Emphysema quantified: mapping regional airway dimensions using 2D phase contrast X-ray imaging

On the quantification of sample microstructure using single-exposure x-ray dark-field imaging via a single-grid setup

The size of the smallest detectable sample feature in an x-ray imaging system is usually restricted by the spatial resolution of the system. This limitation can now be overcome using the diffusive dark-field signal, which is generated by unresolved phase effects or the ultra-small-angle x-ray scattering from unresolved sample microstructures. A quantitative measure of this dark-field signal can be useful in revealing the microstructure size or material for medical diagnosis, security screening and materials science. Recently, we derived a new method to quantify the diffusive dark-field signal in terms of a scattering angle using a single-exposure grid-based approach. In this manuscript, we look at the problem of quantifying the sample microstructure size from this single-exposure dark-field signal. We do this by quantifying the diffusive dark-field signal produced by 5 different sizes of polystyrene microspheres, ranging from 1.0 to 10.8 µm, to investigate how the strength of the extracted dark-field signal changes with the sample microstructure size, [Formula: see text]. We also explore the feasibility of performing single-exposure dark-field imaging with a simple equation for the optimal propagation distance, given microstructure with a specific size and thickness, and show consistency between this model and experimental data. Our theoretical model predicts that the dark-field scattering angle is inversely proportional to [Formula: see text], which is also consistent with our experimental data.

Quantifying the x-ray dark-field signal in single-grid imaging

X-ray dark-field imaging reveals the sample microstructure that is unresolved when using conventional methods of x-ray imaging. In this paper, we derive a new method to extract and quantify the x-ray dark-field signal collected using a single-grid imaging set-up, and relate the signal strength to the number of sample microstructures, N. This was achieved by modelling sample-induced changes to the shadow of the upstream grid, and fitting experimental data to this model. Our results suggested that the dark-field scattering angle from our spherical microstructures deviates slightly from the theoretical model of N, which was consistent with results from other experimental methods. We believe the approach outlined here can equip quantitative dark-field imaging of small samples, particularly in cases where only one sample exposure is possible, either due to sample movement or radiation dose limitations. Future directions include an extension into directional dark-field imaging.

Early Diagnosis and Real-Time Monitoring of Regional Lung Function Changes to Prevent Chronic Obstructive Pulmonary Disease Progression to Severe Emphysema

First- and second-hand exposure to smoke or air pollutants is the primary cause of chronic obstructive pulmonary disease (COPD) pathogenesis, where genetic and age-related factors predispose the subject to the initiation and progression of obstructive lung disease. Briefly, airway inflammation, specifically bronchitis, initiates the lung disease, leading to difficulty in breathing (dyspnea) and coughing as initial symptoms, followed by air trapping and inhibition of the flow of air into the lungs due to damage to the alveoli (emphysema). In addition, mucus obstruction and impaired lung clearance mechanisms lead to recurring acute exacerbations causing progressive decline in lung function, eventually requiring lung transplant and other lifesaving interventions to prevent mortality. It is noteworthy that COPD is much more common in the population than currently diagnosed, as only 16 million adult Americans were reported to be diagnosed with COPD as of 2018, although an additional 14 million American adults were estimated to be suffering from COPD but undiagnosed by the current standard of care (SOC) diagnostic, namely the spirometry-based pulmonary function test (PFT). Thus, the main issue driving the adverse disease outcome and significant mortality for COPD is lack of timely diagnosis in the early stages of the disease. The current treatment regime for COPD emphysema is most effective when implemented early, on COPD onset, where alleviating symptoms and exacerbations with timely intervention(s) can prevent steep lung function decline(s) and disease progression to severe emphysema. Therefore, the key to efficiently combatting COPD relies on early detection. Thus, it is important to detect early regional pulmonary function and structural changes to monitor modest disease progression for implementing timely interventions and effectively eliminating emphysema progression. Currently, COPD diagnosis involves using techniques such as COPD screening questionnaires, PFT, arterial blood gas analysis, and/or lung imaging, but these modalities are limited in their capability for early diagnosis and real-time disease monitoring of regional lung function changes. Hence, promising emerging techniques, such as X-ray phase contrast, photoacoustic tomography, ultrasound computed tomography, electrical impedance tomography, the forced oscillation technique, and the impulse oscillometry system powered by robust artificial intelligence and machine learning analysis capability are emerging as novel solutions for early detection and real time monitoring of COPD progression for timely intervention. We discuss here the scope, risks, and limitations of current SOC and emerging COPD diagnostics, with perspective on novel diagnostics providing real time regional lung function monitoring, and predicting exacerbation and/or disease onset for prognosis-based timely intervention(s) to limit COPD–emphysema progression.