High-resolution imaging of coronary calcifications by intense low-energy fluoroscopic X-ray obtained from synchrotron radiation

Purpose: To obtain an intense monochromatic low-energy X-ray from synchrotron radiation (SR) and apply it to detect coronary calcifications.

Methods and Results: The SR beam was reflected with a silicon crystal to be expanded (150 mm in height and 80 mm in width) and to be monochromatized at an energy level of 37 keV. The X-ray was intermittently irradiated to obtain dynamic imaging of 30 images/s. Images were recorded by a digital fluorography system. The low-energy X-ray from SR sharply visualized calcification of coronary arteries, while conventional X-ray could not visualize coronary calcification.

Conclusion: The intense monochromatic low-energy X-ray from SR is sensitive, has high-resolution for imaging coronary calcification and may serve as a screening method for coronary artery disease.

Direct measurement of speed of sound in cartilage in situ using ultrasound and magnetic resonance images

This study verified the accuracy of the speed of sound (SOS) measured by the combination method, which calculates the ratio between the thickness values of cartilage measured by using the magnetic resonance imaging (MRI) and the ultrasonic pulse-echo imaging, and investigated in vivo application of this method. SOS specific to an ultrasound imaging device was used as a reference value to calculate the actual SOS from the ratio of cartilage thicknesses obtained from MR and ultrasound images. The accuracy of the thickness measurement was verified by comparing results obtained using MRI and a non-contact laser, and the accuracy of the calculated SOS was confirmed by comparing results of the pulse-echo and transmission methods in vitro. The difference between laser and MRI measurements was 0.05 ± 0.22 mm. SOS values in a human knee measured by the combination method in the medial and lateral femoral condyles were 1650 ± 79 and 1642 ± 78 m/s, respectively (p < 0.05). The results revealed the feasibility of in situ SOS measurement using the combination method.

Phase-contrast X-ray imaging of the gas diffusion layer of fuel cells

The understanding of and in situ observation of the transport and distribution of water in carbon-paper gas diffusion layers (GDLs) using non-destructive imaging techniques is critical for achieving high performance in polymer electrolyte fuel cells (PEFCs). To investigate the behavior of water in GDLs of PEFCs, phase-contrast X-ray imaging via X-ray interferometric imaging (XII) and diffraction-enhanced imaging (DEI) were performed using 35 keV X-rays. The XII technique is useful for the radiographic imaging of GDLs and in situ observations of water evolution processes in operating PEFCs. DEI provides a way for tomographic imaging of GDLs in PEFCs. Because high-energy X-rays are applicable to the imaging of both carbon papers and heavy materials, which make up PEFCs, phase-contrast X-ray imaging techniques have proven to be valuable for investigation of GDLs.

Local VEGF administration enhances healing of colonic anastomoses in a rabbit model

BACKGROUND/AIMS

Many studies report the role of vascular endothelial growth factor (VEGF) in wound healing, but few describe local VEGF administration to the digestive tract. Leakage from colonic anastomoses, including those due to ischemia, represents a major complication causing increased mortality and morbidity. Angiogenesis is crucial to anastomotic healing and restoration of blood supply, and VEGF is a potent angiogenic factor showing improved healing in various models of reconstruction and anastomosis. Here, we examine the effects of local VEGF-A(165) administration on postoperative rabbit colon anastomosis.

METHODS

Two colotomies per animal were made in the sinistral colon on opposite sides of the mesentery. Randomly assigned VEGF (10 microg/0.1 ml) or saline (0.1 ml) was injected into the muscularis propria on both sides of each colonic anastomosis before closing the access laparotomy using single-layer sutures. On postoperative days 3, 4 and 7, the bursting pressure of partially healed anastomoses was measured. On postoperative day 4, anastomotic tissues were examined for the following: hydroxyproline; histopathologically for inflammatory infiltrate and tissue organization and immunohistochemically for capillary proliferation and density; vessel density of midzone collaterals around anastomoses by microangiography.

RESULTS

Compared to saline, VEGF administration significantly improved bursting pressure (p = 0.014, paired t test) and increased hydroxyproline (p = 0.027, paired t test) on postoperative day 4. Inflammatory cell infiltration and fibroblast proliferation were prominent, and submucosal capillary vascular counts were significantly higher for VEGF.

CONCLUSIONS

Administration of VEGF to colonic anastomosis accelerates wound healing and strengthens the anastomosis by increased angiogenesis.

Fat-saturated diffusion-weighted imaging of the rat pelvis using three-dimensional MP-RAGE MR sequence

In this work we report on the development of a novel technique for fat-saturated three-dimensional (3D) diffusion-weighted (DW) MRI sequence based upon 3D magnetization-prepared rapid gradient-echo (3D-MP-RAGE). In order to saturate fat, two kinds of procedures were competed CHESS-DW-3D-MP-RAGE sequence (CHESS-3D-DWI) and DW-3D-MP-WE-RAGE sequence (WE-3D-DWI) "chemical shift selective: CHESS method vs. water-excitation: WE method". The CHESS-3D-DWI sequence and WE-3D-DWI sequence were compared in terms of their degree of fat suppression. In CHESS-3D-DWI sequence a preparation phase with a "CHESS-90 degrees RF-motion probing gradient: MPG-180 degrees RF-MPG-90 degrees RF" pulse-train was used to sensitize the magnetization to fat-saturated diffusion. In contrast, WE-3D-DWI sequence a RAGE-excitation pulse with a "binominal-pulse 1-1 or 1-2-1" was selected to water-excited (fat-saturated) diffusion imaging. These imaging were done during in vivo studies using an animal experiment. From experimental results obtained with a phantom, the effect of diffusion weighting and the effect of fat-saturation were confirmed. Fat-saturation was much better in the WE-3D-DWI sequence than CHESS-3D-DWI sequence. From rat experimental results, fat-saturated diffusion-weighted image data were obtained. This sequence was useful for in vivo imaging.

Quantitative analysis of amyloid plaques in a mouse model of Alzheimer's disease by phase-contrast X-ray computed tomography

Densely aggregated beta-amyloid peptides are believed to play a key role in the pathogenesis of Alzheimer's disease. Amyloid plaques are a potential target for molecular imaging to determine the clinical status of Alzheimer's disease. Phase-contrast X-ray imaging combined with computed tomography is a promising technique that can be used to visualize the physical density of structures in biological tissues non-invasively, and without the use of imaging agents. Using brain tissue isolated from a mouse model of Alzheimer's disease, we show that beta-amyloid 40-positive/beta-amyloid 42-positive amyloid plaques, but not beta-amyloid 40-negative/beta-amyloid 42-positive amyloid plaques, exist as high-density aggregates that can be specifically detected by phase-contrast X-ray computed tomography. The phase-contrast X-ray computed tomography detected beta-amyloid 40-positive/beta-amyloid 42-positive amyloid plaques in three-dimensions with an extremely high sensitivity comparable to that of histological analysis, and also enabled the load of amyloid plaques to be quantified. Furthermore, the use of phase-contrast X-ray computed tomography reveals that the physical density of beta-amyloid 40-positive/beta-amyloid 42-positive amyloid plaques increases with age, and that the large volume, high-density, amyloid plaques that are specifically observed in aged Alzheimer's disease mice are closely associated with neuritic dystrophy. These results demonstrate that phase-contrast X-ray computed tomography is a highly sensitive imaging technique for analyzing dense-cored amyloid plaques in postmortem samples, and is beneficial in elucidating amyloid pathophysiology in Alzheimer's disease.

Application of synchrotron X-ray imaging to phase objects in orthopedics

Novel imaging of the fine structures of the ribs of a pig and a specimen of human osteosarcoma utilizing the spatial coherence of X-rays was successfully performed with an incident X-ray energy of 30 keV at SPring-8, Japan. The image contrast appearing at the periphery of trabecular bone, small calcifications and small fractures is caused by the phase shift of the X-rays at the boundary of these objects that have different X-ray refractive indices. The image is recorded on mammography film without an intensifying screen. Comparison of the image contrast using different sample-to-film distances, Z, such as Z = 5 m and Z approximately 0 m, showed that the former images were always more informative, i.e. better in resolution and/or image contrast when imaging trabecular bone, bone marrow and small fractures in compact bone, and for imaging cartilage. Radiography using synchrotron X-rays for phase objects should be a powerful tool for diagnosis in orthopedics, especially for bone disease.

Design of synchrotron light source and its beamline dedicated to dual-energy x-ray computed tomography

A synchrotron light source dedicated to medical applications has been designed at National Institute of Radiological Sciences. The storage ring, with circumference of 80 m, is designed for acceleration of 2.3 GeV and a stored current of 420 mA. It is equipped with two multipole wigglers to produce sufficient photon flux in a hard x-ray region required for medical applications. The purposes of the synchrotron light source are clinical performance of medical diagnoses clinically and research and development relating with medical applications. One of the most interesting applications for us is dual-energy x-ray computed tomography (CT). It gives the information about electron density of human tissue. The information plays an important role in advancing heavy-ion radiotherapy of cancers. Electron density can be derived from attenuation coefficients measured by different energy x rays. In this paper, a practical method of the dual-energy x-ray CT with synchrotron radiation is proposed with the theoretical consideration. The primitive experiment using monochromatic x rays emitted from radioisotopes proved the procedure of analysis mentioned here effective to derive electron densities from linear attenuation coefficients for two x rays of a different energy. The beamline dedicated to dual-energy x-ray CT is also proposed. It has a multipole wiggler as a light source and it mainly consists of a dual crystal monochromator and a rotating filter for attenuating photon flux of x rays and two-dimensional detector.

Morphology, fluorescence properties, and their photothermal changes of poly(substituted thiophene) films revealed by near-field fluorescence microspectroscopy

The morphology and fluorescence spectrum of poly(3-[2-(N-dodecylcarbamoyloxy)ethyl]thiophene-2,5-diyl) film were examined with spatial resolution of 100 nm using near-field fluorescence microspectroscopy. Fluorescence spectra observed at protruding domains were blue-shifted compared with flat areas, and further blue-shift was observed there more appreciably by long-time irradiation via a near-field scanning optical microscope probe. It is considered that the polymer chains at the protruding domains take disordered conformations, in which conjugated lengths are shorter and further disordering can be induced more easily by irradiation compared with those in the flat areas.

[Clinical laboratory data and reference intervals standardized in Fukuoka]

In Fukuoka whose population is approximately five million inhabitants, surveys on the accuracy of laboratory data have been performed by the Fukuoka Prefecture Medical Association for the last 30 years. We have been attempting to evaluate the data for routine use since 1988, and it has become possible to share laboratory data between all institutions in Fukuoka prefectures. As a result, reference intervals for 23 clinical chemistry analytes were established in 1995, to which were added in 1996 five serum protein constituents that have been utilized for clinical examinations. Methods for documentations and monitorings the data obtained in the prefecture were also established, standardization of the above analytes extended to 97% of the institutions in the prefecture. Results for 14 of the 23 clinical chemistry analytes have become highly reliable and clinically useful as differences between institutions in terms of results have narrowed. Standardization of other analytes is now in progress.

Preliminary experiment of fluorescent X-ray computed tomography to detect dual agents for biological study

The simultaneous observation of various information, such as blood flow, tissue metabolism and distribution of receptors, is quite important in order to understand the functional state of biomedical objects. The simultaneous detectability of contrast agents by fluorescent X-ray computed tomography (FXCT) with synchrotron radiation is examined in this study. The system consisted of a silicon (111) double-crystal monochromator, an X-ray slit system, a scanning table, a PIN diode, a highly purified germanium detector and an X-ray charge-coupled device (CCD) camera. The monochromatic X-ray beam energy was adjusted to 37.0 keV and collimated into a pencil beam of 1 x 1 mm. The fluorescent spectra of the K alpha lines for iodine and xenon were detected simultaneously. FXCT could image the distribution of both iodine and xenon agents in a phantom clearly and the contrast ratio was significantly better than that of transmission X-ray computed tomography images.

Comparison of in-phantom dose distributions for coronary angiography using an x-ray machine and synchrotron radiation

Coronary cineangiography using synchrotron radiation is anticipated, owing to the high intensity and availability of monoenergy. To investigate allowable dose levels in clinical application, absorbed dose distribution in a tissue substitute phantom for a conventional x-ray machine was measured with thermoluminescent dosimeters at the University of Tsukuba under the practical conditions used for digital angiography. The dose rate at a 0.5-cm depth was 0.145 Gy/s, and the dose per frame was 0.725 mGy for the irradiation period of 5 ms per frame. For synchrotron radiation, the dose distribution measurement was made at a 5-GeV AR (Accumulation Ring) of the High Energy Accelerator Research Organization, in which a polymethylmethacrylate (PMMA) phantom was irradiated with the strongest beam available at the facility, which was 33.32 keV, 5.2 x 6.2 cm2 beam. Using this beam, a 1-mm-diameter coronary artery has been visualized at 1% iodine concentration at the AR. Nonhomogeneous strength distribution in the beam was observed in the vertical direction. The maximum dose rate was 0.556 Gy/s, and it attenuated to 1/3000 at a 30-cm depth in the beam center. At the deep positions, the doses were influenced by the high harmonics, which was confirmed with an EGS4 Monte Carlo calculation. Outside the beam, beam contamination on both sides of the main beam affected the doses. For comparison to the x-ray machine, the measured dose was analytically converted to that needed for a 5.2 x 16 cm2 beam that is used for clinical application. The dose rate at 0.5-cm depth was found to be 0.215 Gy/s, which is 1.48 times larger than that for x-rays. Moreover, the attenuation rate in the phantom was significantly greater than that of the x-ray machine, because of the difference of the energy spectra between the x-rays and synchrotron radiation used.

Visualization, quantification and therapeutic evaluation of angiogenic vessels in cancer by synchrotron microangiography

The usefulness of a synchrotron microangiography system for depicting, quantitating and therapeutically evaluating angiogenic vessels in cancer is illustrated. In 20 mice transplanted with murine colon cancer, sequential changes in the angiogenic vessels were determined by using synchrotron microangiography, using changes in tumor volume for reference. This system allowed the depiction and quantification of angiogenic vessels in the period from one to four weeks after transplantation. The effects of antiangiogenic therapy were evaluated by using a neutralizing antibody against vascular endothelial growth factor. The neutralizing antibody partially suppressed angiogenesis and tumor growth. Synchrotron microangiography is shown to be useful for the depiction, quantification and evaluation of angiogenic vessels in cancer.

High-resolution imaging of coronary calcifications by intense low-energy fluoroscopic X-ray obtained from synchrotron radiation

PURPOSE

To obtain an intense monochromatic low-energy X-ray from synchrotron radiation (SR) and apply it to detect coronary calcifications.

METHODS AND RESULTS

The SR beam was reflected with a silicon crystal to be expanded (150 mm in height and 80 mm in width) and to be monochromatized at an energy level of 37 keV. The X-ray was intermittently irradiated to obtain dynamic imaging of 30 images/s. Images were recorded by a digital fluorography system. The low-energy X-ray from SR sharply visualized calcification of coronary arteries, while conventional X-ray could not visualize coronary calcification.

CONCLUSION

The intense monochromatic low-energy X-ray from SR is sensitive, has high-resolution for imaging coronary calcification and may serve as a screening method for coronary artery disease.

Branching patterns of intramural coronary vessels determined by microangiography using synchrotron radiation

The intramural coronary artery (IMCA) with a diameter of 50-500 micrometers is critical for blood supply to the inner layers of heart muscle. We introduced digital measurement to microangiography using monochromatic synchrotron radiation and quantified branching patterns of the IMCA, the epicardial coronary artery (EPCA), and the distal ileal artery (DIA). The pre- and postbranching diameters were measured (95-1,275 micrometers) in seven dogs. A typical arterial segment divided into two nearly equivalent branches, and a regression line of daughter-to-mother diameter plots was almost identical among the EPCA (y = 0.838x - 16.7 in micrometers), IMCA (y = 0.737x - 2.18), and DIA (y = 0.755x + 8.63). However, a considerable difference was present at a segment where a proximal IMCA branched off from an EPCA (y = 0.182x + 90.2). Moreover, a proximal IMCA diameter had no relationship to the branching order from an EPCA. The precision of this method was confirmed by the good correlation of diameter measurements between two independent observers (r = 0.999, y = 1.02x - 1.07). In conclusion, using digital microangiography we demonstrated that the self-similar branching pattern of coronary arteries was discrete at the connection between the IMCA and EPCA.

[A study of mental and physical reactions after the Hanshin-Awaji Earthquake: mental and physical conditions of female undergraduate students immediately after, 2 months after, and 9 months after the earthquake]

This study assessed how time brings out changes in one's mental and physical reactions to traumatic experiences. Two surveys were conducted on students of Kobe College, located at one of the areas hardest hit by the Hanshin-Awaji Earthquake in January, 1995. Much of the traumatic reactions decreased in strength through January to March, while feelings of survival guilt did not. Guilt feelings of those whose housing were destroyed increased in March, and kept its level even in October. Although general health conditions of those surveyed in October was normal, several post-traumatic reactions increased in October as compared with March. The rate of recovery from post-traumatic reactions seemed to very according to the depth of one's psychological suffering, to one's financial situation, and to the presence of social support. The factor analysis on the items of mental and physical reactions yielded seven factors. The factor of highest eigenvalue in January was one named "anxiety about after-quake tremors", however, this was replaced by one named "emotional confusions" in March.

Digitized cerebral synchrotron radiation angiography: quantitative evaluation of the canine circle of Willis and its large and small branches

BACKGROUND AND PURPOSE

Conventional X-ray angiography lacks the sensitivity and spatial resolution needed to detect small amounts of iodinated contrast material and to quantitate diameters of the small vessels in the brain. The purpose of this study was to ascertain whether digitized synchrotron radiation microangiography, with the use of a high-definition TV camera system, can accurately show small cerebral vessels.

METHODS

Six anesthetized dogs were exposed to monochromatic synchrotron radiation with an energy level of 33.3 keV optimized for iodine detection while iodinated contrast material was injected into the brachiocephalic and vertebral arteries. The images were detected with a high-definition TV camera system with a spatial resolution of 30 microm. In all, 26 cerebral angiograms of the circle of Willis with its branches were obtained, and the images were digitized at a workstation.

RESULTS

The small branches of the circle of Willis were clearly visible on all images. Vasodilatation of the circle of Willis and its large and small branches induced by CO2 inhalation was quantitatively confirmed on the images: for example, the diameter of one small branch was increased from 0.24 +/- 0.04 mm to 0.38 +/- 0.12 mm. Temporal subtraction improved the image quality.

CONCLUSION

The synchrotron radiation angiographic system is useful for visualizing large and small vessels deep in the brain as well as for quantitating their diameters.

Synchrotron microangiography reveals configurational changes and to-and-fro flow in intramyocardial vessels

In 8 dogs, in situ microangiography using synchrotron radiation visualized penetrating transmural arteries (PTAs) with a diameter of >60 micrometers and allowed quantitation of vessel diameters of >140 micrometers. Myocardial contraction reduced the vascular short-axial diameters to 87 +/- 17% (n = 62, P < 0.001, paired t-test) of the end-diastolic values and increased the longitudinal dimension to 129 +/- 5% (n = 45, P < 0.001). The diameter reduction in the subendocardial PTA segments was significantly more marked than that in the subepicardial PTA segments (60 +/- 12 vs. 88 +/- 12%, n=13, P < 0.001, paired t-test). Intracoronary administration of dobutamine (0.1 micrograms. kg-1. min-1) increased, and in contrast, partial clamping of the coronary artery (ischemia) decreased, the configurational changes. To-and-fro blood flow was clearly observed in PTAs with visual identification of capacitive backflow, resistive forward flow during ischemia on coronary arteriography, and even under baseline conditions in coronary venography. Thus this method advances our understanding of mechanical influences on the coronary circulation.

Dynamic intravenous coronary angiography using 2D monochromatic synchrotron radiation

A method of examination for coronary artery disease that is less invasive and easier than coronary angiography (CAG) has been sought. We have developed a dynamic intravenous coronary angiography (IVCAG) system using synchrotron radiation (SR) and have used it clinically. Four patients suspected of having angina pectoris underwent IVCAG. An SR beam was reflected asymmetrically with a silicon crystal to produce a wide (150 mm x 80 mm) and monochromatic (37 keV) X-ray beam, with an energy level to achieve high sensitivity to the contrast agent. Following an intravenous injection of contrast agent, irradiation was applied for 4 ms periods at 33 ms intervals for dynamic IVCAG at 30 images s-1. Images were acquired with an image intensifier and recorded with a digital fluorography system. The dynamic images permitted clear visualization of the coronary arteries and permitted evaluation of coronary anatomy. Two patients exhibited no stenotic lesions, one patient had a 90% stenosis in the right coronary artery, and the remaining patient had a 25% stenosis at the site of previous percutaneous transluminal coronary angioplasty in the left anterior descending artery (LAD). The total irradiation doses used for IVCAG were less than those for conventional angiography. Dynamic IVCAG can be readily used for the evaluation of coronary arteries.

Dose response of various radiation detectors to synchrotron radiation

Accurate dosimetry is particularly difficult for low- to medium-energy x-rays as various interaction processes with different dependences on material properties determine the dose distribution in tissue and radiation detectors. Monoenergetic x-rays from synchrotron radiation offer the unique opportunity to study the dose response variation with photon energy of radiation detectors without the compounding effect of the spectral distribution of x-rays from conventional sources. The variation of dose response with photon energies between 10 and 99.6 keV was studied for two TLD materials (LiF:Mg,Ti and LiF:Mg,Cu,P), MOSFET semiconductors, radiographic and radiochromic film. The dose response at synchrotron radiation energies was compared with the one for several superficial/orthovoltage radiation qualities (HVL 1.4 mm Al to 4 mm Cu) and megavoltage photons from a medical linear accelerator. A calibrated parallel plate ionization chamber was taken as the reference dosimeter. The variation of response with x-ray energy was modelled using a two-component model that allows determination of the energy for maximum response as well as its magnitude. MOSFET detectors and the radiographic film were found to overrespond to low-energy x-rays by up to a factor of 7 and 12 respectively, while the radiochromic film underestimated the dose by approximately a factor of 2 at 24 keV. The TLDs showed a slight overresponse with LiF:Mg, Cu, P demonstrating better tissue equivalence than LiF:Mg, Ti (maximum deviation from water less than 25%). The results of the present study demonstrate the usefulness of monoenergetic photons for the study of the energy response of radiation detectors. The variations in energy response observed for the MOSFET detectors and GAF chromic film emphasize the need for a correction for individual dosimeters if accurate dosimetry of low- to medium-energy x-rays is attempted.

Medical applications with synchrotron radiation in Japan

In Japan, various medical applications of synchrotron X-ray imaging, such as angiography, monochromatic X-ray computed tomography (CT), radiography and radiation therapy, are being developed. In particular, coronary arteriography (CAG) is quite an important clinical application of synchrotron radiation. Using a two-dimensional imaging method, the first human intravenous CAG was carried out at KEK in May 1996; however, further improvements of image quality are required in clinical practice. On the other hand, two-dimensional aortographic CAG revealed canine coronary arteries as clearly as those on selective CAG, and coronary arteries less than 0.2 mm in diameter. Among applications of synchrotron radiation to X-ray CT, phase-contrast X-ray CT and fluorescent X-ray CT are expected to be very interesting future applications of synchrotron radiation. For actual clinical applications of synchrotron radiation, a medical beamline and a laboratory are now being constructed at SPring-8 in Harima.

Development of a two-dimensional imaging system for clinical applications of intravenous coronary angiography using intense synchrotron radiation produced by a multipole wiggler

A two-dimensional clinical intravenous coronary angiography system, comprising a large-size view area produced by asymmetrical reflection from a silicon crystal using intense synchrotron radiation from a multipole wiggler and a two-dimensional detector with an image intensifier, has been completed. An advantage of the imaging system is that two-dimensional dynamic imaging of the cardiovascular system can be achieved due to its two-dimensional radiation field. This world-first two-dimensional system has been successfully adapted to clinical applications. Details of the imaging system are described in this paper.

Development of a rotating X-ray shutter for coronary angiography using synchrotron radiation

The first clinical examination using a two-dimensional imaging system of coronary angiography with monochromated synchrotron radiation was carried out at the National Laboratory for High Energy Physics in May 1996. A rotating X-ray shutter was developed to produce a pulsed X-ray beam with 2-6 ms of beam spill to suppress image blurring, at a frequency of 30 Hz. A performance test of the X-ray shutter using synchrotron radiation was carried out, and it was verified that the shutter had satisfactory specifications for clinical applications. With this X-ray shutter the monitored radiation dose in clinical examinations was consistent with theoretical expectations and kept within a reasonable level of radiation protection.

Dynamic intravenous coronary arteriography using synchrotron radiation and its application to the measurement of coronary blood flow

We have developed dynamic intravenous coronary arteriography (IVCAG) using a monochromatic (33.3 keV), 2-dimensional X-ray beam (70 x 70 mm) generated from synchrotron radiation. To investigate its use to visualize the coronary arteries and to estimate coronary blood flow, we performed IVCAG in 10 dogs and 1 goat. The animals were irradiated with the synchrotron beam after intravenous injection of a contrast agent, and images were obtained using a TV camera and videorecorder. In the dogs, blood flow in the left anterior descending coronary artery (LAD) was also estimated from the images by applying a transit-time analysis. We obtained dynamic IVCAG images in the dogs and goat and could visualize even a deliberately created coronary stenosis about 1 mm in length. In addition, coronary blood flow could be estimated with an acceptable degree of accuracy. LAD flow calculated from IVCAG was 14.7 +/- 5.1 ml/min, whereas measured LAD flow was 16.6 +/- 4.8 ml/min. There was a close correlation between the estimated and measured LAD flows (r = 0.90, p < 0.01). Thus, dynamic IVCAG is minimally invasive, permits the simultaneous evaluation of coronary anatomy and blood flow, and may be feasible for clinical application.

Use of synchrotron radiation microangiography to assess development of small collateral arteries in a rat model of hindlimb ischemia

BACKGROUND

Current methods of angiography cannot provide images of arteries measuring < 200 microns in diameter. We have recently developed a new angiography system that uses monochromatic synchrotron radiation and a high-definition video system with a spatial resolution of 30 microns. In the present study, we applied this microangiography system to visualize small arteries in normal and ischemic rat limbs and investigated the development of collateral arteries.

METHODS AND RESULTS

Microangiography was performed in the normal and the ischemic limb 4 weeks after the excision of the femoral artery. In the normal limb, up to the fourth branches of the iliac and/or femoral arteries (diameter < 100 microns) were readily identified. Some of these branches were found to perfuse the distal thigh area. In the ischemic limb, an extensive structural remodeling of the vascular network was observed. Numerous small arteries had developed from the branches of the iliac artery to constitute a fine arterial network, the so-called "midzone," which was composed of linear, normal appearing arteries and those with an undulating, unbranched appearance.

CONCLUSIONS

The small collateral artery network was angiographically visualized with a resolution limit < 100 microns. The linear collaterals appeared to result from an opening of preexisting vessels. The undulating, unbranched vessels were not observed in the normal limbs and seemed to be vessels that were newly formed after limb ischemia. Synchrotron radiation microangiography appears to be a powerful means of assessing the development of small collateral arteries, which may help to provide a basis for understanding of the collateral circulation.

Synchrotron radiation in the study of the variation of dose response in thermoluminescence dosimeters with radiation energy

Thermoluminescence dosimetry (TLD) is a versatile technique with many applications for dosimetry of ionising radiation. However, in the range of kilovoltage x-rays which is widely used for diagnostic and therapeutic medical applications, problems arise from the differing dose response of most TL dosimeters with the radiation energy. The dose response of various TL detector types was investigated in mono-energetic x-ray beams of 26.8, 33.2, 40, 80.4 and 99.6keV from a synchrotron radiation source at the National Laboratory for High Energy Physics in Japan. This response was studied as a function of TL material (LiF:Mg,Ti, LiF:Mg,Cu,P and Al2O3), the detector geometry and size, and their thermal history. Due to the asymmetric diffraction from a Si crystal employed to produce monoenergetic photons there was more than 50% dose inhomogeneity in some of radiation fields used. Therefore, the different TL dosimeter types were rotated around and the results related to the reading of a set of "standard" LiF:Mg,Ti ribbons which were included in all experiments as reference detectors. No significant influence of the detector shape (physical size, thickness) on the dose response with energy could be found. However, the pre-irradiation thermal history influences the dose response with radiation energy: a fast cool down of LiF:Mg,Ti after a high temperature anneal will increase the sensitivity by more than a factor of two. The relatively new TLD material LiF:Mg,Cu,P (GR-200, obtained from Solid Dosimeter & Detector Laboratories, Beijing) was found to be approximately 100 times more sensitive than the standard LiF:Mg,Ti. In addition it proved to be more tissue equivalent for photon radiation between 27keV and 40keV. The performance of LiF:Mg,Cu,P makes it a very interesting TL material deserving further evaluation for applications in diagnostic and therapeutic x-rays.

Small-vessel radiography in situ with monochromatic synchrotron radiation

PURPOSE

To evaluate the usefulness of a radiographic system with monochromatic synchrotron radiation to depict small vessels and peripheral secretory ducts.

MATERIALS AND METHODS

Radiography of various organs was tested in 14 anesthetized dogs and pancreatography was performed in an excised human pancreas by using the following system: monochromatic synchrotron radiation with an energy level just above the k absorption edge of iodine as an x-ray source and a high-definition TV system with a high-light-sensitivity image pick-up tube camera coupled with a fluorescent screen as a detector.

RESULTS

This system allowed depiction of small vessels (diameter < 50-100 microns) of the heart (penetrating transmural artery), brain (perforating arteries that arise directly in the circle of Willis), and intestinal organs (vasa recta and their submucosal communications) and of small branches (down to the fifth order) of the pancreatic duct.

CONCLUSION

The synchrotron radiation system may be useful for evaluating microcirculatory disorders and early-stage malignant tumors in various human organs.

Retropharyngeal abscess after radiation therapy and cis-platinum, 5-fluorouracil treatment for nasopharyngeal carcinoma with collagen disease: report of two patients and a review of the literature

Collagen disease are frequently associated with malignant tumors. Recently, radiotherapy combined with chemotherapy has been recommended for improving the efficacy of treatment for nasopharyngeal carcinoma. Two patients with nasopharyngeal carcinoma complicated by collagen diseases (dermatomyositis in one, and Sjögren's syndrome with mixed connective tissue disease in the other) were given radiotherapy combined with chemotherapy consisting of cis-platinum and 5-fluorouracil. Following this combination therapy, both patients developed retropharyngeal abscess and ulceration of the mucosal membrane on the posterior wall of the oropharynx; there was no tumor cell involvement. Because these injuries were more severe than would have been expected from radiotherapy alone, it is recommended that special attention be paid to combination therapy in patients with nasopharyngeal carcinoma complicated by collagen disease.

Two-dimensional intravenous coronary arteriography using above-K-edge monochromatic synchrotron X-ray

RATIONALE AND OBJECTIVES

For intravenous (i.v.) coronary arteriography, a real-time two-dimensional (2D) imaging system is being developed using above-K-edge monochromatic X-rays alone. The potential diagnostic value of this system was examined in the current study.

METHODS

The angiographic system consisted of an asymmetric silicon (311) monocrystal, an image intensifier, and a charged-coupled device camera. It was constructed at the beam line of the Tristan Accumulation Ring. Monochromatic X-rays of 33.32 keV were used, and each image was recorded over 2 msec.

RESULTS

Ventricular wall motion and the anatomy of the coronary arteries could be seen in dogs by sequential images obtained without subtraction. The left anterior descending coronary artery, left circumflex coronary artery, and right coronary artery and the branches of these vessels were observed. The parts of the coronary arteries overlapping the aorta and left ventricle were revealed somewhat during washout of the contrast material.

CONCLUSION

For a 2D imaging system, monochromatic i.v. coronary angiography using an energy above the iodine K-edge might be able to image the coronary arteries without subtraction. However, the image quality needs to be improved by increasing the X-ray flux, decreasing background radiation scatter from the object, and decreasing contamination with 99-keV X-rays.

Visualization of penetrating transmural arteries in situ by monochromatic synchrotron radiation

BACKGROUND

Penetrating transmural arteries with a diameter of < 500 microns are considered to be a critical vascular component that causes a transmural variation of myocardial blood flow under various pathophysiological conditions. However, the conventional coronary angiographic system is not oriented to the visualization of such small arteries as these.

METHODS AND RESULTS

We magnified and monochromatized the inherently narrow beam (3 mm along the vertical direction) of synchrotron radiation by using an asymmetrically cut silicon crystal with 311 reflecting planes to obtain a monochromatic x-ray with relatively large beam size (60 x 25 mm) and with an energy of just above (+130 eV) the K-absorption edge of the contrast materials (33.17 and 37.41 ke V for iodine and barium, respectively). We irradiated dogs or excised hearts with the monochromatic x-ray and obtained coronary angiograms using an image intensifier and video system with a spatial resolution of 170 microns. In the anesthetized dog experiments, we visualized the transmural penetrating arteries (5 to 15 mm in length) arising every 4 to 7 mm from the epicardial branch. Visualization of these arteries filled with heavy element-loaded microspheres (15 microns in diameter) in the excised-heart experiments, in which the monochromatic x-ray was irradiated to the hearts through a 10- to 20-cm acrylic plate, indicated that this system could be used for human patients, in whom body absorption of x-ray is substantial.

CONCLUSIONS

Coronary angiogram by means of monochromatic x-ray is useful for a precise evaluation of coronary circulation, both in clinical setting and in physiological animal experiments.

High spatial resolution CT with a synchrotron radiation system

OBJECTIVE

We describe a monochromatic X-ray CT system using synchrotron radiation, which has been constructed employing a vertical wiggler beam line at the National Laboratory for High-Energy Physics in Tsukuba, Japan. This CT system was produced to facilitate examination of the microstructures of material and biological specimens.

MATERIALS AND METHODS

The system provides excellent contrast and has a spatial resolution capacity ranging from 2 to 100 mm. In this preliminary experiment, the images of the rat were obtained at 36-mm slice thickness and 33.2-keV X-ray energy.

RESULTS

The nasal cartilage, skull, and teeth of a live rat were clearly demonstrated with 36-mm spatial resolution.

CONCLUSION

Using a monochromatic X-ray CT system with synchrotron radiation, detailed structures of rat skull were imaged clearly.

Mechanical evaluation of three methods of plating distal radial osteotomies

Eighteen intact canine cadaver radii underwent nondestructive axial testing, and were osteotomized, plated, and retested. Each bone was tested with and without mediolateral or craniocaudal restriction of motion. Fixation of the osteotomies was performed under static compression with a cranially applied 5-hole 3.5 mm dynamic compression plate, a cranially applied 7-hole 3.5 mm T-plate, or a medially applied 7-hole 2.7 mm dynamic compression plate. There was no loss of axial stiffness after osteotomy and fixation, and there were no differences in axial stiffness between the methods of fixation. Mediolateral stiffness (bending around the craniocaudal axis) was consistently greater than craniocaudal stiffness (bending around the mediolateral axis) before and after osteotomy and plate fixation. There was no difference in the axial stiffness of otherwise intact radii when craniocaudal or mediolateral screw holes were drilled; however, all radii with craniocaudal screw holes and one radius with mediolateral screw holes fractured at a screw hole at high axial loads.

[Application of the thermoelastic stress imaging method to prosthodontics. (2) Basic study of the stress field of artificial molar teeth, in which the existence of saliva was considered]

A basic study was conducted utilizing a thermoelastic stress imaging method for stress analysis of model of simplified artificial molars based on an interocclusal contact relationship. This involved examining the effect of artificial saliva application on a stress field in a situation where occlusal pressure was applied in a dynamic sliding movement. As a result, the following conclusions were obtained. 1. The thermoelastic stress imaging method allowed the stress field to be determined artificial saliva application at distributed load due to plane contact in dynamic sliding movement. 2. Compared with the case of non-saliva application, in a squaremodel having a sliding movement and to which artificial saliva was applied, the pattern of the high compressive stress area was found to be a circle or an ellipsoid. This showed a slight dispersion trend at 10 degrees, with the contact plane as the boundary, and the dispersion of stress concentration began to become clearer at 20; stress concentration on the contact plane tended to disappear at 30 degrees, and sliding was conspicuous and determination impossible at 45 degrees. 3. Results showed that 10 degrees was a transition angle at which a different aspect was shown, representing a trend in a stress field pattern change accompanying an increase in the facet bevel angle when artificial saliva was applied. 4. From the results of stress analysis using the square-shape sliding movement model to which artificial saliva was applied, 10 degrees to 20 degrees of facet bevel of artificial molars was considered preferable in consideration of the presence of saliva.

New trend of cardiac imaging--intravenous coronary arteriography by synchrotron radiation

Synchrotron radiation is a broadspectrum intense X-ray beam. Selected X-ray wavelength was obtained by Bragg reflex. That is a monochromatic beam, which has a high spatial resolution, and has a K-edge discontinuity in attenuation coefficient, which, by energy subtraction, contributes to improve time resolution. An attempt to apply this method to intravenous coronary arteriography was performed in 7 anesthetized dogs. The beam was obtained by synchrotron radiation from accumulation ring, was reflected by silicon crystal, and was detected by 7 inch image intensifier system. Two-dimensional real time images were recorded on video tape. Phantom experiment was also performed. In dogs, coronary arteries were clearly distinguished by synchrotron radiation, especially at real time by video system. Phantom experiment suggested that coronary arteries could be visualized even over the visualized left ventricle. In conclusion, synchrotron radiation using two-dimensional real time images is expected to be useful in intravenous coronary arteriography in man.

Synchrotron radiation at the Photon Factory for non-invasive coronary angiography: experimental studies

Synchrotron radiation available at the Photon Factory, National Laboratory for High Energy Physics, provides a new X-ray source which is highly suitable for K-edge subtraction. This is due to its high intensity, its parallelism and its monochromaticity, available in a monochromator system. Experiments were performed using wiggler synchrotron radiation. Since the beam size is relatively-small for in-vivo imaging, a phantom coupled with a detector was moved horizontally using a scanning table. K-edge subtraction was successfully applied both to the coronary artery phantom filled with barium sulphate, and to rat angiography using iodine contrast material. The potential use and value of energy subtraction was successfully demonstrated.