Coherent scattering and bone mineral measurement: the dependence of sensitivity on angle and energy

How to improve x-ray scattering techniques to quantify bone mineral density using spectroscopy

PURPOSE

The purpose of this study was to develop a new diagnostic technique for measuring bone mineral density (BMD) for the assessment of osteoporosis, which improves upon the coherent to Compton scattering ratio (CCSR) method, which was first developed in the 1980s. To help the authors achieve these goals, they have identified and studied two new indices for CCSR, the forward scattered to backward scattered (FS-BS) and the forward scattered to transmitted (FS-T) ratios. They believe that, at small angles, these two parameters can offer a practical in vivo determination of BMD that can be used to overcome the limitations of past CCSR systems, including high radiation dosages, costs, and examination durations.

METHODS

In previous CCSR studies, a high-activity radioactive source with a long half-live (usually (241)Am) and an expensive and bulky cryogenic HPGe detector were applied to both in vivo and in vitro measurements. To make this technique more suitable for clinical applications, the possibility of using a standard diagnostic x-ray tube generating a continuous spectrum was investigated in this paper. Scattered radiation from trabecular bone-simulating phantoms containing various mineral densities that span the normal range of in vivo BMD was collected in this study using relatively inexpensive noncryogenic CdTe or NaI detectors.

RESULTS

The initial results demonstrate that a modified version of CCSR can be successfully applied to trabecular bone assessment using a diagnostic x-ray tube with a continuous spectrum in two variations, the FS-BS and the FS-T ratio. When FS-BS is measured, intensity spectra in the forward and backward directions must be collected while FS-T requires only the integral intensity of the scattered and transmitted (T) spectra in the energy region above 40 keV. For both of these methods, forward scattering angles less than or equal to 15° and backward scattering angles greater than or equal to (165°= 180° - 15°) are needed.

CONCLUSIONS

The authors determined that FS-T is more sensitive to changes in BMD than transmission or absorption alone and that the FS-BS method can yield an absolute measurement of the mean atomic number of the scattering medium, after a correction for path-dependent attenuation. Since this study determined that the FS-T ratio is independent of the incident energy over a broad energy region, it will be possible to apply FS-T to bone densitometry using inexpensive integral photon detectors. The authors believe that, by replacing the radionuclide source with an x-ray tube and the cryogenically cooled HPGe detector with a single solid state CdTe, NaI, or silicon detector or an annular array of detectors, as suggested in this study, the past difficulties of CCSR concerning high radiation exposure, costs, and durations as well as lack of convenience can be overcome and that CCSR could eventually become popular in clinical settings.

Bone-composition imaging using coherent-scatter computed tomography: Assessing bone health beyond bone mineral density

Quantitative analysis of bone composition is necessary for the accurate diagnosis and monitoring of metabolic bone diseases. Accurate assessment of the bone mineralization state is the first requirement for a comprehensive analysis. In diagnostic imaging, x-ray coherent scatter depends upon the molecular structure of tissues. Coherent-scatter computed tomography (CSCT) exploits this feature to identify tissue types in composite biological specimens. We have used CSCT to map the distributions of tissues relevant to bone disease (fat, soft tissue, collagen, and mineral) within bone-tissue phantoms and an excised cadaveric bone sample. Using a purpose-built scanner, we have measured hydroxyapatite (bone mineral) concentrations based on coherent-scatter patterns from a series of samples with varying hydroxyapatite content. The measured scatter intensity is proportional to mineral density in true g/cm3. Repeated measurements of the hydroxyapatite concentration in each sample were within, at most, 2% of each other, revealing an excellent precision in determining hydroxyapatite concentration. All measurements were also found to be accurate to within 3% of the known values. Phantoms simulating normal, over-, and under-mineralized bone were created by mixing known masses of pure collagen and hydroxyapatite. An analysis of the composite scatter patterns gave the density of each material. For each composite, the densities were within 2% of the known values. Collagen and hydroxyapatite concentrations were also examined in a bone-mimicking phantom, incorporating other bone constituents (fat, soft tissue). Tomographic maps of the coherent-scatter properties of each specimen were reconstructed, from which material-specific images were generated. Each tissue was clearly distinguished and the collagen-mineral ratio determined from this phantom was also within 2% of the known value. Existing bone analysis techniques cannot determine the collagen-mineral ratio in intact specimens. Finally, to demonstrate the in situ potential of this technique, the mineralization state of an excised normal cadaveric radius was examined. The average collagen-mineral ratio of the cortical bone derived from material-specific images of the radius was 0.53+/-0.04, which is in agreement with the expected value of 0.55 for healthy bones.

Characteristics of low-angle x-ray scattering from some biological samples

Design of medical imaging devices based on the detection of low-angle coherent scattering is a subject of increasing interest. The technique is based on the differences in the distribution of photons coherently scattered from different body tissues. Coherent scattering is also useful in monitoring changes that may occur in a healthy tissue (e.g. carcinoma). In this work, low angle scattering properties of some tissues and tissue-equivalent materials are studied. Special care is given to the possibility of distinguishing between tissues of similar water content (e.g. muscle and blood). For this purpose, a Monte Carlo simulation is updated, introducing molecular form factor data, which include molecular interference effects. This program is used to simulate the angular distribution of scattered photons from two tissue-equivalent materials (lucite and water) and three biological samples (muscle, fat and blood). Simulation results agree well with previously measured angular distributions of scattered photons at 59.54 keV. Scattering from water and lucite is also measured at 8.047 keV. The effects of scattering geometry, sample thickness, incident photon energy and tissue type on the angular distribution of scattered photons are investigated. Results reveal the potential of measuring the full width at half maximum (FWHM) of the scattered photon distribution for tissue characterization. Energies up to 13 keV and sample thickness of 0.3 cm reported maximum differences between investigated samples. These conditions are expected to maximize the potential of using coherent scattering set-ups to monitor changes in biological samples even if their water contents are similar. Present results may act as a guide for the optimization of coherent scattering imaging systems.

Photon backscattering tissue characterization by energy dispersive spectroscopy evaluations

Techniques for in vivo tissue characterization based on scattered photons have usually been confined to evaluating coherent and Compton peaks. However, information can also be obtained from the energy analysis of the Compton scattered distribution. This paper looks at the extension of a technique validated by the authors for characterizing tissues composed of low-atomic-number elements. To this end, an EDXRS (energy dispersive x-ray spectrometry) computer simulation procedure was performed and applied to test the validity of a figure of merit able to characterize binary compounds. This figure of merit is based on the photon fluence values in a restricted energy interval of the measured distribution of incoherently scattered photons. After careful experimental tests with 59.54 keV incident photons at scattering angles down to 60degrees, the simulation procedure was applied to quasi-monochromatic and polychromatic high-radiance sources. The results show that the characterization by the figure of merit, which operates satisfactorily with monochromatic sources, is unsatisfactory in the latter cases, which seem to favour a different parameter for compound characterization.

Tomographic imaging of the angular-dependent coherent-scatter cross section

A new special-purpose computed tomographic (CT) imaging system is described which produces images based on measurements of the low-angle (0-10 degrees) x-ray diffraction properties of an object. Low-angle scatter in the diagnostic x-ray energy range is dominated by coherent scatter, and the system uses first-generation CT geometry to acquire a diffraction pattern for each pencil beam. The patterns are used to reconstruct a series of images which represent the coherent-scatter intensity at a series of scatter angles. To demonstrate the potential of coherent-scatter CT (CSCT), the scanner has been built and used to image a phantom consisting of a water-filled Lucite cylinder containing rods of polyethylene, Lucite, polycarbonate, and nylon. In this paper, the system is described and a sequence of CSCT images of this phantom is shown. Coherent-scatter cross sections of these materials are generated for each pixel from this sequence of images and compared with cross sections measured separately. The resulting excellent agreement shows that the angular-dependent coherent-scatter cross section can be accurately imaged in a tomographic slice through an object. These cross sections give material-specific information about the object. The long-term goal of this research is to make measurements of bone-mineral content for every pixel in a tomographic slice.