Phase contrast imaging of breast tumours with synchrotron radiation

Exploring phase contrast imaging with a laser-based Kα x-ray source up to relativistic laser intensity

This study explores the ability of a hard Kα x-ray source (17.48 keV) produced by a 10 TW class laser system operated at high temporal contrast ratio and high repetition rate for phase contrast imaging. For demonstration, a parametric study based on a known object (PET films) shows clear evidence of feasibility of phase contrast imaging over a large range of laser intensity on target (from ~1017 W/cm2 to 7.0 × 1018 W/cm2). To highlight this result, a comparison of raw phase contrast and retrieved phase images of a biological object (a wasp) is done at different laser intensities below the relativistic intensity regime and up to 1.3 × 1019 W/cm2. This brings out attractive imaging strategies by selecting suitable laser intensity for optimizing either high spatial resolution and high quality of image or short acquisition time.

Evaluation of texture features at staging liver fibrosis based on phase contrast X-ray imaging

BACKGROUND

The purpose of this study is to explore the potential of phase contrast imaging to detect fibrotic progress in its early stage; to investigate the feasibility of texture features for quantified diagnosis of liver fibrosis; and to evaluate the performance of back propagation (BP) neural net classifier for characterization and classification of liver fibrosis.

METHODS

Fibrous mouse liver samples were imaged by X-ray phase contrast imaging, nine texture measures based on gray-level co-occurrence matrix were calculated and the feasibility of texture features in the characterization and discrimination of liver fibrosis at early stages was investigated. Furthermore, 36 or 18 features were applied to the input of BP classifier; the classification performance was evaluated using receiver operating characteristic curve.

RESULTS

The phase contrast images displayed a vary degree of texture pattern from normal to severe fibrosis stages. The BP classifier could distinguish liver fibrosis among normal, mild, moderate and severe stages; the average accuracy was 95.1% for 36 features, and 91.1% for 18 features.

CONCLUSION

The study shows that early stages of liver fibrosis can be discriminated by the morphological features on the phase contrast images. BP network model based on combination of texture features is demonstrated effective for staging liver fibrosis.

Factors influencing real time internal structural visualization and dynamic process monitoring in plants using synchrotron-based phase contrast X-ray imaging

Minimally invasive investigation of plant parts (root, stem, leaves, and flower) has good potential to elucidate the dynamics of plant growth, morphology, physiology, and root-rhizosphere interactions. Laboratory based absorption X-ray imaging and computed tomography (CT) systems are extensively used for in situ feasibility studies of plants grown in natural and artificial soil. These techniques have challenges such as low contrast between soil pore space and roots, long X-ray imaging time, and low spatial resolution. In this study, the use of synchrotron (SR) based phase contrast X-ray imaging (PCI) has been demonstrated as a minimally invasive technique for imaging plants. Above ground plant parts and roots of 10 day old canola and wheat seedlings grown in sandy clay loam soil were successfully scanned and reconstructed. Results confirmed that SR-PCI can deliver good quality images to study dynamic and real time processes such as cavitation and water-refilling in plants. The advantages of SR-PCI, effect of X-ray energy, and effective pixel size to study plant samples have been demonstrated. The use of contrast agents to monitor physiological processes in plants was also investigated and discussed.

Signs analysis and clinical assessment: phase-contrast computed tomography of human breast tumours

Purpose

To analyse the diagnostic signs present in slices of human breast tumour specimens using synchrotron radiation phase-contrast imaging computed tomography (PCI-CT) for the first time and assess the feasibility of this technique for clinical applications.

Materials and Methods

The ethics committee of our university and relevant clinical hospital approved this prospective study, and written informed consent was obtained from all patients. PCI-CT of human breast tumour specimens with synchrotron radiation was performed at the Shanghai Synchrotron Radiation Facility (SSRF). A total of 14 specimens of early-stage carcinomas and 8 specimens of adenomas were enrolled. Based on raw data reconstruction, the diagnostic signs present in the slices were analysed and correlated with histopathology. We proposed a criterion for clinical diagnosis according to the evaluated signs and the Breast Imaging Reporting and Data System (BI-RADS) for reference. The criterion was then assessed by clinicians in a double-blind method. Finally, descriptive statistics were evaluated, depending on the assessment results.

Results

The 14 carcinoma specimens and 8 adenoma specimens were diagnosed as malignant and benign tumours, respectively. The total coincidence rate was 100%.

Conclusion

Our study results demonstrate that the X-ray diagnostic signs observed in the specimen slices and the criterion used for clinical diagnosis were accurate and reliable. The criterion based on signs analysis can be used to differentiate early-stage benign or malignant tumours. As a promising imaging method, PCI-CT can serve as a possible and feasible supplement to BI-RADS in the future.

[Phase contrast imaging of the breast. Basic principles and steps towards clinical implementation]

CLINICAL/METHODICAL ISSUE

Breast cancer is the most common cancer and the leading cause of cancer deaths in women worldwide.

STANDARD RADIOLOGICAL METHODS

Mammography is the only imaging technique approved for nationwide breast cancer screening. Digital full field mammography has improved mammographic image quality. Nevertheless, mammography has a low positive predictive value and a low sensitivity especially in mammographically dense breasts. One of the major limitations is the inherently low contrast between healthy breast parenchyma and breast cancer.

METHODICAL INNOVATIONS

Phase contrast imaging is based on the phase shift that occurs when X-rays encounter a change in refractive index between different materials.

PERFORMANCE

The improved soft tissue contrast makes the technology particularly promising for breast diagnostics.

ACHIEVEMENTS

The studies presented here suggest that phase contrast imaging provides additional diagnostic information both using phase contrast mammography and phase contrast computed tomography (CT).

PRACTICAL RECOMMENDATIONS

This paper provides an overview of the basic principles of the phase contrast imaging and describes recent developments towards in vivo and ex vivo phase contrast imaging of the breast.

Compact laser accelerators for X-ray phase-contrast imaging

Advances in X-ray imaging techniques have been driven by advances in novel X-ray sources. The latest fourth-generation X-ray sources can boast large photon fluxes at unprecedented brightness. However, the large size of these facilities means that these sources are not available for everyday applications. With advances in laser plasma acceleration, electron beams can now be generated at energies comparable to those used in light sources, but in university-sized laboratories. By making use of the strong transverse focusing of plasma accelerators, bright sources of betatron radiation have been produced. Here, we demonstrate phase-contrast imaging of a biological sample for the first time by radiation generated by GeV electron beams produced by a laser accelerator. The work was performed using a greater than 300 TW laser, which allowed the energy of the synchrotron source to be extended to the 10-100 keV range.

X-ray phase-contrast imaging of the breast--advances towards clinical implementation

Breast cancer constitutes about one-quarter of all cancers and is the leading cause of cancer death in women. To reduce breast cancer mortality, mammographic screening programmes have been implemented in many Western countries. However, these programmes remain controversial because of the associated radiation exposure and the need for improvement in terms of diagnostic accuracy. Phase-contrast imaging is a new X-ray-based technology that has been shown to provide enhanced soft-tissue contrast and improved visualization of cancerous structures. Furthermore, there is some indication that these improvements of image quality can be maintained at reduced radiation doses. Thus, X-ray phase-contrast mammography may significantly contribute to advancements in early breast cancer diagnosis. Feasibility studies of X-ray phase-contrast breast CT have provided images that allow resolution of the fine structure of tissue that can otherwise only be obtained by histology. This implies that X-ray phase-contrast imaging may also lead to the development of entirely new (micro-) radiological applications. This review provides a brief overview of the physical characteristics of this new technology and describes recent developments towards clinical implementation of X-ray phase-contrast imaging of the breast.

Feasibility of breast cancer screening by PIXE analysis of hair

To reveal the role of key elements present in the hair of breast cancer patients on cancer development, the levels of a number of elements in scalp hair samples of 82 people including healthy individuals, people suffering from benign breast disease, and breast cancer patients were measured by PIXE analysis. Pellets of hair samples were prepared and bombarded by 2.2 MeV proton beam of a 3-MV Van de Graaff accelerator. The number of incident ions hitting the sample was indirectly measured using the RBS spectrum of a thin Ag film placed in the beam path. The concentrations of S, Cl, K, Ca, Fe, and Cu in the hair of healthy individuals were in agreement with those observed in the hair of hyperplasia and cancer patients within standard deviations. However, a lower average level of zinc was found in samples from hyperplasia and breast cancer patients. Strong positive correlations were found between iron and potassium as well as between calcium and potassium in the cancer patients. These results could be of significance in the screening for breast cancer.

Three-dimensional reconstruction of blood vessels in the rabbit eye by X-ray phase contrast imaging

Background

A clear understanding of the blood vessels in the eye is helpful in the diagnosis and treatment of ophthalmic diseases, such as glaucoma. Conventional techniques such as micro-CT imaging and histology are not sufficiently accurate to identify the vessels in the eye, because their diameter is just a few microns. The newly developed medical imaging technology, X-ray phase-contrast imaging (XPCI), is able to distinguish the structure of the vessels in the eye. In this study, XPCI was used to identify the internal structure of the blood vessels in the eye.

Methods

After injection with barium sulfate via the ear border artery, an anesthetized rabbit was killed and its eye was fixed in vitro in 10% formalin solution. We acquired images using XPCI at the Shanghai Synchrotron Radiation Facility. The datasets were converted into slices by filtered back-projection (FBP). An angiographic score was obtained as a parameter to quantify the density of the blood vessels. A three-dimensional (3D) model of the blood vessels was then established using Amira 5.2 software.

Results

With XPCI, blood vessels in the rabbit eye as small as 18 μm in diameter and a sixth of the long posterior ciliary artery could be clearly distinguished. In the 3D model, we obtained the level 4 branch structure of vessels in the fundus. The diameters of the arteria centralis retinae and its branches are about 200 μm, 110 μm, 95 μm, 80 μm and 40 μm. The diameters of the circulus arteriosus iridis major and its branches are about 210 μm, 70 μm and 30 μm. Analysis of vessel density using the angiographic score showed that the blood vessels had maximum density in the fundus and minimum density in the area anterior to the equator (scores 0.27 ± 0.029 and 0.16 ± 0.032, respectively). We performed quantitative angiographic analysis of the blood vessels to further investigate the density of the vessels.

Conclusions

XPCI provided a feasible means to determine the structure of the blood vessels in the eye. We were able to determine the diameters and morphological characteristics of the vessels from both 2D images and the 3D model. By analyzing the images, we obtained measurements of the density distribution of the microvasculature, and this approach may provide valuable reference information prior to glaucoma filtration surgery.

Ideal-observer detectability in photon-counting differential phase-contrast imaging using a linear-systems approach

PURPOSE

To provide a cascaded-systems framework based on the noise-power spectrum (NPS), modulation transfer function (MTF), and noise-equivalent number of quanta (NEQ) for quantitative evaluation of differential phase-contrast imaging (Talbot interferometry) in relation to conventional absorption contrast under equal-dose, equal-geometry, and, to some extent, equal-photon-economy constraints. The focus is a geometry for photon-counting mammography.

METHODS

Phase-contrast imaging is a promising technology that may emerge as an alternative or adjunct to conventional absorption contrast. In particular, phase contrast may increase the signal-difference-to-noise ratio compared to absorption contrast because the difference in phase shift between soft-tissue structures is often substantially larger than the absorption difference. We have developed a comprehensive cascaded-systems framework to investigate Talbot interferometry, which is a technique for differential phase-contrast imaging. Analytical expressions for the MTF and NPS were derived to calculate the NEQ and a task-specific ideal-observer detectability index under assumptions of linearity and shift invariance. Talbot interferometry was compared to absorption contrast at equal dose, and using either a plane wave or a spherical wave in a conceivable mammography geometry. The impact of source size and spectrum bandwidth was included in the framework, and the trade-off with photon economy was investigated in some detail. Wave-propagation simulations were used to verify the analytical expressions and to generate example images.

RESULTS

Talbot interferometry inherently detects the differential of the phase, which led to a maximum in NEQ at high spatial frequencies, whereas the absorption-contrast NEQ decreased monotonically with frequency. Further, phase contrast detects differences in density rather than atomic number, and the optimal imaging energy was found to be a factor of 1.7 higher than for absorption contrast. Talbot interferometry with a plane wave increased detectability for 0.1-mm tumor and glandular structures by a factor of 3-4 at equal dose, whereas absorption contrast was the preferred method for structures larger than ∼0.5 mm. Microcalcifications are small, but differ from soft tissue in atomic number more than density, which is favored by absorption contrast, and Talbot interferometry was barely beneficial at all within the resolution limit of the system. Further, Talbot interferometry favored detection of "sharp" as opposed to "smooth" structures, and discrimination tasks by about 50% compared to detection tasks. The technique was relatively insensitive to spectrum bandwidth, whereas the projected source size was more important. If equal photon economy was added as a restriction, phase-contrast efficiency was reduced so that the benefit for detection tasks almost vanished compared to absorption contrast, but discrimination tasks were still improved close to a factor of 2 at the resolution limit.

CONCLUSIONS

Cascaded-systems analysis enables comprehensive and intuitive evaluation of phase-contrast efficiency in relation to absorption contrast under requirements of equal dose, equal geometry, and equal photon economy. The benefit of Talbot interferometry was highly dependent on task, in particular detection versus discrimination tasks, and target size, shape, and material. Requiring equal photon economy weakened the benefit of Talbot interferometry in mammography.

Multimodal hard X-ray imaging of a mammography phantom at a compact synchrotron light source

The Compact Light Source is a miniature synchrotron producing X-rays at the interaction point of a counter-propagating laser pulse and electron bunch through the process of inverse Compton scattering. The small transverse size of the luminous region yields a highly coherent beam with an angular divergence of a few milliradians. The intrinsic monochromaticity and coherence of the produced X-rays can be exploited in high-sensitivity differential phase-contrast imaging with a grating-based interferometer. Here, the first multimodal X-ray imaging experiments at the Compact Light Source at a clinically compatible X-ray energy of 21 keV are reported. Dose-compatible measurements of a mammography phantom clearly demonstrate an increase in contrast attainable through differential phase and dark-field imaging over conventional attenuation-based projections.

Comparison of in vitro breast cancer visibility in analyser-based computed tomography with histopathology, mammography, computed tomography and magnetic resonance imaging

High-resolution analyser-based X-ray imaging computed tomography (HR ABI-CT) findings on in vitro human breast cancer are compared with histopathology, mammography, computed tomography (CT) and magnetic resonance imaging. The HR ABI-CT images provided significantly better low-contrast visibility compared with the standard radiological images. Fine cancer structures indistinguishable and superimposed in mammograms were seen, and could be matched with the histopathological results. The mean glandular dose was less than 1 mGy in mammography and 12-13 mGy in CT and ABI-CT. The excellent visibility of in vitro breast cancer suggests that HR ABI-CT may have a valuable role in the future as an adjunct or even alternative to current breast diagnostics, when radiation dose is further decreased, and compact synchrotron radiation sources become available.

Phase-contrast digital tomosynthesis

PURPOSE

Phase-contrast (PC) edge enhancement occurs at the boundary between different tissues and is an interference effect that results from the differential phase-shifts that the x-rays acquire while traversing the two tissues. While observable in planar phase-contrast radiographs, the impact of digital tomosynthesis on this edge enhancement effect has not been previously reported. The purpose of this work is to demonstrate: (1) that phase-contrast digital tomosynthesis (PC-DTS) is possible with a conventional x-ray source, (2) that the reconstructed tomosynthesis images demonstrate and retain edge enhancement as compared to planar phase-contrast radiographs and (3) tomosynthesis improves object contrast by reducing the effects of superimposed structures.

METHODS

An unmodified, commercially available cabinet x-ray system (Faxitron LX-60) was used. The system contains a tungsten anode x-ray tube that was operated at 24 kVp and 3 mAs for each PC radiographic image taken, with a nominal focal spot size of 0.010 mm. The digital detector uses CsI/CMOS with a pixel size of 0.054 mm x 0.054 mm. Objects to be imaged were attached to a computer-controlled rotating motor and are rotated +/- 25 degrees about a central position in one degree increments. At each increment, three phase-contrast radiographs are taken and then averaged to reduce the effect of noise. These planar images are then used to reconstruct a series of 56 longitudinal tomographic images with an image offset increment of about 0.7 mm.

RESULTS

Tomographic z-plane resolution was measured to be approximately 4 mm. When compared to planar PC images, the tomosynthesis images were shown to retain the PC boundary edge enhancement in addition to an improvement in object contrast.

CONCLUSIONS

Our work demonstrates that PC digital tomosynthesis retains the edge-enhancement observed in planar PC radiograph and further improves soft-tissue conspicuity by reducing the effects of superimposed tissue structure.