Luigi Rigon

An innovative digital imaging set-up allowing a low-dose approach to phase contrast applications in the medical field

Recently, new imaging modalities based on the detection of weak phase perturbations effects, among which are phase contrast and diffraction imaging, have been developed by several researchers. Due to their high sensitivity to weakly absorbing details, these techniques seem to be very promising for applications in the medical field. On the other hand, digital radiology is undergoing a wide diffusion, and its benefits are presently very well understood. Up to now, however, the strong pixel size constraints associated with phase contrast pattern detection limited the possibility of exploiting the advantages of phase contrast in digital radiology applications. In this paper, an innovative setup capable of removing the pixel size constraints, and thus opening the way to low dose digital phase contrast imaging, is described. Furthermore, we introduce an imaging technique based on the detection of radiation scattered at small angles: the information extracted from the sample is increased at no dose expense. We believe that several radiological fields, mammography being the first important example, may benefit from the herein described innovative imaging techniques.

Mammography with Synchrotron Radiation: First Clinical Experience with Phase-Detection Technique

PURPOSE To prospectively evaluate the diagnostic contribution of mammography with synchrotron radiation in patients with questionable or suspicious breast abnormalities identified at combined digital mammography (DM) and ultrasonography (US). MATERIALS AND METHODS The ethics committee approved this prospective study, and written informed consent was obtained from all patients. Mammography with synchrotron radiation was performed with a phase-detection technique at a synchrotron radiation laboratory. Forty-nine women who met at least one of the inclusion criteria (palpable mass, focal asymmetry, architectural distortion, or equivocal or suspicious mass at DM; none clarified at US) were enrolled. Forty-seven women (mean age, 57.8 years ± 8.8 [standard deviation]; age range, 43-78 years) completed the study protocol, which involved biopsy or follow-up for 1 year as the reference standard. Breast Imaging Reporting and Data System (BI-RADS) scores of 1-3 were considered to indicate a negative result, while scores 4-5 were considered to indicate a positive result. The visibility of breast abnormalities and the glandular parenchymal structure at DM and at mammography with synchrotron radiation was compared by using the Wilcoxon signed rank test. RESULTS In 29 of the 31 patients with a final diagnosis of benign entity, mammography with synchrotron radiation yielded BI-RADS scores of 1-3. In 13 of the remaining 16 patients with a final diagnosis of malignancy, mammography with synchrotron radiation yielded BI-RADS scores of 4-5. Therefore, a sensitivity of 81% (13 of 16 patients) and a specificity of 94% (29 of 31 patients) were achieved with use of the described BI-RADS dichotomization system. CONCLUSION These study results suggest that mammography with synchrotron radiation can be used to clarify cases of questionable or suspicious breast abnormalities identified at DM. SUPPLEMENTAL MATERIAL http://radiology.rsna.org/lookup/suppl/doi:10.1148/radiol.11100745/-/DC1.

A new DEI algorithm capable of investigating sub-pixel structures

Diffraction enhanced imaging (DEI) is a phase-sensitive x-ray imaging technique based on the use of an analyser crystal placed between the sample and the detector. In the recent years, DEI has proven outstanding image quality both in material science and medical imaging, as well as the capability to provide quantitative information. However, in the case of objects featuring a fine refractive structure, which is not resolved by the spatial resolution of the detector, the fundamental requirements for the applicability of the DEI algorithm are not fulfilled. Herein a new algorithm is presented that takes into account this particular case. Formally similar to DEI, it allows obtaining quantitative information on the absorption and refraction properties of the object. Thus, structures in the sub-pixel length scale can be imaged and analysed quantitatively.

PITRE: software for phase-sensitive X-ray image processing and tomography reconstruction

Synchrotron-radiation computed tomography has been applied in many research fields. Here, PITRE (Phase-sensitive X-ray Image processing and Tomography REconstruction) and PITRE_BM (PITRE Batch Manager) are presented. PITRE supports phase retrieval for propagation-based phase-contrast imaging/tomography (PPCI/PPCT), extracts apparent absorption, refractive and scattering information of diffraction enhanced imaging (DEI), and allows parallel-beam tomography reconstruction for conventional absorption CT data and for PPCT phase retrieved and DEI-CT extracted information. PITRE_BM is a batch processing manager for PITRE: it executes a series of tasks, created via PITRE, without manual intervention. Both PITRE and PITRE_BM are coded in Interactive Data Language (IDL), and have a user-friendly graphical user interface. They are freeware and can run on Microsoft Windows systems via IDL Virtual Machine, which can be downloaded for free and does not require a license. The data-processing principle and some examples of application will be presented.

Three-image diffraction enhanced imaging algorithm to extract absorption, refraction, and ultrasmall-angle scattering

As different methods to improve diffraction enhanced imaging are proposed, the authors introduce a simple algorithm that follows the original idea of Chapman et al. [Phys. Med. Biol. 42, 2015 (1997)], but extend it to a general object featuring absorption, refraction, and ultrasmall-angle scattering. The information relative to the three effects is decoupled, requiring only three images in input. Simulation and experiment give accurate results, provided the refraction and scattering angles are small compared to the rocking curve width. The proposed algorithm can be readily and fruitfully implemented in several applications, particularly when time and dose constraints are relevant.

Breast tomography with synchrotron radiation: preliminary results*

A system for in vivo breast imaging with monochromatic x-rays has been designed and built at the synchrotron radiation facility Elettra in Trieste (Italy) and will be operational in 2004. The system design involves the possibility of performing both planar mammography and breast tomography. In the present work, the first results obtained with a test set-up for breast tomography are shown and discussed. Tomographic images of in vitro breasts were acquired using monochromatic x-ray beams in the energy range 20-28 keV and a linear array silicon pixel detector. Tomograms were reconstructed using standard filtered backprojection algorithms; the effect of different filters was evaluated. The attenuation coefficients of fibroglandular and adipose tissue were measured, and a quantitative comparison of images acquired at different energies was performed by calculating the differential signal-to-noise ratio of fibroglandular details in adipose tissue. All images required a dose comparable to the dose delivered in clinical, conventional mammography and showed a high resolution of the breast structures without the overlapping effects that limit the visibility of the structures in 2D mammography. A quantitative evaluation of the images proves that the image quality at a given dose increases in the considered energy range and for the considered breast sizes.

Focusing X-rays with simple arrays of prism-like structures.

This report discusses the optimization strategy, the theoretical background and first experimental data of a new refractive lens for focusing X-rays. In order to reduce the absorption of X-rays in this transmission lens, optically passive material was removed from the necessarily concave lens shape in a highly regular pattern. The feature dimensions require lens production and replication by deep X-ray lithography, which allows shaping in only one dimension. Consequently such a lens can focus in one direction only, so a crossed lens pair is needed for two-dimensional focusing. The single lens is composed of two large prisms of millimetre size, which touch each other at one of the tips, like an old sand clock. Each large prism contains a highly regular structure of essentially identical prism-like smaller segments. The first lens prototypes focused an X-ray beam with a vertical size of 500 microm and a photon energy of 8 keV to a line with a width of only 2.8 microm. This is only slightly worse than the line width of 1.73 microm expected for its focal length of f = 2.18 m. The photon density enhancement in the focus was 25, but could have been larger as the lens can intercept a beam height of 2.6 mm.

Generalized diffraction enhanced imaging to retrieve absorption, refraction and scattering effects

A simple algorithm that generalizes the diffraction enhanced imaging (DEI) technique is introduced and discussed by means of simulated and experimental data. While the original DEI algorithm by Chapman et al (1997 Phys. Med. Biol. 42 2015) is limited to objects featuring absorption and refraction only, also ultra-small-angle scattering is considered here. Utilizing only three images in input three parametric images are produced conveying information relative to the three effects. The quality of the parametric images depends on the choice of the input images, as is demonstrated by means of a Monte Carlo simulation. With an appropriate choice, the algorithm gives accurate results on simulated and experimental datasets, as long as the refraction and scattering angles introduced by the object are small compared with the width of the rocking curve. The proposed algorithm can be implemented in several applications, as a valid alternative to multiple-image methods, particularly when time and dose constraints are relevant.

Qualitative evaluation of titanium implant integration into bone by diffraction enhanced imaging

Diffraction enhanced imaging (DEI) uses refraction of x-rays at edges, which allows pronounced visualization of material borders and rejects scattering which often obscures edges and blurs images. Here, the first evidence is presented that, using DEI, a destruction-free evaluation of the quality of integration of metal implants into bone is possible. Experiments were performed in rabbits and sheep with model implants to investigate the option for DEI as a tool in implant research. The results obtained from DEI were compared to conventional histology obtained from the specimens. DE images allow the identification of the quality of ingrowth of bone into the hydroxyapatite layer of the implant. Incomplete integration of the implant with a remaining gap of less than 0.3 mm caused the presence of a highly refractive edge at the implant/bone border. In contrast, implants with bone fully grown onto the surface did not display a refractive signal. Therefore, the refractive signal could be utilized to diagnose implant healing and/or loosening.

Towards breast tomography with synchrotron radiation at Elettra: First images

The aim of the SYRMA-CT collaboration is to set-up the first clinical trial of phase-contrast breast CT with synchrotron radiation (SR). In order to combine high image quality and low delivered dose a number of innovative elements are merged: a CdTe single photon counting detector, state-of-the-art CT reconstruction and phase retrieval algorithms. To facilitate an accurate exam optimization, a Monte Carlo model was developed for dose calculation using GEANT4. In this study, high isotropic spatial resolution (120 μm)(3) CT scans of objects with dimensions and attenuation similar to a human breast were acquired, delivering mean glandular doses in the range of those delivered in clinical breast CT (5-25 mGy). Due to the spatial coherence of the SR beam and the long distance between sample and detector, the images contain, not only absorption, but also phase information from the samples. The application of a phase-retrieval procedure increases the contrast-to-noise ratio of the tomographic images, while the contrast remains almost constant. After applying the simultaneous algebraic reconstruction technique to low-dose phase-retrieved data sets (about 5 mGy) with a reduced number of projections, the spatial resolution was found to be equal to filtered back projection utilizing a four fold higher dose, while the contrast-to-noise ratio was reduced by 30%. These first results indicate the feasibility of clinical breast CT with SR.