Comparison of propagation-based CT using synchrotron radiation and conventional cone-beam CT for breast imaging

Development of a low-dose strategy for propagation-based imaging helical computed tomography (PBI-HCT): high image quality and reduced radiation dose

Background. Propagation-based imaging computed tomography (PBI-CT) has been recently emerging for visualizing low-density materials due to its excellent image contrast and high resolution. Based on this, PBI-CT with a helical acquisition mode (PBI-HCT) offers superior imaging quality (e.g., fewer ring artifacts) and dose uniformity, making it ideal for biomedical imaging applications. However, the excessive radiation dose associated with high-resolution PBI-HCT may potentially harm objects or hosts being imaged, especially in live animal imaging, raising a great need to reduce radiation dose.Methods. In this study, we strategically integrated Sparse2Noise (a deep learning approach) with PBI-HCT imaging to reduce radiation dose without compromising image quality. Sparse2Noise uses paired low-dose noisy images with different photon fluxes and projection numbers for high-quality reconstruction via a convolutional neural network (CNN). Then, we examined the imaging quality and radiation dose of PBI-HCT imaging using Sparse2Noise, as compared to when Sparse2Noise was used in low-dose PBI-CT imaging (circular scanning mode). Furthermore, we conducted a comparison study on the use of Sparse2Noise versus two other state-of-the-art low-dose imaging algorithms (i.e., Noise2Noise and Noise2Inverse) for imaging low-density materials using PBI-HCT at equivalent dose levels.Results. Sparse2Noise allowed for a 90% dose reduction in PBI-HCT imaging while maintaining high image quality. As compared to PBI-CT imaging, the use of Sparse2Noise in PBI-HCT imaging shows more effective by reducing additional radiation dose (30%-36%). Furthermore, helical scanning mode also enhances the performance of existing low-dose algorithms (Noise2Noise and Noise2Inverse); nevertheless, Sparse2Noise shows significantly higher signal-to-noise ratio (SNR) value compared to Noise2Noise and Noise2Inverse at the same radiation dose level.Conclusions and significance. Our proposed low-dose imaging strategy Sparse2Noise can be effectively applied to PBI-HCT imaging technique and requires lower dose for acceptable quality imaging. This would represent a significant advance imaging for low-density materials imaging and for future live animals imaging applications.

Grating-based phase-contrast computed tomography for breast tissue at an inverse compton source

The introduction of mammography screening programs has significantly reduced breast cancer mortality rates. Nevertheless, some lesions remain undetected, especially in dense breast tissue. Studies have shown that phase-contrast imaging can improve breast cancer diagnosis by increasing soft tissue contrast. Furthermore, grating-based phase-contrast imaging enables the simultaneous acquisition of absorption, phase-contrast, and scattering, so-called dark-field images. The latter allows the classification of microcalcifications. In addition, breast computed tomography (BCT) systems can identify and discriminate overlapping but clinically relevant structures. This study investigates the benefit of combining grating-based phase-contrast with BCT. We explore the potential of grating-based phase-contrast breast computed tomography (gbpc-BCT) with a breast phantom and a freshly dissected fibroadenoma. Improved image contrast could be achieved with radiation doses comparable to those used in clinical BCT.

Sparse2Noise: Low-dose synchrotron X-ray tomography without high-quality reference data

BACKGROUND

Synchrotron radiation computed tomography (SR-CT) holds promise for high-resolution in vivo imaging. Notably, the reconstruction of SR-CT images necessitates a large set of data to be captured with sufficient photons from multiple angles, resulting in high radiation dose received by the object. Reducing the number of projections and/or photon flux is a straightforward means to lessen the radiation dose, however, compromises data completeness, thus introducing noises and artifacts. Deep learning (DL)-based supervised methods effectively denoise and remove artifacts, but they heavily depend on high-quality paired data acquired at high doses. Although algorithms exist for training without high-quality references, they struggle to effectively eliminate persistent artifacts present in real-world data.

METHODS

This work presents a novel low-dose imaging strategy namely Sparse2Noise, which combines the reconstruction data from paired sparse-view CT scan (normal-flux) and full-view CT scan (low-flux) using a convolutional neural network (CNN). Sparse2Noise does not require high-quality reconstructed data as references and allows for fresh training on data with very small size. Sparse2Noise was evaluated by both simulated and experimental data.

RESULTS

Sparse2Noise effectively reduces noise and ring artifacts while maintaining high image quality, outperforming state-of-the-art image denoising methods at same dose levels. Furthermore, Sparse2Noise produces impressive high image quality for ex vivo rat hindlimb imaging with the acceptable low radiation dose (i.e., 0.5 Gy with the isotropic voxel size of 26 μm).

CONCLUSIONS

This work represents a significant advance towards in vivo SR-CT imaging. It is noteworthy that Sparse2Noise can also be used for denoising in conventional CT and/or phase-contrast CT.

Designing a breast support device for phase contrast tomographic imaging: getting ready for a clinical trial

OBJECTIVE

To design a device that can support the breast during phase-contrast tomography, and characterise its fit parameterisation and comfort rating.

METHODS

27 participants were recruited to trial a system for breast support during simulated phase contrast imaging, including being positioned on a prone imaging table while wearing the device. Participants underwent a photogrammetry analysis to establish the geometric parameterisations. All participants trialled a single-cup design while 14 participants also trialled a double-cup with suction holder and all completed a series of questionnaires to understand subjective comfort.

RESULTS

Photogrammetry revealed significant positive correlations between bra cup volume and measured prone volume (p < 0.001), and between "best fit" single-cup holder volume and measured prone volume (p < 0.005). Both holders were suitable devices in terms of subjective comfort and immobilisation while stationary. However, some re-engineering to allow for quick, easy fitting in future trials where rotation through the radiation beam will occur is necessary. Light suction was well-tolerated when required.

CONCLUSION

All participants indicated the table and breast support devices were comfortable, and they would continue in the trial.

ADVANCES IN KNOWLEDGE

Phase contrast tomography is an emerging breast imaging modality and clinical trials are commencing internationally. This paper describes the biomedical engineering designs, in parallel with optimal imaging, that are necessary to measure breast volume so that adequate breast support can be achieved. Breast support devices have implications for comfort, motion correction and maximising breast tissue visualisation.

A novel hardware duo of beam modulation and shielding to reduce scatter acquisition and dose in cone-beam breast CT

PURPOSE

In cone-beam breast CT, scattered photons form a large portion of the acquired signal, adversely impacting image quality throughout the frequency response of the imaging system. Prior simulation studies provided proof of concept for utilization of a hardware solution to prevent scatter acquisition. Here, we report the design, implementation, and characterization of an auxiliary apparatus of fluence modulation and scatter shielding that does indeed lead to projections with a reduced level of scatter.

METHODS

An apparatus was designed for permanent installation within an existing cone-beam CT system. The apparatus is composed of two primary assemblies: a "Fluence Modulator" (FM) and a "Scatter Shield" (SS). The design of the assemblies enables them to operate in synchrony during image acquisition, converting the sourced x-rays into a moving narrow beam. During a projection, this narrow beam sweeps the entire fan angle coverage of the imaging system. As the two assemblies are contingent on one another, their joint implementation is described in the singular as apparatus FM-SS. The FM and the SS assemblies are each comprised a metal housing, a sensory system, and a robotic system. A controller unit handles their relative movements. A series of comparative studies were conducted to evaluate the performance of a cone-beam CT system in two "modes" of operation: with and without FM-SS installed, and to compare the results of physical implementation with those previously simulated. The dynamic range requirements of the utilized detector in the cone-beam CT imaging system were first characterized, independent of the mode of operation. We then characterized and compared the spatial resolution of the imaging system with, and without, FM-SS. A physical breast phantom, representative of an average size breast, was developed and imaged. Actual differences in signal level obtained with, versus without, FM-SS were then compared to the expected level gains based on previously reported simulations. Following these initial assessments, the scatter acquisition in each projection in both modes of operation was investigated. Finally, as an initial study of the impact of FM-SS on radiation dose in an average size breast, a series of Monte Carlo simulations were coupled with physical measurements of air kerma, with and without FM-SS.

RESULTS

With implementation of FM-SS, the detector's required dynamic range was reduced by a factor of 5.5. Substantial reduction in the acquisition of the scattered rays, by a factor of 5.1 was achieved. With the implementation of FM-SS, deposited dose was reduced by 27% in the studied breast.

CONCLUSIONS

The disclosed implementation of FM-SS, within a cone-beam breast CT system, results in reduction of scatter-components in acquired projections, reduction of dose deposit to the breast, and relaxation of requirements for the detector's dynamic range. Controlling or correcting for patient motion occurring during image acquisition remains an open problem to be solved prior to practical clinical usage of FM-SS cone-beam breast CT.

Dedicated breast CT: state of the art-Part II. Clinical application and future outlook

Dedicated breast CT is being increasingly used for breast imaging. This technique provides images with no compression, removal of tissue overlap, rapid acquisition, and available simultaneous assessment of microcalcifications and contrast enhancement. In this second installment in a 2-part review, the current status of clinical applications and ongoing efforts to develop new imaging systems are discussed, with particular emphasis on how to achieve optimized practice including lesion detection and characterization, response to therapy monitoring, density assessment, intervention, and implant evaluation. The potential for future screening with breast CT is also addressed. KEY POINTS: • Dedicated breast CT is an emerging modality with enormous potential in the future of breast imaging by addressing numerous clinical needs from diagnosis to treatment. • Breast CT shows either noninferiority or superiority with mammography and numerical comparability to MRI after contrast administration in diagnostic statistics, demonstrates excellent performance in lesion characterization, density assessment, and intervention, and exhibits promise in implant evaluation, while potential application to breast cancer screening is still controversial. • New imaging modalities such as phase-contrast breast CT, spectral breast CT, and hybrid imaging are in the progress of R & D.

Recent advances in X-ray imaging of breast tissue: From two- to three-dimensional imaging

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.

Functional lung imaging with synchrotron radiation: Methods and preclinical applications

Many lung disease processes are characterized by structural and functional heterogeneity that is not directly appreciable with traditional physiological measurements. Experimental methods and lung function modeling to study regional lung function are crucial for better understanding of disease mechanisms and for targeting treatment. Synchrotron radiation offers useful properties to this end: coherence, utilized in phase-contrast imaging, and high flux and a wide energy spectrum which allow the selection of very narrow energy bands of radiation, thus allowing imaging at very specific energies. K-edge subtraction imaging (KES) has thus been developed at synchrotrons for both human and small animal imaging. The unique properties of synchrotron radiation extend X-ray computed tomography (CT) capabilities to quantitatively assess lung morphology, and also to map regional lung ventilation, perfusion, inflammation and biomechanical properties, with microscopic spatial resolution. Four-dimensional imaging, allows the investigation of the dynamics of regional lung functional parameters simultaneously with structural deformation of the lung as a function of time. This review summarizes synchrotron radiation imaging methods and overviews examples of its application in the study of disease mechanisms in preclinical animal models, as well as the potential for clinical translation both through the knowledge gained using these techniques and transfer of imaging technology to laboratory X-ray sources.