Quality and parameter control of X-ray absorption gratings by angular X-ray transmission

Initial Characterization of Dark-Field CT on a Clinical Gantry

X-ray computed tomography (CT) is an important non-destructive imaging technique, particularly in clinical diagnostics. Even with the latest innovations like dual-energy and photon-counting CT, the image contrast is solely generated from attenuation in the tissue. An extension - fully compatible with these novelties - is dark-field CT, which retrieves an additional, so-called dark-field contrast. Unlike the attenuation channel, the dark-field channel is sensitive to tissue microstructure and porosity below the resolution of the imaging system, which allows additional insights into the health of the lung tissue or the structure of calcifications. The potential clinical value has been demonstrated in several preclinical studies and recently also in radiography patient studies. Just recently the first dark-field CT for the human body was established at the Technical University of Munich and in this paper, we discuss the performance of this prototype. We evaluate the interferometer components and the imposed challenges that the integration into the CT gantry brings by comparing the results to simulations and measurements at a laboratory setup. The influence of the clinical X-ray source on the Talbot-Lau interferometer and the impact of vibrations, which are immanent on the clinical CT gantry, are analyzed in detail to reveal their characteristic frequencies and origin. A beam hardening correction is introduced as an important step to adapt to the poly-chromatic spectrum and make quantitative dark-field imaging possible. We close with an analysis of the image resolution and the applied patient dose, and conclude that the performance is sufficient to suggest initial patient studies using the presented dark-field CT system.

Self-aligned multi-layer X-ray absorption grating using large-area fabrication methods for X-ray phase-contrast imaging

X-ray phase-contrast (XPCi) imaging methods are an emerging medical imaging approach that provide significantly better soft tissue contrast and could function as a viable extension to conventional X-ray, CT, and even some MRI. Absorption gratings play a central role in grating-based XPCi systems, especially because they enable the acquisition of three images in a single exposure: transmission, refraction, and dark-field. An impediment to commercial development and adoption of XPCi imaging systems is the lack of large area, high aspect ratio absorption gratings. Grating technology development, primarily due to technological limitations, has lagged system development and today prevents the scaling up of XPCi system into a footprint and price point acceptable to the medical market. In this work, we report on a self-aligned multi-layer grating fabrication process that can enable large-area X-ray absorption gratings with micron-scale feature sizes. We leverage large-area fabrication techniques commonly employed by the thin-film transistor (TFT) display industry. Conventional ITO-on-glass substrates are used with a patterned film of Cr/Au/Cr that serves as a self-aligned lithography mask for backside exposure. Commonly available SU-8 photoresist is patterned using the backside exposure mask followed by an electroplating step to fill the gaps in the SU-8 with X-ray attenuating material. Consequently, the electroplated patterned material acts as a self-aligned photomask for subsequent SU-8 layer patterning and so forth. The repeatability of the reported process makes it suitable for achieving higher aspect ratio structures and is advantageous over previously reported X-ray LIGA approaches. A prototype three-layer grating, with a thickness of around [Formula: see text], having a visibility of 0.28 at [Formula: see text] with a [Formula: see text] active area was fabricated on a 4-inch glass substrate and demonstrated by modifying a commercially available 3D propagation-based XPCi Microscope. The scalable and cost-effective approach to build larger area X-ray gratings reported in this work can help expedite the commercial development and adoption of previously reported Talbot-Lau, speckle-tracking, as well as coded-aperture XPCi systems for large-area clinical and industrial applications.

Dark-field chest X-ray imaging for the assessment of COVID-19-pneumonia

Background

Currently, alternative medical imaging methods for the assessment of pulmonary involvement in patients infected with COVID-19 are sought that combine a higher sensitivity than conventional (attenuation-based) chest radiography with a lower radiation dose than CT imaging.

Methods

Sixty patients with COVID-19-associated lung changes in a CT scan and 40 subjects without pathologic lung changes visible in the CT scan were included (in total, 100, 59 male, mean age 58 ± 14 years). All patients gave written informed consent. We employed a clinical setup for grating-based dark-field chest radiography, obtaining both a dark-field and a conventional attenuation image in one image acquisition. Attenuation images alone, dark-field images alone, and both displayed simultaneously were assessed for the presence of COVID-19-associated lung changes on a scale from 1 to 6 (1 = surely not, 6 = surely) by four blinded radiologists. Statistical analysis was performed by evaluation of the area under the receiver–operator-characteristics curves (AUC) using Obuchowski’s method with a 0.05 level of significance.

Results

We show that dark-field imaging has a higher sensitivity for COVID-19-pneumonia than attenuation-based imaging and that the combination of both is superior to one imaging modality alone. Furthermore, a quantitative image analysis shows a significant reduction of dark-field signals for COVID-19-patients.

Conclusions

Dark-field imaging complements and improves conventional radiography for the visualisation and detection of COVID-19-pneumonia.

Computed tomography (CT) imaging uses X-rays to obtain images of the inside of the body. It is used to look at lung damage in patients with COVID-19. However, CT imaging exposes the patient to a considerable amount of radiation. As radiation exposure can lead to the development of cancer, exposure should be minimised. Conventional plain X-ray imaging uses lower amounts of radiation but lacks sensitivity. We used dark-field chest X-ray imaging, which also uses low amounts of radiation, to assess the lungs of patients with COVID-19. Radiologists identified pneumonia in patients more easily from dark-field images than from usual plain X-ray images. We anticipate dark-field X-ray imaging will be useful to follow-up patients suspected of having lung damage.

Frank, Gassert et al. use dark-field chest X-ray imaging to assess COVID-19-pneumonia. Dark-field imaging has a higher sensitivity for COVID-19-pneumonia than attenuation-based imaging and provides an ultralow dose alternative to computed tomography imaging for that purpose.

Fabrication of X-ray absorption gratings by centrifugal deposition of bimodal tungsten particles in high aspect ratio silicon templates

Grating-based X-ray imaging employs high aspect ratio absorption gratings to generate contrast induced by attenuating, phase-shifting, and small-angle scattering properties of the imaged object. The fabrication of the absorption gratings remains a crucial challenge of the method on its pathway to clinical applications. We explore a simple and fast centrifugal tungsten particle deposition process into silicon-etched grating templates, which has decisive advantages over conventional methods. For that, we use a bimodal tungsten particle suspension which is introduced into a custom designed grating holder and centrifuged at over 1000×g. Gratings with 45 µm period, 450 µm depth, and 170 mm × 38 mm active area are successfully processed reaching a homogeneous absorber filling. The effective absorbing tungsten thickness in the trenches is 207 µm resulting in a filling ratio of 46.6% compared to a voidless filling. The grating was tested in a Talbot–Lau interferometer designed for clinical X-ray dark-field computed tomography, where visibilities up to 33.6% at 60 kV were achieved.

Dark-field computed tomography reaches the human scale

X-ray computed tomography (CT) is one of the most commonly used diagnostic three-dimensional imaging modalities today. Conventionally, this noninvasive technique generates contrast by measuring the X-ray attenuation properties of different tissues. Considering the wave nature of X-rays, complementary contrast can be achieved by further measuring their small-angle scattering (dark-field) properties. This provides additional valuable diagnostic information on otherwise unresolved tissue microstructure. In our work, we have translated this wave-optical mechanism from the optical bench to a human-sized prototype CT system. This involved the integration of an interferometer into a clinical CT gantry and overcoming several associated challenges regarding vibrations, continuous gantry rotation, and large field of view. This development puts complementary X-ray contrast within reach for real-word medical applications.

X-ray computed tomography (CT) is one of the most commonly used three-dimensional medical imaging modalities today. It has been refined over several decades, with the most recent innovations including dual-energy and spectral photon-counting technologies. Nevertheless, it has been discovered that wave-optical contrast mechanisms—beyond the presently used X-ray attenuation—offer the potential of complementary information, particularly on otherwise unresolved tissue microstructure. One such approach is dark-field imaging, which has recently been introduced and already demonstrated significantly improved radiological benefit in small-animal models, especially for lung diseases. Until now, however, dark-field CT could not yet be translated to the human scale and has been restricted to benchtop and small-animal systems, with scan durations of several minutes or more. This is mainly because the adaption and upscaling to the mechanical complexity, speed, and size of a human CT scanner so far remained an unsolved challenge. Here, we now report the successful integration of a Talbot–Lau interferometer into a clinical CT gantry and present dark-field CT results of a human-sized anthropomorphic body phantom, reconstructed from a single rotation scan performed in 1 s. Moreover, we present our key hardware and software solutions to the previously unsolved roadblocks, which so far have kept dark-field CT from being translated from the optical bench into a rapidly rotating CT gantry, with all its associated challenges like vibrations, continuous rotation, and large field of view. This development enables clinical dark-field CT studies with human patients in the near future.

Robust Bottom-Up Gold Filling of Deep Trenches and Gratings

This work extends an extreme variant of superconformal Au electrodeposition to deeper device architectures while exploring factors that constrain its function and the robustness of void-free processing. The unconventional bottom-up process is used to fill diffraction gratings with trenches 94 μm deep and 305 μm deep, with aspect ratios (height/width) of just below 20 and 15, respectively, in near-neutral 0.16 mol·L^-1 Na₃Au(SO₃)₂ + 0.64 mol·L^-1 Na₂SO₃ electrolyte containing 50 μmol·L^-1 Bi³⁺. Although the aspect ratios are modest compared to previously demonstrated void-free filling beyond AR = 60, the deepest trenches filled exceed those in previous work by 100 μm - a nearly 50 % increase in depth. Processes that substantially accelerate the start of bottom-up deposition demonstrate a linkage between transport and void-free filling. Final profiles are highly uniform across 65 mm square gratings because of self-passivation inherent in the process. Electron microscopy and electron backscatter diffraction confirm the fully dense Au and void-free filling suggested by the electrochemical measurements. X-ray transmission "fringe visibility" average more than 80 % at 50 kV X-ray tube voltage across the deeper gratings and 70 % at 40 kV across the shallower gratings, also consistent with uniformly dense, void-free fill across the gratings.