Toward clinical X-ray phase-contrast CT: demonstration of enhanced soft-tissue contrast in human specimen

Optimization of signal and noise in x-ray phase and dark field imaging with a wire mesh

Phase differences imparted by tissue are significantly larger than attenuation differences. In addition, small angle scatter from tissue microstructure can provide a dark field signal that is complementary to attenuation and phase. Unfortunately, the low spatial coherence of clinical sources reduces phase and dark field contrast. Our method structures the beam with a single low-cost wire mesh that does not need precise alignment and relaxes the coherence requirement on the source. In addition, focusing polycapillary optics, which can be permanently attached to sources, are employed to allow for the use of high-power primary sources by increasing the phase signal after the focus. However, the coarseness of the mesh reduces the phase and dark field signal-to-noise ratio (SNR) compared with grating-based techniques, so optimization of the phase and dark-field SNR is an important consideration. Here, we consider the impact on the SNR of the distances between the mesh and the source and detector, and of x-ray tube voltages, to optimize the system.

Accurate and noise robust crosstalk removal techniques for edge illumination phase-based x-ray imaging systems

In x-ray phase contrast imaging (XPCI) using the edge illumination method (EI), crosstalk (XT) between adjacent pixels due to, e.g., light diffusion in the scintillator in indirect conversion detector systems is an issue that blurs images and reduces both image sharpness and quantitative accuracy. We provide a detailed mathematical description of this phenomenon and propose two independent methods to mitigate its negative effects. The effectiveness of these techniques is demonstrated through both simulated and experimental data, showcasing the improvements in image quality and quantitative accuracy. In particular, the experimental data include an intact mouse skull where soft tissue details of the brain are visualized and improved with the proposed deconvolution methods; to the best of our knowledge, details of the murine brain structure inside an intact skull had not been observed before with laboratory-based XPCI systems.

Self-supervised denoising of grating-based phase-contrast computed tomography

In the last decade, grating-based phase-contrast computed tomography (gbPC-CT) has received growing interest. It provides additional information about the refractive index decrement in the sample. This signal shows an increased soft-tissue contrast. However, the resolution dependence of the signal poses a challenge: its contrast enhancement is overcompensated by the low resolution in low-dose applications such as clinical computed tomography. As a result, the implementation of gbPC-CT is currently tied to a higher dose. To reduce the dose, we introduce the self-supervised deep learning network Noise2Inverse into the field of gbPC-CT. We evaluate the behavior of the Noise2Inverse parameters on the phase-contrast results. Afterward, we compare its results with other denoising methods, namely the Statistical Iterative Reconstruction, Block Matching 3D, and Patchwise Phase Retrieval. In the example of Noise2Inverse, we show that deep learning networks can deliver superior denoising results with respect to the investigated image quality metrics. Their application allows to increase the resolution while maintaining the dose. At higher resolutions, gbPC-CT can naturally deliver higher contrast than conventional absorption-based CT. Therefore, the application of machine learning-based denoisers shifts the dose-normalized image quality in favor of gbPC-CT, bringing it one step closer to medical application.

Speckle tracking phase-contrast computed tomography at an inverse Compton X-ray source

Speckle-based X-ray imaging (SBI) is a phase-contrast method developed at and for highly coherent X-ray sources, such as synchrotrons, to increase the contrast of weakly absorbing objects. Consequently, it complements the conventional attenuation-based X-ray imaging. Meanwhile, attempts to establish SBI at less coherent laboratory sources have been performed, ranging from liquid metal-jet X-ray sources to microfocus X-ray tubes. However, their lack of coherence results in interference fringes not being resolved. Therefore, algorithms were developed which neglect the interference effects. Here, we demonstrate phase-contrast computed tomography employing SBI in a laboratory-setting with an inverse Compton X-ray source. In this context, we investigate and compare also the performance of the at synchrotron conventionally used phase-retrieval algorithms for SBI, unified modulated pattern analysis (UMPA) with a phase-retrieval method developed for low coherence systems (LCS). We successfully retrieve a full computed tomography in a phantom as well as in biological specimens, such as larvae of the greater wax moth (Galleria mellonella), a model system for studies of pathogens and infections. In this context, we additionally demonstrate quantitative phase-contrast computed tomography using SBI at a low coherent set-up.

Optimization of contrast and dose in x-ray phase-contrast tomography with a Talbot-Lau interferometer

X-ray phase-contrast imaging has become a valuable tool for biomedical research due to its improved contrast abilities over regular attenuation-based imaging. The recently emerged Talbot-Lau interferometer can provide quantitative attenuation, phase-contrast and dark-field image data, even with low-brilliance x-ray tube sources. Thus, it has become a valid option for clinical environments. In this study, we analyze the effects of x-ray tube voltage and total number of images on the contrast-to-noise ratio (CNR) and dose-weighted CNR (CNRD) calculated from tomographic transmission and phase-contrast data of a phantom sample. Constant counting statistics regardless of the voltage was ensured by adjusting the image exposure time for each voltage setting. The results indicate that the x-ray tube voltage has a clear effect on both image contrast and noise. This effect is amplified in the case of phase-contrast images, which is explained by the polychromatic x-ray spectrum and the dependence of interferometer visibility on the spectrum. CNRD is additionally affected by the total imaging time. While submerging the sample into a water container effectively reduces image artefacts and improves the CNR, the additional attenuation of the water must be compensated with a longer exposure time. This reduces dose efficiency. Both the CNR and CNRD are higher in the phase-contrast images compared to transmission images. For transmission images, and phase-contrast images without the water container, CNRD can be increased by using higher tube voltages (in combination with a lower exposure time). For phase-contrast images with the water container, CNRD is increased with lower tube voltages. In general, the CNRD does not strongly depend on the number of tomographic angles or phase steps used.

Method for auto-alignment and determination of parameter space in dual-phase grating interferometry

X-ray dual-phase grating interferometry provides quantitative micro-structural information beyond the optical resolution through its tunable correlation length. Ensuring optimal performance of the set-up requires accurate correlation length estimation and precise alignment of the gratings. This paper presents an automated procedure for determining the complete geometrical parameters of the interferometer set-up with a high degree of precision. The algorithm's effectiveness is then evaluated through a series of experimental tests, illustrating its accuracy and robustness.

Phase retrieval for X-ray differential phase contrast radiography with knowledge transfer learning from virtual differential absorption model

Grating-based X-ray phase contrast radiography and computed tomography (CT) are promising modalities for future medical applications. However, the ill-posed phase retrieval problem in X-ray phase contrast imaging has hindered its use for quantitative analysis in biomedical imaging. Deep learning has been proved as an effective tool for image retrieval. However, in practical grating-based X-ray phase contrast imaging system, acquiring the ground truth of phase to form image pairs is challenging, which poses a great obstacle for using deep leaning methods. Transfer learning is widely used to address the problem with knowledge inheritance from similar tasks. In the present research, we propose a virtual differential absorption model and generate a training dataset with differential absorption images and absorption images. The knowledge learned from the training is transferred to phase retrieval with transfer learning techniques. Numerical simulations and experiments both demonstrate its feasibility. Image quality of retrieved phase radiograph and phase CT slices is improved when compared with representative phase retrieval methods. We conclude that this method is helpful in both X-ray 2D and 3D imaging and may find its applications in X-ray phase contrast radiography and X-ray phase CT.

Pixel-wise beam-hardening correction for dark-field signal in X-ray dual-phase grating interferometry

The dark-field signal provided by X-ray grating interferometry is an invaluable tool for providing structural information beyond the direct spatial resolution and their variations on a macroscopic scale. However, when using a polychromatic source, the beam-hardening effect in the dark-field signal makes the quantitative sub-resolution structural information inaccessible. Especially, the beam-hardening effect in dual-phase grating interferometry varies with spatial location, inter-grating distance, and diffraction order. In this work, we propose a beam-hardening correction algorithm, taking into account all these factors. The accuracy and robustness of the algorithm are then validated by experimental results. This work contributes a necessary step toward accessing small-angle scattering structural information in dual-phase grating interferometry.

Cycloidal-spiral sampling for three-modal x-ray CT flyscans with two-dimensional phase sensitivity

We present a flyscan compatible acquisition scheme for three-modal X-Ray Computed Tomography (CT) with two-dimensional phase sensitivity. Our approach is demonstrated using a "beam tracking" setup, through which a sample's attenuation, phase (refraction) and scattering properties can be measured from a single frame, providing three complementary contrast channels. Up to now, such setups required the sample to be stepped at each rotation angle to sample signals at an adequate rate, to prevent resolution losses, anisotropic resolution, and under-sampling artefacts. However, the need for stepping necessitated a step-and-shoot implementation, which is affected by motors' overheads and increases the total scan time. By contrast, our proposed scheme, by which continuous horizontal and vertical translations of the sample are integrated with its rotation (leading to a "cycloidal-spiral" trajectory), is fully compatible with continuous scanning (flyscans). This leads to greatly reduced scan times while largely preserving image quality and isotropic resolution.

Volumetric High-Resolution X-Ray Phase-Contrast Virtual Histology of Breast Specimens With a Compact Laboratory System

The assessment of margin involvement is a fundamental task in breast conserving surgery to prevent recurrences and reoperations. It is usually performed through histology, which makes the process time consuming and can prevent the complete volumetric analysis of large specimens. X-ray phase contrast tomography combines high resolution, sufficient penetration depth and high soft tissue contrast, and can therefore provide a potential solution to this problem. In this work, we used a high-resolution implementation of the edge illumination X-ray phase contrast tomography based on "pixel-skipping" X-ray masks and sample dithering, to provide high definition virtual slices of breast specimens. The scanner was originally designed for intra-operative applications in which short scanning times were prioritised over spatial resolution; however, thanks to the versatility of edge illumination, high-resolution capabilities can be obtained with the same system simply by swapping x-ray masks without this imposing a reduction in the available field of view. This makes possible an improved visibility of fine tissue strands, enabling a direct comparison of selected CT slices with histology, and providing a tool to identify suspect features in large specimens before slicing. Combined with our previous results on fast specimen scanning, this works paves the way for the design of a multi-resolution EI scanner providing intra-operative capabilities as well as serving as a digital pathology system.

Three-dimensional virtual histology of the cerebral cortex based on phase-contrast X-ray tomography

In this work, we optimize the setups and experimental parameters of X-ray phase-contrast computed-tomography for the three-dimensional imaging of the cyto- and myeloarchitecture of cerebral cortex, including both human and murine tissue. We present examples for different optical configurations using state-of-the art synchrotron instruments for holographic tomography, as well as compact laboratory setups for phase-contrast tomography in the direct contrast (edge-enhancement) regime. Apart from unstained and paraffin-embedded tissue, we tested hydrated tissue, as well as heavy metal stained and resin-embedded tissue using two different protocols. Further, we show that the image quality achieved allows to assess the neuropathology of multiple sclerosis in a biopsy sample collected during surgery.

Quantitative X-ray phase contrast computed tomography with grating interferometry : Biomedical applications of quantitative X-ray grating-based phase contrast computed tomography

The ability of biomedical imaging data to be of quantitative nature is getting increasingly important with the ongoing developments in data science. In contrast to conventional attenuation-based X-ray imaging, grating-based phase contrast computed tomography (GBPC-CT) is a phase contrast micro-CT imaging technique that can provide high soft tissue contrast at high spatial resolution. While there is a variety of different phase contrast imaging techniques, GBPC-CT can be applied with laboratory X-ray sources and enables quantitative determination of electron density and effective atomic number. In this review article, we present quantitative GBPC-CT with the focus on biomedical applications.

Dual-Energy X-Ray Dark-Field Material Decomposition

Dual-energy imaging is a clinically well-established technique that offers several advantages over conventional X-ray imaging. By performing measurements with two distinct X-ray spectra, differences in energy-dependent attenuation are exploited to obtain material-specific information. This information is used in various imaging applications to improve clinical diagnosis. In recent years, grating-based X-ray dark-field imaging has received increasing attention in the imaging community. The X-ray dark-field signal originates from ultra small-angle scattering within an object and thus provides information about the microstructure far below the spatial resolution of the imaging system. This property has led to a number of promising future imaging applications that are currently being investigated. However, different microstructures can hardly be distinguished with current X-ray dark-field imaging techniques, since the detected dark-field signal only represents the total amount of ultra small-angle scattering. To overcome these limitations, we present a novel concept called dual-energy X-ray dark-field material decomposition, which transfers the basic material decomposition approach from attenuation-based dual-energy imaging to the dark-field imaging modality. We develop a physical model and algorithms for dual-energy dark-field material decomposition and evaluate the proposed concept in experimental measurements. Our results suggest that by sampling the energy-dependent dark-field signal with two different X-ray spectra, a decomposition into two different microstructured materials is possible. Similar to dual-energy imaging, the additional microstructure-specific information could be useful for clinical diagnosis.

Construction of a Multi-Phase Contrast Computed Tomography Kidney Atlas

The Human BioMolecular Atlas Program (HuBMAP) seeks to create a molecular atlas at the cellular level of the human body to spur interdisciplinary innovations across spatial and temporal scales. While the preponderance of effort is allocated towards cellular and molecular scale mapping, differentiating and contextualizing findings within tissues, organs and systems are essential for the HuBMAP efforts. The kidney is an initial organ target of HuBMAP, and constructing a framework (or atlas) for integrating information across scales is needed for visualizing and integrating information. However, there is no abdominal atlas currently available in the public domain. Substantial variation in healthy kidneys exists with sex, body size, and imaging protocols. With the integration of clinical archives for secondary research use, we are able to build atlases based on a diverse population and clinically relevant protocols. In this study, we created a computed tomography (CT) phase-specific atlas for the abdomen, which is optimized for the kidney organ. A two-stage registration pipeline was used by registering extracted abdominal volume of interest from body part regression, to a high-resolution CT. Affine and non-rigid registration were performed to all scans hierarchically. To generate and evaluate the atlas, multiphase CT scans of 500 control subjects (age: 15 - 50, 250 males, 250 females) are registered to the atlas target through the complete pipeline. The abdominal body and kidney registration are shown to be stable with the variance map computed from the result average template. Both left and right kidneys are substantially localized in the high-resolution target space, which successfully demonstrated the sharp details of its anatomical characteristics across each phase. We illustrated the applicability of the atlas template for integrating across normal kidney variation from 64 cm³ to 302 cm³.

Empirical beam hardening and ring artifact correction for x-ray grating interferometry (EBHC-GI)

PURPOSE

Talbot-Lau grating interferometry enables the use of polychromatic x-ray sources, extending the range of potential applications amenable to phase contrast imaging. However, these sources introduce beam hardening effects not only from the samples but also from the gratings. As a result, grating inhomogeneities due to manufacturing imperfections can cause spectral nonuniformity artifacts when used with polychromatic sources. Consequently, the different energy dependencies of absorption, phase, and visibility contrasts impose challenges that so far have limited the achievable image quality. The purpose of this work was to develop and validate a correction strategy for grating-based x-ray imaging that accounts for beam hardening generated from both the imaged object and the gratings.

METHODS

The proposed two-variable polynomial expansion strategy was inspired by work performed to address beam hardening from a primary modulator. To account for the multicontrast nature of grating interferometry, this approach was extended to each contrast to obtain three sets of correction coefficients, which were determined empirically from a calibration scan. The method's feasibility was demonstrated using a tabletop Talbot-Lau grating interferometer micro-computed tomography (CT) system using CT acquisitions of a water sample and a silicon sample, representing low and high atomic number materials. Spectral artifacts such as cupping and ring artifacts were quantified using mean squared error (MSE) from the beam-hardening-free target image and standard deviation within a reconstructed image of the sample. Finally, the model developed using the water sample was applied to a fixated murine lung sample to demonstrate robustness for similar materials.

RESULTS

The water sample's absorption CT image was most impacted by spectral artifacts, but following correction to decrease ring artifacts, an 80% reduction in MSE and 57% reduction in standard deviation was observed. The silicon sample created severe artifacts in all contrasts, but following correction, MSE was reduced by 94% in absorption, 96% in phase, and 90% in visibility images. These improvements were due to the removal of ring artifacts for all contrasts and reduced cupping in absorption and phase images and reduced capping in visibility images. When the water calibration coefficients were applied to the lung sample, ring artifacts most prominent in the absorption contrast were eliminated.

CONCLUSIONS

The described method, which was developed to remove artifacts in absorption, phase, and normalized visibility micro-CT images due to beam hardening in the system gratings and imaged object, reduced the MSE by up to 96%. The method depends on calibrations that can be performed on any system and does not require detailed knowledge of the x-ray spectrum, detector energy response, grating attenuation properties and imperfections, or the geometry and composition of the imaged object.

Microstructure-Property Relationship of Polyurethane Foams Modified with Baltic Sea Biomass: Microcomputed Tomography vs. Scanning Electron Microscopy

In this paper, novel rigid polyurethane foams modified with Baltic Sea biomass were compared with traditional petro-based polyurethane foam as reference sample. A special attention was focused on complex studies of microstructure, which was visualized and measured in 3D with high-resolution microcomputed tomography (microCT) and, as commonly applied for this purpose, scanning electron microscopy (SEM). The impact of pore volume, area, shape and orientation on appearance density and thermal insulation properties of polyurethane foams was determined. The results presented in the paper confirm that microcomputed tomography is a useful tool for relatively quick estimation of polyurethane foams’ microstructure, what is crucial especially in the case of thermal insulation materials.

Imaging characteristics of intravascular spherical contrast agents for grating-based x-ray dark-field imaging – effects of concentrations, spherical sizes and applied voltage

This study investigates the x-ray scattering characteristics of microsphere particles in x-ray-grating-based interferometric imaging at different concentrations, bubble sizes and tube voltages (kV). Attenuation (ATI), dark-field (DFI) and phase-contrast (PCI) images were acquired. Signal-to-noise (SNR) and contrast-to-noise ratios with water (CNRw) and air as reference (CNRa) were determined. In all modalities, a linear relationship between SNR and microbubbles concentration, respectively, microsphere size was found. A significant gain of SNR was found when varying kV. SNR was significantly higher in DFI and PCI than ATI. The highest gain of SNR was shown at 60 kV for all media in ATI and DFI, at 80 kV for PCI. SNR for all media was significantly higher compared to air and was slightly lower compared to water. A linear relationship was found between CNRa, CNRw, concentration and size. With increasing concentration and decreasing size, CNRa and CNRw increased in DFI, but decreased in PCI. Best CNRa and CNRw was found at specific combination of kV and concentration/size. Highest average CNRa and CNRw was found for microspheres in ATI and PCI, for microbubbles in DFI. Microspheres are a promising contrast-media for grating-based-interferometry, if kV, microsphere size and concentration are appropriately combined.

Single spectrum three-material decomposition with grating-based x-ray phase-contrast CT

Grating-based x-ray phase-contrast imaging provides three simultaneous image channels originating from a single image acquisition. While the phase signal provides direct access to the electron density in tomography, there is additional information on sub-resolutional structural information which is called dark-field signal in analogy to optical microscopy. The additional availability of the conventional attenuation image qualifies the method for implementation into existing diagnostic routines. The simultaneous access to the attenuation coefficient and the electron density allows for quantitative two-material discrimination as demonstrated lately for measurements at a quasi-monochromatic compact synchrotron source. Here, we investigate the transfer of the method to conventional polychromatic x-ray sources and the additional inclusion of the dark-field signal for three-material decomposition. We evaluate the future potential of grating-based x-ray phase-contrast CT for quantitative three-material discrimination for the specific case of early stroke diagnosis at conventional polychromatic x-ray sources. Compared to conventional CT, the method has the potential to discriminate coagulated blood directly from contrast agent extravasation within a single CT acquisition. Additionally, the dark-field information allows for the clear identification of hydroxyapatite clusters due to their micro-structure despite a similar attenuation as the applied contrast agent. This information on materials with sub-resolutional microstructures is considered to comprise advantages relevant for various pathologies.

Modeling of an X-ray grating-based imaging interferometer using ray tracing

X-ray imaging by means of a grating-based Talbot-Lau interferometer has become an important tool for a wide variety of application areas such as security, medical and materials analysis. Imaging modalities include attenuation, differential phase contrast, and visibility contrast (or so-called dark field). We have developed a novel modeling approach based on ray tracing with commercially available software (Zemax OpticStudio) that yields image projections for all three modalities. The results compare favorably with experimental findings. Our polychromatic ray-based model accommodates realistic 3-D CAD objects with tailored materials properties and also allows for both surface and bulk scattering. As such, the model can simulate imaging of complicated objects as well as assist in a physical understanding of experimental projection details.

Synchrotron Radiation-based X-ray phase-contrast imaging of the aortic walls in acute aortic dissection

Objective

Synchrotron radiation-based X-ray phase-contrast tomography (XPCT) imaging is an innovative modality for the quantitative analysis of three-dimensional morphology. XPCT has been used in this study to evaluate ascending aorta specimens from patients with acute type A aortic dissection (ATAAD) and to analyze the morphologic structure of the aortic wall in patients with this condition.

Methods

Aortic specimens from 12 patients were obtained during repairs for ATAAD and were fixed with formalin. Five patients had Marfan syndrome (MFS), and seven did not. In addition, six normal aortas were obtained from autopsies. Using XPCT (effective pixel size, 12.5 μm; density resolution, 1 mg/cm³), the density of the tunica media (TM) in each sample was measured at eight points. The specimens were subsequently analyzed pathologically.

Results

The density of the TM was almost constant within each normal aorta (mean, 1.081 ± 0.001 g/cm³). The mean density was significantly lower in the ATAAD aortas without MFS (1.066 ± 0.003 g/cm³; P < .0001) and differed significantly between the intimal and adventitial sides (1.063 ± 0.003 vs 1.074 ± 0.002 g/cm³, respectively; P < .0001). The overall density of the TM was significantly higher in the ATAAD aortas with MFS than those without MFS (1.079 ± 0.008 g/cm³; P = .0003), and greater variation and markedly different distributions were observed in comparison with the normal aortas. These density variations were consistent with the pathologic findings, including the presence of cystic medial necrosis and malalignment of the elastic lamina in the ATAAD aortas with and without MFS.

Conclusions

XPCT exhibited differences in the structure of the aortic wall in aortic dissection specimens with and without MFS and in normal aortas. Medial density was homogeneous in the normal aortas, markedly varied in those with MFS, and was significantly lower and different among those without MFS. These changes may be present in the TM before the onset of aortic dissection.

A theoretical framework for comparing noise characteristics of spectral, differential phase-contrast and spectral differential phase-contrast x-ray imaging

Spectral and grating-based differential phase-contrast (DPC) x-ray imaging are two emerging technologies that offer additional information compared with conventional attenuation-based x-ray imaging. In the case of spectral imaging, energy-resolved measurements allow the generation of material-specific images by exploiting differences in the energy-dependent attenuation. DPC imaging uses the phase shift that an x-ray wave exhibits when traversing an object as contrast generation mechanism. Recently, we have investigated the combination of these two imaging techniques (spectral DPC imaging) and demonstrated potential advantages compared with spectral imaging. In this work, we present a noise analysis framework that allows the prediction of (co-) variances and noise power spectra for all three imaging methods. Moreover, the optimum acquisition parameters for a particular imaging task can be determined. We use this framework for a performance comparison of all three imaging methods. The comparison is focused on (projected) electron density images since they can be calculated with all three imaging methods. Our study shows that spectral DPC imaging enables the calculation of electron density images with strongly reduced noise levels compared with the other two imaging methods for a large range of clinically relevant pixel sizes. In contrast to conventional DPC imaging, there are no long-range noise correlations for spectral DPC imaging. This means that excessive low frequency noise can be avoided. We confirm the analytical predictions by numerical simulations.

Spectral Differential Phase Contrast X-Ray Radiography

We investigate the combination of two emerging X-ray imaging technologies, namely spectral imaging and differential phase contrast imaging. By acquiring spatially and temporally registered images with several different X-ray spectra, spectral imaging can exploit differences in the energy-dependent attenuation to generate material selective images. Differential phase contrast imaging uses an entirely different contrast generation mechanism: The phase shift that an X-ray wave exhibits when traversing an object. As both methods can determine the (projected) electron density, we propose a novel material decomposition algorithm that uses the spectral and the phase contrast information simultaneously. Numerical experiments show that the combination of these two imaging techniques benefits from the strengths of the individual methods while the weaknesses are mitigated: Quantitatively accurate basis material images are obtained and the noise level is strongly reduced, compared to conventional spectral X-ray imaging.

Discrimination analysis of breast calcifications using x-ray dark-field radiography

BACKGROUND

X-ray dark-field radiography could enhance mammography by providing more information on imaged tissue and microcalcifications. The dark field signal is a measure of small angle scattering and can thus provide additional information on the imaged materials. This information can be useful for material distinction of calcifications and the diagnosis of breast cancer by classifying benign and malign association of these calcifications.

METHODS

For this study, institutional review board approval was obtained. We present the evaluation of images acquired with interferometric grating-based x-ray imaging of 323 microcalcifications (166 malign and 157 benign associated) in freshly dissected breast tissue and compare the results to the information extracted in follow-up pathological evaluation. The number of imaged calcifications is sufficiently higher than in similar previous studies. Fourteen calcification properties were extracted from the digital images and used as predictors in three different models common in discrimination analysis namely a simple threshold model, a naive Bayes model and a linear regression model, which classify the calcifications as associated with a benign or suspicious finding. Three of these fourteen predictors have been newly defined in this work and are independent from the tissue background surrounding the microcalcifications. Using these predictors no background correction is needed, as in previous works in this field. The new predictors are the length of the first and second principle component of the absorption and dark-field data, as well as the angle between the first principle component and the dark-field axis. We called these predictors data length, data width, and data orientation.

RESULTS

In fourfold cross-validation malignancy of the imaged tissue was predicted. Models that take only classical absorption predictors into account reached a sensitivity of 53.3% at a specificity of 81.1%. For a combination of predictors that also include dark field information, a sensitivity of 63.2% and specificity of 80.8% were obtained. The included dark field information consisted of the newly introduced parameters, data orientation and data width.

CONCLUSIONS

While remaining at a similar specificity, the sensitivity, with which a trained model was able to distinguish malign from benign associated calcifications, was increased by 10% on including dark-field information. This suggests grating-based x-ray imaging as a promising clinical imaging method in the field of mammography.

Grating-based phase-contrast CT (PCCT): histopathological correlation of human liver cirrhosis and hepatocellular carcinoma specimen

AIMS

To correlate signal intensities in grating-based phase-contrast CT (PCCT) images obtained at a synchrotron light source and a conventional X-ray source with tissue components in human liver cirrhosis and hepatocellular carcinoma (HCC) specimen.

METHODS

Study approval was obtained by the institutional review board. Human specimen of liver cirrhosis and HCC were imaged at experimental grating-based PCCT setups using either a synchrotron radiation source or a conventional X-ray tube. Tissue samples were sectioned and processed for H&E and Elastica van Gieson staining. PCCT and histological images were manually correlated. Depending on morphology and staining characteristics tissue components like fibrosis, HCC, inflammation, connective tissue and necrosis were differentiated and visually correlated with signal intensity in PCCT images using a 5-point Likert scale with normal liver parenchyma as a reference.

RESULTS

Grating-based PCCT images of human cirrhotic liver and HCC specimen showed high soft-tissue contrast allowing correlation with histopathological sections. Signal intensities were similar in both setups independent of the nature of the radiation source. Connective tissue and areas of haemorrhage displayed the highest signal intensities, fibrotic liver tissue the lowest.

CONCLUSIONS

Grating-based PCCT provides comparable results for the characterisation of human specimen of liver cirrhosis and HCC using either a synchrotron light source or a conventional X-ray tube. Due to its high soft-tissue contrast and its applicability to conventional X-ray tubes grating-based PCCT holds potential for preclinical research and virtual histology applications.

Advanced X-ray Imaging Technology

Since their discovery by Wilhelm Conrad Röntgen in 1895, X-rays have become the most widely available, typically fastest, and usually most cost-effective medical imaging modality today. From the early radiographic approaches using X-ray films as detectors, the portfolio of medical X-ray imaging devices developed into a large range of dedicated instrumentation for various applications. While X-ray imaging has come a long way, there are some physical properties of X-rays, which have not yet been fully exploited, and which may offer quite some room for further enhancements of current X-ray imaging equipment. Firstly, X-ray imaging today is mainly black and white, despite the fact that X-ray generators actually create a full spectrum of X-ray energies, and that the interactions of X-rays that occur within the human body are not the same for all energies and every material. Exploiting these spectral dependencies allows to not only obtain a black and white CT image, but also to obtain more molecularly specific information, which is relevant particularly in oncological precision radiology. The second aspect of X-rays, and so far in radiology mainly neglected and unused, is the physical fact that X-rays can also be interpreted in the wave picture, and not only as presently been done in the particle picture. If interpreted as waves, X-rays-just like visible light-experience a phase shift in matter, and this-if exploited correctly-can produce a new class of X-ray images, which then depict the wave interactions of X-rays with matter, rather than only the attenuating properties, as done until now.

The trigonometric orthogonality of phase-stepping curves in grating-based x-ray phase-contrast imaging: Integral property and its implications for noise optimization

PURPOSE

Grating-based x-ray phase-contrast imaging (GPCI) is a promising technique for clinical applications as it can provide two newly emerging imaging modalities (differential phase-contrast and dark-field contrast) in addition to the conventional absorption contrast. As far, phase-stepping strategy is the most commonly used approach in GPCI to indirectly acquire differential phase-contrast and dark-field contrast. It is known that the obtained phase-stepping curves (PSCs) have the cosine property and the convolution property, leading to two types of information retrieval approaches in literature: the Fourier component analysis and the multi-order moment analysis. The purpose of this paper is to derive a new property of PSCs and apply the property to noise optimization for information retrieval.

METHODS

Based on the cosine expression of the flat PSC without the sample and the well-established convolution relationship between the flat PSC and the sample PSC, we reveal an important integral property of PSCs: the inner product of PSCs and an arbitrary function contains only zero-order and first-order components in the Fourier series. Furthermore, we apply the property to the direct multi-order moment analysis and propose a set of generalized forms including an optimal one in the presence of noise.

RESULTS

To validate the effectiveness of our analysis, we compared the simulated and real experiment results retrieved by the original direct multi-order moment analysis with the ones retrieved by our proposed noise-optimal form. A significant improvement of noise performance by our method is observed and the improvement ratio in differential phase-contrast is consistent with our theoretical calculation (39.2%).

CONCLUSIONS

In this paper, we reveal a new integral property of the acquired PSCs with and without samples in GPCI, which can be applied to information retrieval approaches like the direct multi-order moment analysis. Then we optimize these approaches to improve the noise performance, offering great potentials of dose reduction in practical applications.

A Deep Learning Reconstruction Framework for Differential Phase-Contrast Computed Tomography With Incomplete Data

Differential phase-contrast computed tomography (DPC-CT) is a powerful analysis tool for soft-tissue and low-atomic-number samples. Limited by the implementation conditions, DPC-CT with incomplete projections happens quite often. Conventional reconstruction algorithms face difficulty when given incomplete data. They usually involve complicated parameter selection operations, which are also sensitive to noise and are time-consuming. In this paper, we report a new deep learning reconstruction framework for incomplete data DPC-CT. It involves the tight coupling of the deep learning neural network and DPC-CT reconstruction algorithm in the domain of DPC projection sinograms. The estimated result is not an artifact caused by the incomplete data, but a complete phase-contrast projection sinogram. After training, this framework is determined and can be used to reconstruct the final DPC-CT images for a given incomplete projection sinogram. Taking the sparse-view, limited-view and missing-view DPC-CT as examples, this framework is validated and demonstrated with synthetic and experimental data sets. Compared with other methods, our framework can achieve the best imaging quality at a faster speed and with fewer parameters. This work supports the application of the state-of-the-art deep learning theory in the field of DPC-CT.

Advanced Neuroimaging Techniques: Basic Principles and Clinical Applications

Advanced neuroimaging techniques are increasingly being implemented in clinical practice as complementary tools to conventional imaging because they can provide crucial functional information about the pathophysiology of a variety of disorders. Therefore, it is important to understand the basic principles underlying them and their role in diagnosis and management. In this review, we will primarily focus on the basic principles and clinical applications of perfusion imaging, diffusion imaging, magnetic resonance spectroscopy, functional MRI, and dual-energy computerized tomography. Our goal is to provide the reader with a basic understanding of these imaging techniques and when they should be used in clinical practice.

Three-dimensional visualization of fibrous tissues in cirrhotic rats via X-ray phase-contrast computed tomography with iodine staining

To accurately characterize cirrhosis, knowledge of the 3D fibrous structures is essential. Histology is the gold standard in cirrhosis screening, but it mainly provides structural information in 2D planes and destroys the 3D samples in the process. The aim of this study was to evaluate the potential of X-ray phase-contrast computed tomography (PCCT) with iodine staining for the 3D nondestructive visualization of internal structural details in entire cirrhotic livers with histopathologic correlation. In this study, cirrhotic livers induced by carbon tetrachloride (CCl₄) in rats were imaged via PCCT and then histopathologically processed. Characteristics of the cirrhosis, i.e. abnormal nodules surrounded by annular fibrosis, were established and a 3D reconstruction of these structures was also performed via PCCT. Fibrosis area, septal width and nodular size were measured and the correlation for these quantitative measurements between PCCT and histopathologic findings was analyzed. The results showed that fibrous bands, small nodules and angio-architecture in cirrhosis were clearly presented in the PCCT images, with histopathologic findings as standard reference. In comparison with histopathology, PCCT was associated with a very close value for fibrosis area, septal width and nodular size. The quantitative measurements showed a strong correlation between PCCT and histopathology. Additionally, the 3D structures of fibrous bands and microvasculature were presented simultaneously. PCCT provides excellent results in the assessment of cirrhosis characteristics and 3D presentation of these feature structures compared with histopathology. Thus, the technique may serve as an adjunct nondestructive 3D modality for cirrhosis characterization.

Feasibility of Micro-Computed Tomography Imaging for Direct Assessment of Surgical Resection Margins During Breast-Conserving Surgery

BACKGROUND

To analyze the feasibility and accuracy of micro-computed tomography (micro-CT) for surgical margin assessment in breast excision specimen.

MATERIALS AND METHODS

Two data sets of 30 micro-CT scans were retrospectively evaluated for positive resection margins by four observers in two phases, using pathology as a gold standard. Results of phase 1 were evaluated to define micro-CT evaluation guidelines for phase 2. Interobserver agreement was also assessed (kappa). In addition, a prospective study was conducted in which 40 micro-CT scans were directly acquired, reconstructed, and evaluated for positive resection margins by one observer. A suspect positive resection margin on micro-CT was annotated onto the specimen with ink, enabling local validation by pathology. Main outcome measures were accuracy, sensitivity, specificity, and positive predictive value (PPV).

RESULTS

Average accuracy, sensitivity, specificity, and PPV for the four observers were 63%, 38%, 70%, and 22%, respectively, in phase 1 and 72%, 40%, 78%, and 26%, respectively, in phase 2. The interobserver agreement was fair [kappa (range), 0.31 (0.12-0.80) in phase 1 and 0.23 (0-0.43) in phase 2]. In the prospective study 70% of the surgical resection margins were correctly evaluated. Ten specimens were annotated for positive resection margins, which correlated with three positive and three close (<1 mm) margins on pathology. Sensitivity, specificity, and PPV were 38%, 78%, and 30%, respectively.

CONCLUSIONS

Micro-CT imaging of breast excision specimen has moderate accuracy and considerable interobserver variation for analysis of surgical resection margins. Especially sensitivity and PPV need to be improved before micro-CT-based margin assessment can be introduced in clinical practice.

3D grating-based X-ray phase-contrast computed tomography for high-resolution quantitative assessment of cartilage: An experimental feasibility study with 3T MRI, 7T MRI and biomechanical correlation

Objective

Aim of this study was, to demonstrate the feasibility of high-resolution grating-based X-ray phase-contrast computed tomography (PCCT) for quantitative assessment of cartilage.

Materials and methods

In an experimental setup, 12 osteochondral samples were harvested from n = 6 bovine knees (n = 2 each). From each knee, one cartilage sample was degraded using 2.5% Trypsin. In addition to PCCT and biomechanical cartilage stiffness measurements, 3T and 7T MRI was performed including MSME SE T2 and ME GE T2* mapping sequences for relaxationtime measurements. Paired t-tests and receiver operating characteristics (ROC) curves were used for statistical analyses.

Results

PCCT provided high-resolution images for improved morphological cartilage evaluation as compared to 3T and 7T MRI. Quantitative analyses revealed significant differences between the superficial and the deep cartilage layer for T2 mapping as well as for PCCT (P<0.05). No significant difference was detected for PCCT between healthy and degraded samples (P>0.05). MRI and stiffness measurements showed significant differences between healthy and degraded osteochondral samples. Accuracy in the prediction of cartilage degradation was excellent for MRI and biomechanical analyses.

Conclusion

In conclusion, high-resolution grating-based X-ray PCCT cartilage imaging is feasible. In addition to MRI and biomechanical analyses it provides complementary, water content independent, information for improved morphological and quantitative characterization of articular cartilage ultrastructure.

MicroCT imaging reveals differential 3D micro-scale remodelling of the murine aorta in ageing and Marfan syndrome

Aortic wall remodelling is a key feature of both ageing and genetic connective tissue diseases, which are associated with vasculopathies such as Marfan syndrome (MFS). Although the aorta is a 3D structure, little attention has been paid to volumetric assessment, primarily due to the limitations of conventional imaging techniques. Phase-contrast microCT is an emerging imaging technique, which is able to resolve the 3D micro-scale structure of large samples without the need for staining or sectioning.

Methods: Here, we have used synchrotron-based phase-contrast microCT to image aortae of wild type (WT) and MFS Fbn1^C1039G/+ mice aged 3, 6 and 9 months old (n=5). We have also developed a new computational approach to automatically measure key histological parameters.

Results: This analysis revealed that WT mice undergo age-dependent aortic remodelling characterised by increases in ascending aorta diameter, tunica media thickness and cross-sectional area. The MFS aortic wall was subject to comparable remodelling, but the magnitudes of the changes were significantly exacerbated, particularly in 9 month-old MFS mice with ascending aorta wall dilations. Moreover, this morphological remodelling in MFS aorta included internal elastic lamina surface breaks that extended throughout the MFS ascending aorta and were already evident in animals who had not yet developed aneurysms.

Conclusions: Our 3D microCT study of the sub-micron wall structure of whole, intact aorta reveals that histological remodelling of the tunica media in MFS could be viewed as an accelerated ageing process, and that phase-contrast microCT combined with computational image analysis allows the visualisation and quantification of 3D morphological remodelling in large volumes of unstained vascular tissues.

The evolution of image reconstruction for CT-from filtered back projection to artificial intelligence

Abstract

The first CT scanners in the early 1970s already used iterative reconstruction algorithms; however, lack of computational power prevented their clinical use. In fact, it took until 2009 for the first iterative reconstruction algorithms to come commercially available and replace conventional filtered back projection. Since then, this technique has caused a true hype in the field of radiology. Within a few years, all major CT vendors introduced iterative reconstruction algorithms for clinical routine, which evolved rapidly into increasingly advanced reconstruction algorithms. The complexity of algorithms ranges from hybrid-, model-based to fully iterative algorithms. As a result, the number of scientific publications on this topic has skyrocketed over the last decade. But what exactly has this technology brought us so far? And what can we expect from future hardware as well as software developments, such as photon-counting CT and artificial intelligence? This paper will try answer those questions by taking a concise look at the overall evolution of CT image reconstruction and its clinical implementations. Subsequently, we will give a prospect towards future developments in this domain.

Key Points

• Advanced CT reconstruction methods are indispensable in the current clinical setting.

• IR is essential for photon-counting CT, phase-contrast CT, and dark-field CT.

• Artificial intelligence will potentially further increase the performance of reconstruction methods.

Qualitative and Quantitative Evaluation of Structural Myocardial Alterations by Grating-Based Phase-Contrast Computed Tomography

OBJECTIVES

Grating-based phase-contrast computed tomography (gb-PCCT) relies on x-ray refraction instead of absorption to generate high-contrast images in biological soft tissue. The aim of this study was to evaluate the potential of gb-PCCT for the depiction of structural changes in heart disease.

MATERIALS AND METHODS

Four human heart specimens from patients with hypertensive disease, ischemic disease, dilated heart disease, and cardiac lipomatosis were examined. The gb-PCCT setup consisted of an x-ray tube (40 kV, 70 mA), grating-interferometer, and detector, and allowed simultaneous acquisition of phase- and absorption-contrast data. With histopathology as the standard of reference, myocardium (MC), fibrotic scar (FS), interstitial fibrosis (IF), and fatty tissue (FT) were visually and quantitatively evaluated. Systematic differences in absorption- and phase-contrast Hounsfield units (HUabs and HUp) were assessed.

RESULTS

Thirteen corresponding cross-sections were included, and MC, FS, IF, and FT were found in 13 (100%), 4 (30.8%), 7 (53.8%), and 13 (100%) cross-sections, respectively. Mean HUp/HUabs were 52.5/54.1, 86.6/69.7, 62.4/62.3, and -38.6/-258.9 for MC, FS, IF, and FT, respectively. An overlap in HUabs was observed for MC and IF (P = 0.84) but not for HUp (P < 0.01). Contrast-to-noise ratios were significantly higher in phase- than in absorption-contrast for MC/FT (35.4 vs 7.8; P < 0.01) and for MC/FS (12.3 vs 0.2; P < 0.01).

CONCLUSIONS

Given its superior soft tissue contrast, gb-PCCT is able to depict structural changes in different cardiomyopathies, which can currently not be obtained by x-ray absorption-based imaging methods. If current technical limitations can be overcome, gb-PCCT may evolve as a powerful tool for the anatomical assessment of cardiomyopathy.

Micro-imaging of Brain Cancer Radiation Therapy Using Phase-contrast Computed Tomography

PURPOSE

Experimental neuroimaging provides a wide range of methods for the visualization of brain anatomic morphology down to subcellular detail. Still, each technique-specific detection mechanism presents compromises among the achievable field-of-view size, spatial resolution, and nervous tissue sensitivity, leading to partial sample coverage, unresolved morphologic structures, or sparse labeling of neuronal populations and often also to obligatory sample dissection or other sample invasive manipulations. X-ray phase-contrast imaging computed tomography (PCI-CT) is an experimental imaging method that simultaneously provides micrometric spatial resolution, high soft-tissue sensitivity, and ex vivo full organ rodent brain coverage without any need for sample dissection, staining or labeling, or contrast agent injection. In the present study, we explored the benefits and limitations of PCI-CT use for in vitro imaging of normal and cancerous brain neuromorphology after in vivo treatment with synchrotron-generated x-ray microbeam radiation therapy (MRT), a spatially fractionated experimental high-dose radiosurgery. The goals were visualization of the MRT effects on nervous tissue and a qualitative comparison of the results to the histologic and high-field magnetic resonance imaging findings.

METHODS AND MATERIALS

MRT was administered in vivo to the brain of both healthy and cancer-bearing rats. At 45 days after treatment, the brain was dissected out and imaged ex vivo using propagation-based PCI-CT.

RESULTS

PCI-CT visualizes the brain anatomy and microvasculature in 3 dimensions and distinguishes cancerous tissue morphology, necrosis, and intratumor accumulation of iron and calcium deposits. Moreover, PCI-CT detects the effects of MRT throughout the treatment target areas (eg, the formation of micrometer-thick radiation-induced tissue ablation). The observed neurostructures were confirmed by histologic and immunohistochemistry examination and related to the micro-magnetic resonance imaging data.

CONCLUSIONS

PCI-CT enabled a unique 3D neuroimaging approach for ex vivo studies on small animal models in that it concurrently delivers high-resolution insight of local brain tissue morphology in both normal and cancerous micro-milieu, localizes radiosurgical damage, and highlights the deep microvasculature. This method could assist experimental small animal neurology studies in the postmortem evaluation of neuropathology or treatment effects.

Ex Vivo Assessment of Coronary Atherosclerotic Plaque by Grating-Based Phase-Contrast Computed Tomography: Correlation With Optical Coherence Tomography

OBJECTIVES

The aim of this study was to determine the diagnostic accuracy of grating-based phase-contrast computed tomography (gb-PCCT) to classify and quantify coronary vessel characteristics in comparison with optical coherence tomography (OCT) and histopathology in an ex vivo setting.

MATERIALS AND METHODS

After excision from 5 heart specimens, 15 human coronary arteries underwent gb-PCCT examination using an experimental imaging setup consisting of a rotating molybdenum anode x-ray tube, a Talbot-Lau grating interferometer, and a single photon counting detector. Subsequently, all vessels were imaged by OCT and histopathologically processed. Optical coherence tomography, gb-PCCT, and histopathology images were manually matched using anatomical landmarks. Optical coherence tomography and gb-PCCT were reviewed by 2 independent observers blinded to histopathology. Vessel, lumen, and plaque area were measured, and plaque characteristics (lipid rich, calcified, and fibrous) were determined for each section. Measures of diagnostic accuracy were derived, applying histopathology as the standard of reference.

RESULTS

Of a total of 286 assessed cross sections, 241 corresponding sections were included in the statistical analysis. Quantitative measures derived from gb-PCCT were significantly higher than from OCT (P < 0.001) and were strongly correlated with histopathology (Pearson r ≥0.85 for gb-PCCT and ≥0.61 for OCT, respectively). Results of Bland-Altman analysis demonstrated smaller mean differences between OCT and histopathology than for gb-PCCT and histopathology. Limits of agreement were narrower for gb-PCCT with regard to lumen area, for OCT with regard to plaque area, and were comparable with regard to vessel area. Based on histopathology, 228/241 (94.6%) sections were classified as fibrous, calcified, or lipid rich. The diagnostic accuracy of gb-PCCT was excellent for the detection of all plaque components (sensitivity, ≥0.95; specificity, ≥0.94), whereas the results for OCT showed sensitivities of ≥0.73 and specificities of ≥0.66.

CONCLUSIONS

In this ex vivo setting, gb-PCCT provides excellent results in the assessment of coronary atherosclerotic plaque characteristics and vessel dimensions in comparison to OCT and histopathology. Thus, the technique may serve as adjunct nondestructive modality for advanced plaque characterization in an experimental setting.

Improved reconstruction of phase-stepping data for Talbot-Lau x-ray imaging

Grating-based Talbot-Lau x-ray interferometry is a popular method for measuring absorption, phase shift, and small-angle scattering. The standard acquisition method for this modality is phase stepping, where the Talbot pattern is reconstructed from multiple images acquired at different grating positions. We review the implicit assumptions in phase-stepping reconstruction, and find that the assumptions of perfectly known grating positions and homoscedastic noise variance are violated in some scenarios. Additionally, we investigate a recently reported estimation bias in the visibility and dark-field signal. To adapt the phase-stepping reconstruction to these findings, we propose three improvements to the reconstruction. These improvements are (a) to use prior knowledge to compute more accurate grating positions to reduce moiré artifacts, (b) to utilize noise variance information to reduce dark-field and phase noise in high-visibility acquisitions, and (c) to perform correction of an estimation bias in the interferometer visibility, leading to more quantitative dark-field imaging in acquisitions with a low signal-to-noise ratio. We demonstrate the benefit of our methods on simulated data, as well as on images acquired with a Talbot-Lau interferometer.

Three Dimensional Visualization of Human Cardiac Conduction Tissue in Whole Heart Specimens by High-Resolution Phase-Contrast CT Imaging Using Synchrotron Radiation

BACKGROUND

The feasibility of synchrotron radiation-based phase-contrast computed tomography (PCCT) for visualization of the atrioventricular (AV) conduction axis in human whole heart specimens was tested using four postmortem structurally normal newborn hearts obtained at autopsy.

METHODS

A PCCT imaging system at the beamline BL20B2 in a SPring-8 synchrotron radiation facility was used. The PCCT imaging of the conduction system was performed with "virtual" slicing of the three-dimensional reconstructed images. For histological verification, specimens were cut into planes similar to the PCCT images, then cut into 5-μm serial sections and stained with Masson's trichrome.

RESULTS

In PCCT images of all four of the whole hearts of newborns, the AV conduction axis was distinguished as a low-density structure, which was serially traceable from the compact node to the penetrating bundle within the central fibrous body, and to the branching bundle into the left and right bundle branches. This was verified by histological serial sectioning.

CONCLUSION

This is the first demonstration that visualization of the AV conduction axis within human whole heart specimens is feasible with PCCT.

Opportunities for new CT contrast agents to maximize the diagnostic potential of emerging spectral CT technologies

The introduction of spectral CT imaging in the form of fast clinical dual-energy CT enabled contrast material to be differentiated from other radiodense materials, improved lesion detection in contrast-enhanced scans, and changed the way that existing iodine and barium contrast materials are used in clinical practice. More profoundly, spectral CT can differentiate between individual contrast materials that have different reporter elements such that high-resolution CT imaging of multiple contrast agents can be obtained in a single pass of the CT scanner. These spectral CT capabilities would be even more impactful with the development of contrast materials designed to complement the existing clinical iodine- and barium-based agents. New biocompatible high-atomic number contrast materials with different biodistribution and X-ray attenuation properties than existing agents will expand the diagnostic power of spectral CT imaging without penalties in radiation dose or scan time.

Qualitative and Quantitative Imaging Evaluation of Renal Cell Carcinoma Subtypes with Grating-based X-ray Phase-contrast CT

Current clinical imaging methods face limitations in the detection and correct characterization of different subtypes of renal cell carcinoma (RCC), while these are important for therapy and prognosis. The present study evaluates the potential of grating-based X-ray phase-contrast computed tomography (gbPC-CT) for visualization and characterization of human RCC subtypes. The imaging results for 23 ex vivo formalin-fixed human kidney specimens obtained with phase-contrast CT were compared to the results of the absorption-based CT (gbCT), clinical CT and a 3T MRI and validated using histology. Regions of interest were placed on each specimen for quantitative evaluation. Qualitative and quantitative gbPC-CT imaging could significantly discriminate between normal kidney cortex (54 ± 4 HUp) and clear cell (42 ± 10), papillary (43 ± 6) and chromophobe RCCs (39 ± 7), p < 0.05 respectively. The sensitivity for detection of tumor areas was 100%, 50% and 40% for gbPC-CT, gbCT and clinical CT, respectively. RCC architecture like fibrous strands, pseudocapsules, necrosis or hyalinization was depicted clearly in gbPC-CT and was not equally well visualized in gbCT, clinical CT and MRI. The results show that gbPC-CT enables improved discrimination of normal kidney parenchyma and tumorous tissues as well as different soft-tissue components of RCCs without the use of contrast media.

Talbot-Lau X-ray phase contrast for tiling-based acquisitions without reference scanning

PURPOSE

Grating-based Talbot-Lau interferometers are a popular choice for phase-contrast X-ray acquisitions. Here, an air reference scan has to be acquired prior to an object scan. This particularly complicates acquisition of large objects: large objects are tiled into multiple scans due to the small field of view of current gratings. However, phase reference drifts occurring between these scans may require to repeatedly move the object in and out of the X-ray beam to update the reference information.

METHODS

We developed an image processing technique that completely removes the need for phase reference scans in tiled acquisitions. We estimate the reference from object scans using a tailored iterated robust regression, using a novel efficient optimizer.

RESULTS

Our evaluation indicates that the estimated reference is not only close to the acquired reference but also improves the final image quality. We hypothesize that this is because we mitigate errors that are introduced when actually acquiring the reference phase.

CONCLUSION

Phase-contrast imaging of larger objects may benefit from computational estimation of phase reference data due to reduced scanning complexity and improved image quality.

Intact Imaging of Human Heart Structure Using X-ray Phase-Contrast Tomography

Structural examination of human heart specimens at the microscopic level is a prerequisite for understanding congenital heart diseases. It is desirable not to destroy or alter the properties of such specimens because of their scarcity. However, many of the currently available imaging techniques either destroy the specimen through sectioning or alter the chemical and mechanical properties of the specimen through staining and contrast agent injection. As a result, subsequent studies may not be possible. X-ray phase-contrast tomography is an imaging modality for biological soft tissues that does not destroy or alter the properties of the specimen. The feasibility of X-ray phase-contrast tomography for the structural examination of heart specimens was tested using infantile and fetal heart specimens without congenital diseases. X-ray phase-contrast tomography was carried out at the SPring-8 synchrotron radiation facility using the Talbot grating interferometer at the bending magnet beamline BL20B2 to visualize the structure of five non-pretreated whole heart specimens obtained by autopsy. High-resolution, three-dimensional images were obtained for all specimens. The images clearly showed the myocardial structure, coronary vessels, and conduction bundle. X-ray phase-contrast tomography allows high-resolution, three-dimensional imaging of human heart specimens. Intact imaging using X-ray phase-contrast tomography can contribute to further structural investigation of heart specimens with congenital heart diseases.

Cardiac CT Imaging of Plaque Vulnerability: Hype or Hope?

Advances in cardiovascular computed tomography (CT) have resulted in an excellent ability to exclude coronary heart disease (CHD). Anatomical information, functional information, and spectral information can already be obtained with current CT technologies. Moreover, novel developments such as targeted nanoparticle contrast agents, photon-counting CT, and phase contrast CT will further enhance the diagnostic value of cardiovascular CT. This review provides an overview of current state of the art and future cardiovascular CT imaging.

Ex vivo characterization of pathologic fluids with quantitative phase-contrast computed tomography

PURPOSE

X-ray phase-contrast imaging (PCI) provides additional information beyond absorption characteristics by detecting the phase shift of the X-ray beam passing through material. The grating-based system works with standard polychromatic X-ray sources, promising a possible clinical implementation. PCI has been shown to provide additional information in soft-tissue samples. The aim of this study was to determine if ex vivo quantitative phase-contrast computed tomography (PCCT) may differentiate between pathologic fluid collections.

MATERIALS AND METHODS

PCCT was performed with the grating interferometry method. A protein serial dilution, human blood samples and 17 clinical samples of pathologic fluid retentions were imaged and correlated with clinical chemistry measurements. Conventional and phase-contrast tomography images were reconstructed. Phase-contrast Hounsfield Units (HUp) were used for quantitative analysis analogously to conventional HU. The imaging was analyzed using overall means, ROI values as well as whole-volume-histograms and vertical gradients. Contrast to noise ratios were calculated between different probes and between imaging methods.

RESULTS

HUp showed a very good linear correlation with protein concentration in vitro. In clinical samples, HUp correlated rather well with cell count and triglyceride content. PCI was better than absorption imaging at differentiating protein concentrations in the protein samples as well as at differentiating blood plasma from cellular components. PCI also allowed for differentiation of watery samples (such as lymphoceles) from pus.

CONCLUSION

Phase-contrast computed tomography is a promising tool for the differentiation of pathologic fluids that appear homogenous with conventional attenuation imaging.

Simultaneous Maximum-Likelihood Reconstruction of Absorption Coefficient, Refractive Index and Dark-Field Scattering Coefficient in X-Ray Talbot-Lau Tomography

A maximum-likelihood reconstruction technique for X-ray Talbot-Lau tomography is presented. This technique allows the iterative simultaneous reconstruction of discrete distributions of absorption coefficient, refractive index and a dark-field scattering coefficient. This technique avoids prior phase retrieval in the tomographic projection images and thus in principle allows reconstruction from tomographic data with less than three phase steps per projection. A numerical phantom is defined which is used to evaluate convergence of the technique with regard to photon statistics and with regard to the number of projection angles and phase steps used. It is shown that the use of a random phase sampling pattern allows the reconstruction even for the extreme case of only one single phase step per projection. The technique is successfully applied to measured tomographic data of a mouse. In future, this reconstruction technique might also be used to implement enhanced imaging models for X-ray Talbot-Lau tomography. These enhancements might be suited to correct for example beam hardening and dispersion artifacts and improve overall image quality of X-ray Talbot-Lau tomography.

Interior Tomography from Differential Phase Contrast Data via Hilbert Transform Based on Spline Functions

X-ray phase contrast imaging is an important mode due to its sensitivity to subtle features of soft biological tissues. Grating-based differential phase contrast (DPC) imaging is one of the most promising phase imaging techniques because it works with a normal x-ray tube of a large focal spot at a high flux rate. However, a main obstacle before this paradigm shift is the fabrication of large-area gratings of a small period and a high aspect ratio. Imaging large objects with a size-limited grating results in data truncation which is a new type of the interior problem. While the interior problem was solved for conventional x-ray CT through analytic extension, compressed sensing and iterative reconstruction, the difficulty for interior reconstruction from DPC data lies in that the implementation of the system matrix requires the differential operation on the detector array, which is often inaccurate and unstable in the case of noisy data. Here, we propose an iterative method based on spline functions. The differential data are first back-projected to the image space. Then, a system matrix is calculated whose components are the Hilbert transforms of the spline bases. The system matrix takes the whole image as an input and outputs the back-projected interior data. Prior information normally assumed for compressed sensing is enforced to iteratively solve this inverse problem. Our results demonstrate that the proposed algorithm can successfully reconstruct an interior region of interest (ROI) from the differential phase data through the ROI.