the CNR at fixed dose in bCT. The study evaluates several compositions and diameters of the breast and includes various reconstruction algorithms as well as different dose levels. The results show that a good compromise between CNR and dose is obtained using energies around 28 keV.
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46
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Garcia-Canadilla P, Dejea H, Bonnin A, Balicevic V, Loncaric S, Zhang C, Butakoff C, Aguado-Sierra J, Vázquez M, Jackson LH, Stuckey DJ, Rau C, Stampanoni M, Bijnens B, Cook AC. Complex Congenital Heart Disease Associated With Disordered Myocardial Architecture in a Midtrimester Human Fetus. Circ Cardiovasc Imaging 2019; 11:e007753. [PMID: 30354476 DOI: 10.1161/circimaging.118.007753] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND In the era of increasingly successful corrective interventions in patients with congenital heart disease (CHD), global and regional myocardial remodeling are emerging as important sources of long-term morbidity/mortality. Changes in organization of the myocardium in CHD, and in its mechanical properties, conduction, and blood supply, result in altered myocardial function both before and after surgery. To gain a better understanding and develop appropriate and individualized treatment strategies, the microscopic organization of cardiomyocytes, and their integration at a macroscopic level, needs to be completely understood. The aim of this study is to describe, for the first time, in 3 dimensions and nondestructively the detailed remodeling of cardiac microstructure present in a human fetal heart with complex CHD. METHODS AND RESULTS Synchrotron X-ray phase-contrast imaging was used to image an archival midgestation formalin-fixed fetal heart with right isomerism and complex CHD and compare with a control fetal heart. Analysis of myocyte aggregates, at detail not accessible with other techniques, was performed. Macroanatomic and conduction system changes specific to the disease were clearly observable, together with disordered myocyte organization in the morphologically right ventricle myocardium. Electrical activation simulations suggested altered synchronicity of the morphologically right ventricle. CONCLUSIONS We have shown the potential of X-ray phase-contrast imaging for studying cardiac microstructure in the developing human fetal heart at high resolution providing novel insight while preserving valuable archival material for future study. This is the first study to show myocardial alterations occur in complex CHD as early as midgestation.
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Affiliation(s)
- Patricia Garcia-Canadilla
- Institute of Cardiovascular Science (P.G.-C., A.C.C.), University College London, United Kingdom.,Department of Information and Communications Technologies, Universitat Pompeu Fabra, Barcelona, Spain (P.G.-C., C.Z., C.B., B.B.)
| | - Hector Dejea
- Swiss Light Source, Paul Scherrer Institut, Villigen, Switzerland (H.D., A.B., M.S.).,Institute for Biomedical Engineering, ETH Zurich, Zurich, Switzerland (H.D., M.S.)
| | - Anne Bonnin
- Swiss Light Source, Paul Scherrer Institut, Villigen, Switzerland (H.D., A.B., M.S.)
| | - Vedrana Balicevic
- Faculty of Electrical Engineering and Computing, University of Zagreb, Zagreb, Croatia (V.B., S.L.)
| | - Sven Loncaric
- Faculty of Electrical Engineering and Computing, University of Zagreb, Zagreb, Croatia (V.B., S.L.)
| | - Chong Zhang
- Department of Information and Communications Technologies, Universitat Pompeu Fabra, Barcelona, Spain (P.G.-C., C.Z., C.B., B.B.)
| | - Constantine Butakoff
- Department of Information and Communications Technologies, Universitat Pompeu Fabra, Barcelona, Spain (P.G.-C., C.Z., C.B., B.B.)
| | - Jazmin Aguado-Sierra
- Barcelona Supercomputing Center-Centro Nacional de Supercomputación, Campus Nord Universitat Politecnica de Catalunya, Barcelona, Spain (J.A.-S., M.V.)
| | - Mariano Vázquez
- Barcelona Supercomputing Center-Centro Nacional de Supercomputación, Campus Nord Universitat Politecnica de Catalunya, Barcelona, Spain (J.A.-S., M.V.).,IIIA-CSIC, Bellaterra, Spain (M.V.)
| | - Laurence H Jackson
- Division of Medicine, Centre for Advanced Biomedical Imaging (L.H.J., D.J.S.), University College London, United Kingdom
| | - Daniel J Stuckey
- Division of Medicine, Centre for Advanced Biomedical Imaging (L.H.J., D.J.S.), University College London, United Kingdom
| | - Cristoph Rau
- Diamond Manchester Imaging Branchline (I13-2), Diamond Lightsource, Oxford, United Kingdom (C.R.)
| | - Marco Stampanoni
- Swiss Light Source, Paul Scherrer Institut, Villigen, Switzerland (H.D., A.B., M.S.).,Institute for Biomedical Engineering, ETH Zurich, Zurich, Switzerland (H.D., M.S.)
| | - Bart Bijnens
- Department of Information and Communications Technologies, Universitat Pompeu Fabra, Barcelona, Spain (P.G.-C., C.Z., C.B., B.B.).,Institución Catalana de Investigación y Estudios Avanzados, Barcelona, Spain (B.B.)
| | - Andrew C Cook
- Institute of Cardiovascular Science (P.G.-C., A.C.C.), University College London, United Kingdom
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47
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Piai A, Contillo A, Arfelli F, Bonazza D, Brombal L, Assunta Cova M, Delogu P, Di Trapani V, Donato S, Golosio B, Mettivier G, Oliva P, Rigon L, Taibi A, Tonutti M, Tromba G, Zanconati F, Longo R. Quantitative characterization of breast tissues with dedicated CT imaging. Phys Med Biol 2019; 64:155011. [PMID: 31234148 DOI: 10.1088/1361-6560/ab2c29] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
A quantitative characterization of the soft tissues composing the human breast is achieved by means of a monochromatic CT phase-contrast imaging system, through accurate measurements of their attenuation coefficients within the energy range of interest for breast CT clinical examinations. Quantitative measurements of linear attenuation coefficients are performed on tomographic reconstructions of surgical samples, using monochromatic x-ray beams from a synchrotron source and a free space propagation setup. An online calibration is performed on the obtained reconstructions, in order to reassess the validity of the standard calibration procedure of the CT scanner. Three types of healthy tissues (adipose, glandular, and skin) and malignant tumors, when present, are considered from each sample. The measured attenuation coefficients are in very good agreement with the outcomes of similar studies available in the literature, although they span an energy range that was mostly neglected in the previous studies. No globally significant differences are observed between healthy and malignant dense tissues, although the number of considered samples does not appear sufficient to address the issue of a quantitative differentiation of tumors. The study assesses the viability of the proposed methodology for the measurement of linear attenuation coefficients, and provides a denser sampling of attenuation data in the energy range useful to breast CT.
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Affiliation(s)
- Anna Piai
- Department of Physics, University of Trieste, Via Valerio 2, 34127 Trieste, Italy. INFN Division of Trieste, Via Valerio 2, 34127 Trieste, Italy. Present address: Department of Physics, University of Milan, Via G. Celoria 16, 20133 Milano, Italy
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48
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Ghani MU, Gregory B, Omoumi F, Zheng B, Yan A, Wu X, Liu H. Impact of a single distance phase retrieval algorithm on spatial resolution in X-ray inline phase sensitive imaging. BIOMEDICAL SPECTROSCOPY AND IMAGING 2019; 8:29-40. [PMID: 31788419 PMCID: PMC6883648 DOI: 10.3233/bsi-190186] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
A single-projection based phase retrieval method based on the phase attenuation duality principle (PAD) was used to compare the spatial resolution of the acquired phase sensitive and PAD processed phase retrieved images. An inline phase sensitive prototype was used to acquire the phase sensitive images. The prototype incorporates a micro-focus x-ray source and a flat panel detector with a 50 μm pixel pitch. A phantom composed of a 2 cm thick 50-50 adipose-glandular mimicking slab sandwiched with a 0.82 cm thick slanted PMMA sharp edge was used. Phase sensitive image of the phantom was acquired at 120 kV, 3.35 mAs with a 16 μm tube focal spot size under a geometric magnification (M) of 2.5. The PAD based method was applied to the acquired phase sensitive image for the retrieval of phase values. With necessary data processing, modulation transfer function (MTF) curves were determined for the estimation and comparison of the spatial resolution. The PAD processed phase retrieved values of the phantom were in good agreement with the theoretically calculated values. Phase sensitive images showed higher spatial resolution at all spatial frequencies compared to the phase retrieved images. It was noted that the high-frequency signal components in the retrieved image were suppressed that resulted in lower MTF values. When compared to the phase sensitive image, the cutoff resolution (10% MTF) for phase retrieved image dropped 32% from 15.6 lp/mm (32μm) to 10.6 lp/mm (47μm). The resolution offered by this phase sensitive prototype is radiographically enough to detect breast cancer.
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Affiliation(s)
- Muhammad. U. Ghani
- Advanced Medical Imaging Center and School of Electrical and Computer Engineering, University of Oklahoma,
Norman, OK 73019, USA
| | - Bradley Gregory
- Advanced Medical Imaging Center and School of Electrical and Computer Engineering, University of Oklahoma,
Norman, OK 73019, USA
| | - Farid Omoumi
- Advanced Medical Imaging Center and School of Electrical and Computer Engineering, University of Oklahoma,
Norman, OK 73019, USA
| | - Bin Zheng
- Advanced Medical Imaging Center and School of Electrical and Computer Engineering, University of Oklahoma,
Norman, OK 73019, USA
| | - Aimin Yan
- Department of Radiology, University of Alabama at Birmingham, Birmingham, AL, 35249, USA
| | - Xizeng Wu
- Department of Radiology, University of Alabama at Birmingham, Birmingham, AL, 35249, USA
| | - Hong Liu
- Advanced Medical Imaging Center and School of Electrical and Computer Engineering, University of Oklahoma,
Norman, OK 73019, USA
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49
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Longo R, Arfelli F, Bonazza D, Bottigli U, Brombal L, Contillo A, Cova MA, Delogu P, Di Lillo F, Di Trapani V, Donato S, Dreossi D, Fanti V, Fedon C, Golosio B, Mettivier G, Oliva P, Pacilè S, Sarno A, Rigon L, Russo P, Taibi A, Tonutti M, Zanconati F, Tromba G. Advancements towards the implementation of clinical phase-contrast breast computed tomography at Elettra. JOURNAL OF SYNCHROTRON RADIATION 2019; 26:1343-1353. [PMID: 31274463 DOI: 10.1107/s1600577519005502] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Accepted: 04/23/2019] [Indexed: 06/09/2023]
Abstract
Breast computed tomography (BCT) is an emerging application of X-ray tomography in radiological practice. A few clinical prototypes are under evaluation in hospitals and new systems are under development aiming at improving spatial and contrast resolution and reducing delivered dose. At the same time, synchrotron-radiation phase-contrast mammography has been demonstrated to offer substantial advantages when compared with conventional mammography. At Elettra, the Italian synchrotron radiation facility, a clinical program of phase-contrast BCT based on the free-space propagation approach is under development. In this paper, full-volume breast samples imaged with a beam energy of 32 keV delivering a mean glandular dose of 5 mGy are presented. The whole acquisition setup mimics a clinical study in order to evaluate its feasibility in terms of acquisition time and image quality. Acquisitions are performed using a high-resolution CdTe photon-counting detector and the projection data are processed via a phase-retrieval algorithm. Tomographic reconstructions are compared with conventional mammographic images acquired prior to surgery and with histologic examinations. Results indicate that BCT with monochromatic beam and free-space propagation phase-contrast imaging provide relevant three-dimensional insights of breast morphology at clinically acceptable doses and scan times.
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Affiliation(s)
- Renata Longo
- Department of Physics, University of Trieste, 34127 Trieste, Italy
| | - Fulvia Arfelli
- Department of Physics, University of Trieste, 34127 Trieste, Italy
| | - Deborah Bonazza
- Department of Medical Science, Cattinara Hospital, University of Trieste, 34149 Trieste, Italy
| | - Ubaldo Bottigli
- Department of Physical Sciences, Earth and Environment, University of Siena, 53100 Siena, Italy
| | - Luca Brombal
- Department of Physics, University of Trieste, 34127 Trieste, Italy
| | - Adriano Contillo
- Department of Physics and Earth Science, University of Ferrara, 44122 Ferrara, Italy
| | - Maria A Cova
- Department of Medical Science, Cattinara Hospital, University of Trieste, 34149 Trieste, Italy
| | - Pasquale Delogu
- Department of Physical Sciences, Earth and Environment, University of Siena, 53100 Siena, Italy
| | - Francesca Di Lillo
- Department of Physics `E. Pancini', University of Napoli `Federico II', 80126 Napoli, Italy
| | - Vittorio Di Trapani
- Department of Physical Sciences, Earth and Environment, University of Siena, 53100 Siena, Italy
| | - Sandro Donato
- Department of Physics, University of Trieste, 34127 Trieste, Italy
| | - Diego Dreossi
- Elettra-Sincrotrone Trieste SCpA, 34149 Trieste, Italy
| | - Viviana Fanti
- Department of Physics, University of Cagliari, 09042 Monserrato (CA), Italy
| | | | - Bruno Golosio
- Department of Physics, University of Cagliari, 09042 Monserrato (CA), Italy
| | - Giovanni Mettivier
- Department of Physics `E. Pancini', University of Napoli `Federico II', 80126 Napoli, Italy
| | | | - Serena Pacilè
- Elettra-Sincrotrone Trieste SCpA, 34149 Trieste, Italy
| | - Antonio Sarno
- Department of Physics `E. Pancini', University of Napoli `Federico II', 80126 Napoli, Italy
| | - Luigi Rigon
- Department of Physics, University of Trieste, 34127 Trieste, Italy
| | - Paolo Russo
- Department of Physics `E. Pancini', University of Napoli `Federico II', 80126 Napoli, Italy
| | - Angelo Taibi
- Department of Physics and Earth Science, University of Ferrara, 44122 Ferrara, Italy
| | - Maura Tonutti
- ASUITS, Trieste University Hospital, Department of Radiology, 34100 Trieste, Italy
| | - Fabrizio Zanconati
- Department of Medical Science, Cattinara Hospital, University of Trieste, 34149 Trieste, Italy
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50
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Tavakoli Taba S, Baran P, Lewis S, Heard R, Pacile S, Nesterets YI, Mayo SC, Dullin C, Dreossi D, Arfelli F, Thompson D, McCormack M, Alakhras M, Brun F, Pinamonti M, Nickson C, Hall C, Zanconati F, Lockie D, Quiney HM, Tromba G, Gureyev TE, Brennan PC. Toward Improving Breast Cancer Imaging: Radiological Assessment of Propagation-Based Phase-Contrast CT Technology. Acad Radiol 2019; 26:e79-e89. [PMID: 30149975 DOI: 10.1016/j.acra.2018.07.008] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Revised: 07/05/2018] [Accepted: 07/09/2018] [Indexed: 11/18/2022]
Abstract
RATIONALE AND OBJECTIVES This study employs clinical/radiological evaluation in establishing the optimum imaging conditions for breast cancer imaging using the X-ray propagation-based phase-contrast tomography. MATERIALS AND METHODS Two series of experiments were conducted and in total 161 synchrotron-based computed tomography (CT) reconstructions of one breast mastectomy specimen were produced at different imaging conditions. Imaging factors include sample-to-detector distance, X-ray energy, CT reconstruction method, phase retrieval algorithm applied to the CT projection images and maximum intensity projection. Observers including breast radiologists and medical imaging experts compared the quality of the reconstructed images with reference images approximating the conventional (absorption) CT. Various radiological image quality attributes in a visual grading analysis design were used for the radiological assessments. RESULTS The results show that the application of the longest achievable sample-to-detector distance (9.31 m), the lowest employed X-ray energy (32 keV), the full phase retrieval, and the maximum intensity projection can significantly improve the radiological quality of the image. Several combinations of imaging variables resulted in images with very high-quality scores. CONCLUSION The results of the present study will support future experimental and clinical attempts to further optimize this innovative approach to breast cancer imaging.
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Affiliation(s)
- Seyedamir Tavakoli Taba
- Medical Image Optimisation and Perception Group (MIOPeG), Faculty of Health Sciences, The University of Sydney, Sydney 2141, Australia.
| | - Patrycja Baran
- ARC Centre of Excellence in Advanced Molecular Imaging, School of Physics, The University of Melbourne, Parkville, Australia
| | - Sarah Lewis
- Medical Image Optimisation and Perception Group (MIOPeG), Faculty of Health Sciences, The University of Sydney, Sydney 2141, Australia
| | - Robert Heard
- Health Systems and Global Populations Research Group, Faculty of Health Sciences, The University of Sydney, Sydney, Australia
| | - Serena Pacile
- Elettra Sincrotrone Trieste, Basovizza, Trieste, Italy; Department of Engineering and Architecture, University of Trieste, Trieste, Italy
| | - Yakov I Nesterets
- Commonwealth Scientific and Industrial Research Organisation, Melbourne, Australia; School of Science and Technology, University of New England, Armidale, Australia
| | - Sherry C Mayo
- Commonwealth Scientific and Industrial Research Organisation, Melbourne, Australia
| | - Christian Dullin
- Elettra Sincrotrone Trieste, Basovizza, Trieste, Italy; Institute for Diagnostic and Interventional Radiology, University Medical Center Goettingen, Goettingen, Germany; Max-Plank-Institute for Experimental Medicine, Goettingen, Germany
| | - Diego Dreossi
- Elettra Sincrotrone Trieste, Basovizza, Trieste, Italy
| | - Fulvia Arfelli
- Department of Physics, University of Trieste, and INFN, Trieste, Italy
| | - Darren Thompson
- Commonwealth Scientific and Industrial Research Organisation, Melbourne, Australia; School of Science and Technology, University of New England, Armidale, Australia
| | | | - Maram Alakhras
- Medical Image Optimisation and Perception Group (MIOPeG), Faculty of Health Sciences, The University of Sydney, Sydney 2141, Australia
| | - Francesco Brun
- Elettra Sincrotrone Trieste, Basovizza, Trieste, Italy; Department of Engineering and Architecture, University of Trieste, Trieste, Italy
| | | | - Carolyn Nickson
- Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Australia
| | - Chris Hall
- Australian Synchrotron, Clayton, Australia
| | | | | | - Harry M Quiney
- ARC Centre of Excellence in Advanced Molecular Imaging, School of Physics, The University of Melbourne, Parkville, Australia
| | | | - Timur E Gureyev
- Medical Image Optimisation and Perception Group (MIOPeG), Faculty of Health Sciences, The University of Sydney, Sydney 2141, Australia; ARC Centre of Excellence in Advanced Molecular Imaging, School of Physics, The University of Melbourne, Parkville, Australia; Commonwealth Scientific and Industrial Research Organisation, Melbourne, Australia; School of Science and Technology, University of New England, Armidale, Australia; School of Physics and Astronomy, Monash University, Melbourne, Australia
| | - Patrick C Brennan
- Medical Image Optimisation and Perception Group (MIOPeG), Faculty of Health Sciences, The University of Sydney, Sydney 2141, Australia
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