A Phase-Contrast breast CT facility based on a high-resolution CdTe photon-counting detector is under development at Elettra, the Italian Synchrotron Radiation (SR) facility in Trieste. The CT system exploits propagation-based phasecontrast imaging and phase-retrieval algorithm. The voxel size is 57×57×50 μm3 and the delivered MGDs, about 5 mGy, are comparable with clinical breast CT systems. In the present contribution, the comparisons between histological breast cancers and full breast CT images are presented from samples of breast mastectomy. The high resolution of the breast CT images and low noise due to the phase contrast allow a very fine matching between x-ray CT and histology at acceptable delivered doses.
KEYWORDS: Breast, Monte Carlo methods, Sensors, Tissues, Digital breast tomosynthesis, Clinical trials, X-rays, 3D image processing, X-ray imaging, Breast imaging
In silico reproductions of clinical exams represent an alternative strategy in the research and development of medical devices, which permit to avoid issues and costs related to clinical trials on patient population. In this work, we present a platform for virtual clinical trials in 2D and 3D x-ray breast imaging. The platform, developed by the medical physics team at University of Naples, Italy, permits to simulate digital mammography (DM), digital breast tomosynthesis (DBT) and CT dedicated to the breast (BCT) examinations. It relies on Monte Carlo simulations based on Geant4 toolkit and adopts digital models of patients derived from high-resolution 3D clinical breast images acquired at UC Davis, USA. Uncompressed digital breast models for BCT exam simulations were produced by means of a tissue classification algorithm; the compressed digital breast models for simulating DM and DBT are derived by the uncompressed ones via a simulated tissue compression. For a selected exam, specifications and digital patient, the platform computes breast image projections and glandular dose maps within the organ. Energy integrating a well as photon counting and spectral imaging detection scheme have been simulated. The current version of the software uses the Geant4 standard physics list Option4 and simulates and tracks <105 photons/s, when run on a 16-core CPU at 3.0 GHz. The developed platform will be an invaluable tool for R and D of apparatuses, and it will permit the access to clinical-like data to a broad research community. Digital patient exposures with the available phantom dataset will be possible for the same patient-derived phantom in uncompressed or compressed format, in DM, DBT and BCT modalities.
KEYWORDS: Electron beams, X-rays, Laser systems engineering, X-ray sources, S band, Monte Carlo methods, Optical simulations, Hard x-rays, X-ray imaging, Compton scattering, Particle accelerators
There is a strong demand for small foot-print high-flux hard X-rays machines in order to enable a large variety of science activities and serve a multidisciplinary user community. For this purpose, two compact Inverse Compton Sources (ICSs) are currently being developed in Italy. The most recent one is the Bright and Compact X-ray Source (BriXS) which has recently been proposed to produce very energetic X-rays (up to 180 keV) and high photon flux (up to 1013 photons/s with expected bandwidth of 1-10%). BriXS will be installed in Milan and it will enable advanced large area radiological imaging applications to be conducted with mono-chromatic X-rays, as well as allowing basic fundamental science of matter and health sciences at both pre- and clinical levels. Based on an energy-recovery linac (ERL) scheme and superconducting technology, BriXS will operate in CW regime with an unprecedented electron beam repetition rate of 100 MHz. The second Italian ICS light source is the Southern Europe Thomson back-scattering source for Applied Research (STAR) which is currently installed at the University of Calabria (UniCal). STAR is a compact machine that has been designed to produce monochromatic and tunable, ps-long, polarized X-ray beams in the range 40-140 keV with a photon flux up to 1010 photons/s and energy bandwidth below 10%. The electron beam injector is based on normal-conducting technology in S-Band with a repetition rate up to 100 Hz.
A program devoted to performing the first in vivo synchrotron radiation (SR) breast computed tomography (BCT) is ongoing at the Elettra facility. Using the high spatial coherence of SR, phase-contrast (PhC) imaging techniques can be used. The latest high-resolution BCT acquisitions of breast specimens, obtained with the propagation-based PhC approach, are herein presented as part of the SYRMA-3D collaboration effort toward the clinical exam. Images are acquired with a 60-μm pixel dead-time-free single-photon-counting CdTe detector. The samples are imaged at 32 and 38 keV in a continuous rotating mode, delivering 5 to 20 mGy of mean glandular dose. Contrast-to-noise ratio (CNR) and spatial resolution performances are evaluated for both PhC and phase-retrieved images, showing that by applying the phase-retrieval algorithm a five-time CNR increase can be obtained with a minor loss in spatial resolution across soft tissue interfaces. It is shown that, despite having a poorer CNR, PhC images can provide a sharper visualization of microcalcifications, thus being complementary to phase-retrieved images. Furthermore, the first full-volume scan of a mastectomy sample (9 × 9 × 3 cm3) is reported. This investigation into surgical specimens indicates that SR BCT in terms of CNR, spatial resolution, scan duration, and scan volume is feasible.
A program devoted to perform the first in-vivo monochromatic breast computed tomography (BCT) is ongoing at the Elettra Synchrotron Facility. Since the synchrotron radiation provides high energy resolution and spatial coherence, phase-contrast (PhC) imaging techniques can be used. The latest high resolution BCT acquisitions of breast specimens, obtained with the propagation-based PhC approach, are herein presented as part of a wider framework, devoted to the optimization of acquisition and reconstruction parameters towards the clinical exam. Images are acquired with a state-of-the-art dead-time-free single-photon-counting CdTe detector with a 60 µm pixel size. The samples are imaged at 32 and 38 keV in continuous rotating mode, delivering 5-20 mGy of mean glandular dose (MGD). Contrast-to-noise ratio (CNR) and spatial resolution performances are evaluated for both absorption and phase-retrieved images considering tumor/adipose tissue interfaces. We discuss two different phase-retrieval approaches, showing that a remarkable CNR increase (from 0.5 to 3.6) can be obtained without a significant loss in spatial resolution. It is shown that, even if the non-phase-retrieved image has a poorer CNR, it is useful for evaluating the spiculation of a microcalcification: in this context, absorption and phase-retrieved images have to be regarded as complementary information. Furthermore, the first full volume acquisition of a mastectomy, with a 9 cm diameter and 3 cm height, is reported. This investigation on surgical specimens indicates that monochromatic BCT with synchrotron radiation in terms of CNR, spatial resolution, scan duration and scan volume is feasible.
The design of a grazing incidence focusing optic obtained from a spiral approximation to multiple nested cones
produces an annular image of a point source. The angular size of the annulus depends mainly on the pitch of the winding
and the focal length. For a spiral conical approximation to Wolter optics, the effect is magnified by the double reflection.
However, if the two conical spirals are wound one clock-wise and the other counter-clock-wise, then the aberration is
partially compensated. We use a ray tracing code to evaluate advantages and disadvantages of this optical design for
potential applications of a light weight optics technology based on plastic foils that we are currently investigating.
Thin plastic foils are being investigated to build shell optics for X-ray telescopes. Compared to polished glass
optics, the advantage is in terms of increased collecting area, light weight and lower cost. Plastic material is also
desirable to allow deformation into a complete surface of revolution. We collected plastic materials of common
use for industrial applications and also specialty materials developed for the electronic industry. A comparative
study was then performed to evaluate the optical quality of the selected plastic films. Surface analysis was
carried out with topographic instruments to investigate the microroughness of our samples at different scan
lengths. Preliminary results suggest that a facility for the production of high-performance films with adequate
microroughness is needed.
Winding a plastic foil ribbon into spiral cylinder or spiral cones we can design and build single or multiple reflection X-ray
grazing incidence focusing optics with potential applications in Astronomy as well as experimental physics. The use
of thin plastic foils from common industrial applications and of a mounting technique which does not require the
construction of mandrels make these optics very cost effective.
A spiral geometry focusing optic produces an annular image of a point source with the angular size of the annulus
depending mainly on the pitch of the winding and the focal length. We use a ray-tracing code to evaluate the
performances of cylindrical, and double conical spiral geometry as a function of the design parameters e.g. focal length,
diameter, optic length. Some preliminary results are presented on X-ray imaging tests performed on spiral cylindrical
optics.
As part of an EC funded project, the design for a new phantom has been proposed that consists of a smaller contrast-detail part than the CDMAM phantom and that contains items for other parts of an acceptance protocol for digital mammography. A first prototype of the "DIGIMAM" has been produced. Both the CDMAM phantom and the DIGIMAM phantom were then used on a series of systems and read out as a part of a multi centre study.
The results with the new phantom were very similar to results obtained with the CDMAM phantom: readers scored different from each other and there was an overlap in the scores for the different systems. A system with a poor score in CDMAM had also the worst score for DIGIMAM. Reading time was significantly reduced however. There was promising agreement between automated reading of CDMAM and the scores of the DIGIMAM phantom. In order to reduce the subjectivity of the readings, computerized reading of the DIGIMAM should be developed. In a second version of the phantom, we propose to add more disks of the same size and contrast in each square to improve the statistical power of each reading.
In angiography practice an iodate contrast medium is injected in patient vessels with catheters. The absorption of x-rays raises immediately after the iodine K-edge energy. In digital subtraction angiography, two images are used, acquired before and after the injection of the contrast medium, respectively. The vessels morphology result from the difference of images so obtained. This technique involves a non-negligible risk of morbidity or mortality, due to high concentration of injected contrast agent. We are investigating a new source which produces two thin parallel quasi-monochromatic beams - having peak energies centered before and after the iodine K-edge energy, respectively - by using a conventional x-ray tube and a highly oriented pyrolytic graphite mosaic crystal. The polychromatic x-rays incident on the crystal are monochromatized by Bragg diffraction and split in two thin parallel beams, by means of a collimating system. These two beams impinge on the phantom simulating patient vessels and are detected with solid-state array detectors. The image results as difference between the remaining intensities of two beams. We report a preliminary study of the new technique performed both with theoretical stimulations and experimental measurements. Results of computer simulation give information about characteristics as size and quality of the quasi- monochromatic beams, that should be considered in detail to design a system dedicated to the clinical practice. Experimental measurements have been performed on a small- field detector in order to shows the enhancement of image contrast obtained with the application of the new technique.
A novel x-ray source, providing dichromatic beams for the application of dual-energy radiography, has been assembled and studied. The system works via Bragg diffraction, by monochromatizing the beam produced by a conventional W-anode x-ray tube with a mosaic crystal monochromator. The source generates a laminar beam (10 cm-high and 0.8 cm-wide), composed by two spatially superimposed quasi-monochromatic beams. The characteristics of the radiation field in terms of energy resolution and fluence have been reported, for three pairs of energies. A study of the spectra attenuated by several phantoms of breast equivalent tissue of different thicknesses shows that the optimal energy of the dichromatic beam for dual energy mammography application ranges between 18/36 keV and 18.6/37.2 keV and may be set as a function of the thickness or density of investigated tissue.
Highly Oriented Pyrolytic Graphite is a very efficient and well-known x-ray and neutron monochromator. The crystal macroscopic properties are determined by its microscopic structure. Our aim is to study the crystal internal structure and correlate it with the crystal optical behavior. We studied the texture of the crystal, in particular its spatial homogeneity, for different samples using x-ray diffraction topography. The experiment was performed at the ESRF beamline BM5 using a laminar 18 keV monochromatic beam. Several samples supplied by different manufacturers have been studied. Images of (002) reflected beam have been acquired at the Bragg angle for each sample, using a phosphor coated CCD digital detector. Contrast profiles have been obtained, and exponential fits has been performed allowing to deduce the secondary extinction coefficient. It has been found that some samples are quite perfect and the results agree with ideally imperfect crystals model. Other samples present well defined granular macrostructures (with dimensions of tens of microns) superposed to the well-known Gaussian-like crystallite distribution. The different behavior between different samples should be explained in terms of sample internal structure, which is also related to the different graphitization process used by manufacturers.
The existence of an optimal energy range for mammography has been demonstrated by several authors. Improvement in image contrast and reduction of patient dose can be achieved using narrow energy band X ray beams in the 16 - 24 keV range. Quasi-monochromatic X rays in the mammographic energy range have been produced via Bragg diffraction by making use of a conventional W-anode, Be-window X ray tube and a monochromator optical system based on a set of mosaic crystals. The mosaic crystals are high oriented pyrolytic graphite (002) which provide an interesting choice for monochromators because of their high integrated reflectivity compared to perfect crystals. The monochromator optical system consists of an array of ten crystals (2.8 X 6.0 cm2 of size) which are assembled so as to produce in the image plane an irradiation field obtained with adjacent reflected beams. A scanning technique of the optical system has been applied in order to remove the spatial non- uniformities of the entire irradiation field. The source has been characterized in terms of beam size and monochromaticity, photon flux and exposure rate, field uniformity, capability in low contrast detection, dose reduction, and spatial resolution properties. The system provides a large field (10.5 X 12.0 cm2) of quasi- monochromatic X rays ((Delta) E/E equals 12%) at the energy of 18 keV. The spatial resolution capabilities of the sources are affected by the introduction of an active optical element such as a mosaic crystal monochromator. They may be optimized by choosing the proper irradiation geometry. The mean glandular dose delivered to the standard breast by the quasi-monochromatic source is about a half of those delivered by the conventional mammography units.
X-ray instruments with mosaic crystals are proposed and used in many applications in synchrotron radiation, medical physics and astrophysics. These crystals present a parafocusing of the x-ray beam in the diffraction plane, which is thoroughly analyzed in this paper. We studied the evolution of the cross- section of the diffracted beam, using several samples of Highly Oriented Pyrolythic Graphite crystals coming from different suppliers. The experiment has been performed at the European Synchrotron Radiation Facility (beamline BM5). The results clearly show a parafocusing effect in the 1:1 magnification ratio along the diffraction plane and a defocusing effect along the perpendicular plane. The secondary extinction coefficient is also measured.
Quasi-monochromatic X-rays with energy in the 16 - 24 keV range have been produced in our laboratory by making use of a conventional W-anode X-ray tube and a monochromator optical system via Bragg diffraction. The optical system is based on an array of mosaic crystals which produces an irradiation field obtained with adjacent reflected beams. The field size is about 10.5 X 12.0 cm2 in the image plane. The introduction of an active optical component such as a mosaic crystal array may modify the imaging performances of the system. In order to investigate how the resolution properties of the quasi-monochromatic source are affected by the use of adjacent beams and the Bragg diffraction phenomenon, images of a hole pattern and a slit camera have been obtained with different magnification factors. The images of the hole pattern show duplication effects due to the partial superposition of adjacent beams. Slit camera images show an unexpected increase of the focal spot blurring along the diffraction plane. This behavior could be explained by considering each crystal monochromator of the array as a secondary source and consequently as a focal spot of the beam coming from it. Along the orthogonal direction the image blurring depends on the focal spot size of the X-ray tube.
It has been demonstrated both theoretically and experimentally that mammographic x-ray imaging with monochromatic beams could help to improve subject contrast and to reduce the dose delivered to the patient. To this aim, quasi-monochromatic x-rays have been produced in the mammographic energy range by making use of a conventional W- anode, Be-window x-ray tube and a monochromator optical system based on an array of mosaic crystals. The mosaic crystals are highly oriented pyrolytic graphite which provide a gain in flux as compared to perfect crystals because of their higher integrated reflectivity. The monochromator optical system consists of an array of three crystals which has been assembled so as to produce in the image plane an irradiation field obtained with adjacent reflected beams. The field size reflected by each crystal on the image plane is limited by the desired energy resolution along the horizontal direction and by the crystal size along the perpendicular one. The energy spread of the reflected beams is about 10 percent. The characteristics of the system in terms of energy resolution and fluence rate are reported. Radiographs of test phantoms imaged with quasi-monochromatic beams in the energy range of 18-21 keV have been obtained with a conventional screen/film combination. To remove the spatial non-uniformities of the entire irradiation field a correction procedure has been applied.Large field quasi- monochromatic x-ray beams with the same flux of a standard Mo-anode tube with an anode current of about 600 mA.
We are investigating the performance of a digital photoelectronic imaging system assembled in our laboratory. The primary radiological image is converted to a visible image by a Gd2O2S:Tb fluorescent screen optically coupled to a microchannel plate intensified CCD camera. The imaging system includes a motorized zoom lens, with a nominal zoom range of 6, for changing the imaging field size from 12.0 X 10.7 mm2 to 63 X 56 mm2. Video images are digitized by a real-time frame grabber, integrated with a personal computer for image processing and analysis by using specially developed computer software. The Modulation Transfer Functions of the system have been determined for various zoom factors. A spatial resolution limit of 7.5 lp/mm and of 2.5 lp/mm has been obtained for the maximum and the minimum optical zoom factor, respectively. For large zoom factors the resolution limit is due to the intrinsic resolution of the fluorescent screen.
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