V. Koukou

Dual Energy Method for Breast Imaging: A Simulation Study.

Dual energy methods can suppress the contrast between adipose and glandular tissues in the breast and therefore enhance the visibility of calcifications. In this study, a dual energy method based on analytical modeling was developed for the detection of minimum microcalcification thickness. To this aim, a modified radiographic X-ray unit was considered, in order to overcome the limited kVp range of mammographic units used in previous DE studies, combined with a high resolution CMOS sensor (pixel size of 22.5 μm) for improved resolution. Various filter materials were examined based on their K-absorption edge. Hydroxyapatite (HAp) was used to simulate microcalcifications. The contrast to noise ratio (CNRtc) of the subtracted images was calculated for both monoenergetic and polyenergetic X-ray beams. The optimum monoenergetic pair was 23/58 keV for the low and high energy, respectively, resulting in a minimum detectable microcalcification thickness of 100 μm. In the polyenergetic X-ray study, the optimal spectral combination was 40/70 kVp filtered with 100 μm cadmium and 1000 μm copper, respectively. In this case, the minimum detectable microcalcification thickness was 150 μm. The proposed dual energy method provides improved microcalcification detectability in breast imaging with mean glandular dose values within acceptable levels.

Modeling of the Calcium/Phosphorus Mass ratio for Breast Imaging

Breast microcalcifications are mainly composed of calcite (CaCO3), calcium oxalate (CaC2O4) and apatite (a calcium-phosphate mineral form). Any pathologic alteration (carcinogenesis) of the breast may produce apatite. In the present simulation study, an analytical model was implemented in order to distinguish malignant and non-malignant lesions. The Calcium/Phosphorus (Ca/P) mass ratio and the standard deviation (SD) of the calcifications were calculated. The size of the calcifications ranged from 100 to 1000 μm, in 50 μm increments. The simulation was performed for hydroxyapatite, calcite and calcium oxalate calcifications. The optimum pair of energies for all calcifications was 22keV and 50keV. Hydroxyapatite and calcite calcifications were sufficiently characterized through their distinct confidence interval (99.7%, 3SD) values for calcifications sizes above 500 μm, while the corresponding sizes for hydroxyapatite and calcium oxalate characterization were found above 250 μm. Initial computer simulation results indicate that the proposed method can be used in breast cancer diagnosis, reducing the need for invasive methods, such as biopsies.

X-Ray Spectra for Bone Quality Assessment Using Energy Dispersive Counting and Imaging Detectors with Dual Energy Method

The aim of the present study was the optimization of dual energy x-ray spectra through the estimation of the Coefficient of Variation (CV). The simulation of monoenergetic x-ray beams provides the optimum dual energy pairs minimizing the CV. Single and double exposure methods were used in order to obtain polyenergetic spectra. K-edge filtering was applied to provide quasi-monochromatic beams with equal mean energy to the corresponding monochromatic ones. Furthermore the optimization for the obtained incident spectra was based on a limiting number of counts equal to 105 (CVinc≤0.3%) with minimum peak spectral width. The optimum results for single exposure method obtained from 80kVp with added beam filtration of 850μm Ce achieving a CV value of 0.21%. Whereas for the double exposure technique a CV value of 0.68% was achieved using 50 and 120kVp with added filtration of 400μm Ce and 1000μm Yb respectively. These CV values indicate that this method can be used as a diagnostic tool of great importance in bone quality assessment.

Polynomial dual energy inverse functions for bone Calcium/Phosphorus ratio determination and experimental evaluation.

An X-ray dual energy (XRDE) method was examined, using polynomial nonlinear approximation of inverse functions for the determination of the bone Calcium-to-Phosphorus (Ca/P) mass ratio. Inverse fitting functions with the least-squares estimation were used, to determine calcium and phosphate thicknesses. The method was verified by measuring test bone phantoms with a dedicated dual energy system and compared with previously published dual energy data. The accuracy in the determination of the calcium and phosphate thicknesses improved with the polynomial nonlinear inverse function method, introduced in this work, (ranged from 1.4% to 6.2%), compared to the corresponding linear inverse function method (ranged from 1.4% to 19.5%).

Characterization of breast calcification types using dual energy x-ray method

Calcifications are products of mineralization whose presence is usually associated with pathological conditions. The minerals mostly seen in several diseases are calcium oxalate (CaC2O4), calcium carbonate (CaCO3) and hydroxyapatite (HAp). Up to date, there is no in vivo method that could discriminate between minerals. To this aim, a dual energy x-ray method was developed in the present study. An analytical model was implemented for the determination of the Calcium/Phosphorus mass ratio ([Formula: see text]). The simulation was carried out using monoenergetic and polyenergetic x-rays and various calcification thicknesses (100-1000 [Formula: see text]) and types (CaC2O4, CaCO3, HAp). The experimental evaluation of the method was performed using the optimized irradiation conditions obtained from the simulation study. X-ray tubes, combined with energy dispersive and energy integrating (imaging) detectors, were used for the determination of the [Formula: see text] in phantoms of different mineral types and thicknesses. Based on the results of the experimental procedure, statistical significant difference was observed between the different types of minerals when calcification thicknesses were 300 [Formula: see text] or higher.

Preliminary Study of ZnS:Mn2+ Quantum Dots Response Under UV and X-Ray Irradiation

Quantum Dots are semiconductor nanocrystals, with their optical properties controlled by their size, shape and material composition. The aim of the present study is to examine the scintillation properties of Manganese Doped Zinc Sulfide (ZnS:Mn 2+) Quantum Dot (QDs) nanocrystals under UV and X-ray irradiation. ZnS:Mn 2+ Quantum Dots, with typical diameter of ZnS dots of 13-20nm (also called scintillation QDs, stQDs), were developed and acquired by Mesolight Inc. The initial stQD sample was a solution of 75mg of ZnS:Mn 2+ dissolved in 100μL of Toluene, having a concentration of 75% w/v. Emission characteristics under UV and X-Ray excitation were examined. Two ultraviolet sources were incorporated (315 nm and 365 nm) as well as a medical X-ray tube with tube voltage from 50 to 130 kVp. Parameters such as Energy Quantum Efficiency under UV excitation and Luminescence Efficiency-LE (light energy flux over exposure rate) under X-ray excitation were examined. Luminescence Efficiency (LE) of ZnS:Mn 2+ was higher than that exhibited by previously examined QDs, (ZnCdSeS:ZnS and ZnCuInS:ZnS). The ability of ZnS:Mn 2+ to transform UV photons energy into optical photons energy, tends to increase while the incident UV wavelength decreases. Energy Quantum Efficiency of the sample exhibited a 6% increase when exposed to 315nm UV light compared to 365 nm. The emission spectrum of the stQDs, exhibited a narrow peak (~585nm) in the yellow range.

Optimization of breast cancer detection in Dual Energy X-ray Mammography using a CMOS imaging detector

Dual energy mammography has the ability to improve the detection of microcalcifications leading to early diagnosis of breast cancer. In this simulation study, a prototype dual energy mammography system, using a CMOS based imaging detector with different X-ray spectra, was modeled. The device consists of a 33.91 mg/cm2 Gd2O2S:Tb scintillator screen, placed in direct contact with the sensor, with a pixel size of 22.5 μm. Various filter materials and tube voltages of a Tungsten (W) anode for both the low and high energy were examined. The selection of the filters applied to W spectra was based on their K- edges (K-edge filtering). Hydroxyapatite (HAp) was used to simulate microcalcifications. Calcification signal-to-noise ratio (SNRtc) was calculated for entrance surface dose within the acceptable levels of conventional mammography. Optimization was based on the maximization of SNRtc while minimizing the entrance dose. The best compromise between SNRtc value and dose was provided by a 35kVp X-ray spectrum with added beam filtration of 100μm Pd and a 70kVp Yb filtered spectrum of 800 μm for the low and high energy, respectively. Computer simulation results show that a SNRtc value of 3.6 can be achieved for a calcification size of 200 μm. Compared with previous studies, this method can improve detectability of microcalcifications.

Resolution Properties of a Calcium Tungstate (CaWO4) Screen Coupled to a CMOS Imaging Detector

The aim of the current work was to assess the resolution properties of a calcium tungstate (CaWO4) screen (screen coating thickness: 50.09 mg/cm2, actual thickness: 167.2 μm) coupled to a high resolution complementary metal oxide semiconductor (CMOS) digital imaging sensor. A 2.7x3.6 cm2 CaWO4 sample was extracted from an Agfa Curix universal screen and was coupled directly with the active area of the active pixel sensor (APS) CMOS sensor. Experiments were performed following the new IEC 62220-1-1:2015 International Standard, using an RQA-5 beam quality. Resolution was assessed in terms of the Modulation Transfer Function (MTF), using the slanted-edge method. The CaWO4/CMOS detector configuration was found with linear response, in the exposure range under investigation. The final MTF was obtained through averaging the oversampled edge spread function (ESF), using a custom-made software developed by our team, according to the IEC 62220-1-1:2015. Considering the renewed interest in calcium tungstate for various applications, along with the resolution results of this work, CaWO4 could be also considered for use in X-ray imaging devices such as charged-coupled devices (CCD) and CMOS.

Medical Imaging Image Quality Assessment with Monte Carlo Methods

The aim of the present study was to assess image quality of PET scanners through a thin layer chromatography (TLC) plane source. The source was simulated using a previously validated Monte Carlo model. The model was developed by using the GATE MC package and reconstructed images obtained with the STIR software for tomographic image reconstruction, with cluster computing. The PET scanner simulated in this study was the GE DiscoveryST. A plane source consisted of a TLC plate, was simulated by a layer of silica gel on aluminum (Al) foil substrates, immersed in 18F-FDG bath solution (1MBq). Image quality was assessed in terms of the Modulation Transfer Function (MTF). MTF curves were estimated from transverse reconstructed images of the plane source. Images were reconstructed by the maximum likelihood estimation (MLE)-OSMAPOSL algorithm. OSMAPOSL reconstruction was assessed by using various subsets (3 to 21) and iterations (1 to 20), as well as by using various beta (hyper) parameter values. MTF values were found to increase up to the 12th iteration whereas remain almost constant thereafter. MTF improves by using lower beta values. The simulated PET evaluation method based on the TLC plane source can be also useful in research for the further development of PET and SPECT scanners though GATE simulations.

PVAL breast phantom for dual energy calcification detection

Microcalcifications are the main indicator for breast cancer. Dual energy imaging can enhance the detectability of calcifications by suppressing the tissue background. Two digital images are obtained using two different spectra, for the low- and high-energy respectively, and a weighted subtracted image is produced. In this study, a dual energy method for the detection of the minimum breast microcalcification thickness was developed. The used integrated prototype system consisted of a modified tungsten anode X-ray tube combined with a high resolution CMOS sensor. The breast equivalent phantom used was an elastically compressible gel of polyvinyl alcohol (PVAL). Hydroxyapatite was used to simulate microcalcifications with thicknesses ranging from 50 to 500 μm. The custom made phantom was irradiated with 40kVp and 70kVp. Tungsten (W) anode spectra filtered with 100μm Cadmium and 1000pm Copper, for the low- and high-energy, respectively. Microcalcifications with thicknesses 300μm or higher can be detected with mean glandular dose (MGD) of 1.62mGy.