Dark-field computed tomography reaches the human scale.

X-ray computed tomography (CT) is one of the most commonly used three-dimensional medical imaging modalities today. It has been refined over several decades, with the most recent innovations including dual-energy and spectral photon-counting technologies. Nevertheless, it has been discovered that wave-optical contrast mechanisms-beyond the presently used X-ray attenuation-offer the potential of complementary information, particularly on otherwise unresolved tissue microstructure. One such approach is dark-field imaging, which has recently been introduced and already demonstrated significantly improved radiological benefit in small-animal models, especially for lung diseases. Until now, however, dark-field CT could not yet be translated to the human scale and has been restricted to benchtop and small-animal systems, with scan durations of several minutes or more. This is mainly because the adaption and upscaling to the mechanical complexity, speed, and size of a human CT scanner so far remained an unsolved challenge. Here, we now report the successful integration of a Talbot-Lau interferometer into a clinical CT gantry and present dark-field CT results of a human-sized anthropomorphic body phantom, reconstructed from a single rotation scan performed in 1 s. Moreover, we present our key hardware and software solutions to the previously unsolved roadblocks, which so far have kept dark-field CT from being translated from the optical bench into a rapidly rotating CT gantry, with all its associated challenges like vibrations, continuous rotation, and large field of view. This development enables clinical dark-field CT studies with human patients in the near future.

Sparse sampling computed tomography (SpSCT) for detection of pulmonary embolism: a feasibility study.

OBJECTIVES: Evaluation of sparse sampling computed tomography (SpSCT) regarding subjective and objective image criteria for the detection of pulmonary embolism (PE) at different simulated dose levels. METHODS: Computed tomography pulmonary angiography (CTPA) scans of 20 clinical patients were used to obtain simulated low-dose scans with 100%-50%-25%-12.5%-6.3%-3.1% of the clinical dose, resulting in a total of six dose levels (DL). From these full sampling (FS) data, every second (2-SpSCT) or fourth (4-SpSCT) projection was used to obtain simulated sparse sampling scans. Each image set was evaluated by four blinded radiologists regarding subjective image criteria (artifacts, image quality) and diagnostic performance (confidence, sensitivity, specificity, accuracy, and area under the curve). Additionally, the contrast-to-noise ratio (CNR) was evaluated for objective image quality. RESULTS: Sensitivity was 100% with 2-SpSCT and 4-SpSCT at the 25% DL and the 12.5% DL for all localizations of PE (one subgroup 98.5%). With FS, the sensitivity decreased to 90% at the 12.5% DL. 2-SpSCT and 4-SpSCT showed higher values for sensitivity, specificity, accuracy, and the area under the curve at all DL compared with FS. Subjective image quality was significantly higher for 4-SpSCT compared with FS at each dose level (p < 0.01, paired t test). Only with 4-SpSCT, all examinations were rated as showing diagnostic image quality at the 12.5% DL. CONCLUSIONS: Via SpSCT, a dose reduction down to a 12.5% dose level (corresponding to a mean effective dose of 0.38 mSv in the current study) for CTPA is possible while maintaining high image quality and full diagnostic confidence. KEY POINTS: • With sparse sampling CT, radiation dose could be significantly reduced in clinical routine. • Sparse sampling CT is a novel hardware solution with which less projection images are acquired. • In the current study, a dose reduction of 87.5% (corresponding to a mean effective dose of 0.38 mSv) for CTPA could be achieved while maintaining excellent diagnostic performance.

DXA-equivalent quantification of bone mineral density using dual-layer spectral CT scout scans.

OBJECTIVES: To develop and evaluate a method for areal bone mineral density (aBMD) measurement based on dual-layer spectral CT scout scans. METHODS: A post-processing algorithm using a pair of 2D virtual mono-energetic scout images (VMSIs) was established in order to semi-automatically compute the aBMD at the spine similarly to DXA, using manual soft tissue segmentation, semi-automatic segmentation for the vertebrae, and automatic segmentation for the background. The method was assessed based on repetitive measurements of the standardized European Spine Phantom (ESP) using the standard scout scan tube current (30 mA) and other tube currents (10 to 200 mA), as well as using fat-equivalent extension rings simulating different patient habitus, and was compared to dual-energy X-ray absorptiometry (DXA). Moreover, the feasibility of the method was assessed in vivo in female patients. RESULTS: Derived from standard scout scans, aBMD values measured with the proposed method significantly correlated with DXA measurements (r = 0.9925, p < 0.001), and mean accuracy (DXA, 4.12%; scout, 1.60%) and precision (DXA, 2.64%; scout, 2.03%) were comparable between the two methods. Moreover, aBMD values assessed at different tube currents did not differ significantly (p ≥ 0.20 for all), suggesting that the presented method could be applied to scout scans with different settings. Finally, data derived from sample patients were concordant with BMD values from a reference age-matched population. CONCLUSIONS: Based on dual-layer spectral scout scans, aBMD measurements were fast and reliable and significantly correlated with the according DXA measurements in phantoms. Considering the number of CT acquisitions performed worldwide, this method could allow truly opportunistic osteoporosis screening. KEY POINTS: • 2D scout scans (localizer radiographs) from a dual-layer spectral CT scanner, which are mandatory parts of a CT examination, can be used to automatically determine areal bone mineral density (aBMD) at the spine. • The presented method allowed fast (< 25 s/patient), semi-automatic, and reliable DXA-equivalent aBMD measurements for state-of-the-art DXA phantoms at different tube settings and for various patient habitus, as well as for sample patients. • Considering the number of CT scout scan acquisitions performed worldwide on a daily basis, the presented technique could enable truly opportunistic osteoporosis screening with DXA-equivalent metrics, without involving higher radiation exposure since it only processes existing data that is acquired during each CT scan.

Experimental feasibility of spectral photon-counting computed tomography with two contrast agents for the detection of endoleaks following endovascular aortic repair.

OBJECTIVES: After endovascular aortic repair (EVAR), discrimination of endoleaks and intra-aneurysmatic calcifications within the aneurysm often requires multiphase computed tomography (CT). Spectral photon-counting CT (SPCCT) in combination with a two-contrast agent injection protocol may provide reliable detection of endoleaks with a single CT acquisition. METHODS: To evaluate the feasibility of SPCCT, the stent-lined compartment of an abdominal aortic aneurysm phantom was filled with a mixture of iodine and gadolinium mimicking enhanced blood. To represent endoleaks of different flow rates, the adjacent compartments contained either one of the contrast agents or calcium chloride to mimic intra-aneurysmatic calcifications. After data acquisition with a SPCCT prototype scanner with multi-energy bins, material decomposition was performed to generate iodine, gadolinium and calcium maps. RESULTS: In a conventional CT slice, Hounsfield units (HU) of the compartments were similar ranging from 147 to 168 HU. Material-specific maps differentiate the distributions within the compartments filled with iodine, gadolinium or calcium. CONCLUSION: SPCCT may replace multiphase CT to detect endoleaks without sacrificing diagnostic accuracy. It is a unique feature of our method to capture endoleak dynamics and allow reliable distinction from intra-aneurysmatic calcifications in a single scan, thereby enabling a significant reduction of radiation exposure. KEY POINTS: • SPCCT might enable advanced endoleak detection. • Material maps derived from SPCCT can differentiate iodine, gadolinium and calcium. • SPCCT may potentially reduce radiation burden for EVAR patients under post-interventional surveillance.

Spectral Photon-counting CT: Initial Experience with Dual-Contrast Agent K-Edge Colonography.

Purpose To investigate the feasibility of using spectral photon-counting computed tomography (CT) to differentiate between gadolinium-based and nonionic iodine-based contrast material in a colon phantom by using the characteristic k edge of gadolinium. Materials and Methods A custom-made colon phantom was filled with nonionic iodine-based contrast material, and a gadolinium-filled capsule representing a contrast material-enhanced polyp was positioned on the colon wall. The colon phantom was scanned with a preclinical spectral photon-counting CT system to obtain spectral and conventional data. By fully using the multibin spectral information, material decomposition was performed to generate iodine and gadolinium maps. Quantitative measurements were performed within the lumen and polyp to quantitatively determine the absolute content of iodine and gadolinium. Results In a conventional CT section, absorption values of both contrast agents were similar at approximately 110 HU. Contrast material maps clearly differentiated the distributions, with gadolinium solely in the polyp and iodine in the lumen of the colon. Quantitative measurements of contrast material concentrations in the colon and polyp matched well with those of actual prepared mixtures. Conclusion Dual-contrast spectral photon-counting CT colonography with iodine-filled lumen and gadolinium-tagged polyps may enable ready differentiation between polyps and tagged fecal material. © RSNA, 2016.

Hybrid spectral CT system with clinical rapid kVp-switching x-ray tube and dual-layer detector for improved iodine quantification.

Spectral computed tomography (CT) is a powerful diagnostic tool offering quantitative material decomposition results that enhance clinical imaging by providing physiologic and functional insights. Iodine, a widely used contrast agent, improves visualization in various clinical contexts. However, accurately detecting low-concentration iodine presents challenges in spectral CT systems, particularly crucial for conditions like pancreatic cancer assessment. In this study, we present preliminary results from our hybrid spectral CT instrumentation which includes clinical-grade hardware (rapid kVp-switching x-ray tube, dual-layer detector). This combination expands spectral datasets from two to four channels, wherein we hypothesize improved quantification accuracy for low-dose and low-iodine concentration cases. We modulate the system duty cycle to evaluate its impact on quantification noise and bias. We evaluate iodine quantification performance by comparing two hybrid weighting strategies alongside rapid kVp-switching. This evaluation is performed with a polyamide phantom containing seven iodine inserts ranging from 0.5 to 20 mg/mL. In comparison to alternative methodologies, the maximum separation configuration, incorporating data from both the 80 kVp, low photon energy detector layer and the 140 kVp, high photon energy detector layer produces spectral images containing low quantitative noise and bias. This study presents initial evaluations on a hybrid spectral CT system, leveraging clinical hardware to demonstrate the potential for enhanced precision and sensitivity in spectral imaging. This research holds promise for advancing spectral CT imaging performance across diverse clinical scenarios.

Technical Design Considerations of a Human-Scale Talbot-Lau Interferometer for Dark-Field CT.

Computed tomography (CT) as an important clinical diagnostics method can profit from extension with dark-field imaging, as it is currently restricted to X-rays' attenuation contrast only. Dark-field imaging allows access to more tissue properties, such as micro-structural texture or porosity. The up-scaling process to clinical scale is complex because several design constraints must be considered. The two most important ones are that the finest grating is limited by current manufacturing technology to a [Formula: see text] period and that the interferometer should fit into the CT gantry with minimal modifications only. In this work we discuss why an inverse interferometer and a triangular G1 profile are advantageous and make a compact and sensitive interferometer implementation feasible. Our evaluation of the triangular grating profile reveals a deviation in the interference pattern compared to standard grating profiles, which must be considered in the subsequent data processing. An analysis of the grating orientation demonstrates that currently only a vertical layout can be combined with cylindrical bending of the gratings. We also provide an in-depth discussion, including a new simulation approach, of the impact of the extended X-ray source spot which can lead to large performance loss and present supporting experimental results. This analysis reveals a vastly increased sensitivity to geometry and grating period deviations, which must be considered early in the system design process.

CT-Guided Liver Biopsy: Evaluation of Spectral Data From Dual-Layer Detector CT for Improved Lesion Detection.

PURPOSE: Evaluation of dual-layer spectral computed tomography (CT) for contrast enhancement during image-guided biopsy of liver lesions using virtual monoenergetic images (VMI) and virtual non-contrast (VNC) images. METHODS: Spectral CT data of 20 patients receiving CT-guided needle biopsy of focal liver lesions were used to generate VMI at energy levels from 40 to 200 keV and VNC images. Images were analyzed objectively regarding contrast-to-noise ratio between lesion center (CNRcent) or periphery (CNRperi) and normal liver parenchyma. Lesion visibility and image quality were evaluated on a 4-point Likert scale by two radiologists. RESULTS: Using VMI/VNC images, readers reported an increased visibility of the lesion compared to the conventional CT images in 18/20 cases. In 75% of cases, the highest visibility was derived by VMI-40. Showing all reconstructions simultaneously, VMI-40 offered the highest visibility in 75% of cases, followed by VNC in 12.5% of cases. Either CNRcent (17/20) or/and CNRperi (17/20) was higher (CNR increase > 50%) in 19/20 cases for VMI-40 or VNC images compared to conventional CT images. VMI-40 showed the highest CNRcent in 14 cases and the highest CNRperi in 12 cases. High image quality was present for all reconstructions with a minimum median of 3.5 for VMI-40 and VMI-50. CONCLUSIONS: When implemented in the CT scanner software, automated contrast enhancement of liver lesions during image-guided biopsy may facilitate the procedure.

A comparative study of a dual-energy-like imaging technique based on counting-integrating readout.

PURPOSE: The recent introduction of a specific electronic readout chip, designed for the processing of the same signal pulses from an x-ray sensor in one integrating and one counting channel in each pixel E. Kraft et al., [IEEE Trans. Nucl. Sci. 54, 383-390 (2007)]; E. Kraft, "Counting and integrating microelectronics development for direct conversion X-ray imaging," Ph.D. thesis, 2007; J. Fink, "Characterization of the imaging performance of the simultaneously counting and integrating X-ray detector CIX," Ph.D. thesis, 2010, enables an alternative to conventional dual-energy imaging methods. As shown in a previous paper, the proposed alternative benefits from positively correlated noise in the raw data, inherent to the counting-integrating readout (CIX), which results in a reduction of basis image noise after dual-energy decomposition. In the present paper, the authors compare the new approach to dual-energy imaging to two conventional dual-energy techniques, the dual-kV technique and the dual-crystal technique and to a photon-counting technique based on two energy windows. METHODS: The study is based on x-ray computed tomography (CT) simulations of an anthropomorphic head phantom, where the signal-to-noise ratios and the contrast-to-noise ratios in basis material images and quasi-monochromatic images at 60 keV are compared. Moreover, a simple pictorial illustration of the relevance of input noise correlations in the noise-propagation process during the dual-energy basis material decomposition are presented, as well as measurement data for the correlation obtained as a function of the x-ray flux rate. RESULTS: Under the idealized assumptions of the absence of scatter and detector imperfections like K-escape, crosstalk and detector noise, our comparison shows that among the dual-energy techniques investigated, the CIX concept together with the dual-kV technique performs best, confirming the mitigating effect of correlated measurement data on the dual-energy basis material decomposition. CONCLUSIONS: The novel concept of simultaneous counting of photons and integrating the x-ray energy flux has a large potential for dual-energy applications in both projection and tomographic x-ray imaging. Future work will have to focus on the sensitivity of the CIX dual-energy concept to scattered radiation, detector imperfections and high x-ray fluxes.

Dosimetry on first clinical dark-field chest radiography.

PURPOSE: The purpose of this study was to evaluate the dose characteristic for patient examinations at the first clinical X-ray dark-field chest radiography system and to determine whether the effective patient dose is within a clinically acceptable dose range. METHODS: A clinical setup for grating-based dark-field chest radiography was constructed and commissioned, operating at a tube voltage of 70 kVp. Thermoluminescent dosimeter (TLD) measurements were conducted using an anthropomorphic phantom modeling the reference person to obtain a conversion coefficient relating dose area product (DAP) to effective patient dose at the dark-field system. For 92 patients, the DAP values for posterior-anterior measurements were collected at the dark-field system. Using the previously determined conversion coefficient, the effective dose was calculated. RESULTS: A reference person, modeled by an anthropomorphic phantom, receives an effective dose of 35 µSv. For the examined patients, a mean effective dose of 39 µSv was found. CONCLUSIONS: The effective dose at the clinical dark-field radiography system, generating both attenuation and dark-field images, is within the range of reported standard dose values for chest radiography.

Atherosclerotic plaque composition: analysis with multicolor CT and targeted gold nanoparticles.

PURPOSE: To investigate the potential of spectral computed tomography (CT) (popularly referred to as multicolor CT), used in combination with a gold high-density lipoprotein nanoparticle contrast agent (Au-HDL), for characterization of macrophage burden, calcification, and stenosis of atherosclerotic plaques. MATERIALS AND METHODS: The local animal care committee approved all animal experiments. A preclinical spectral CT system in which incident x-rays are divided into six different energy bins was used for multicolor imaging. Au-HDL, an iodine-based contrast agent, and calcium phosphate were imaged in a variety of phantoms. Apolipoprotein E knockout (apo E-KO) mice were used as the model for atherosclerosis. Gold nanoparticles targeted to atherosclerosis (Au-HDL) were intravenously injected at a dose of 500 mg per kilogram of body weight. Iodine-based contrast material was injected 24 hours later, after which the mice were imaged. Wild-type mice were used as controls. Macrophage targeting by Au-HDL was further evaluated by using transmission electron microscopy and confocal microscopy of aorta sections. RESULTS: Multicolor CT enabled differentiation of Au-HDL, iodine-based contrast material, and calcium phosphate in the phantoms. Accumulations of Au-HDL were detected in the aortas of the apo E-KO mice, while the iodine-based contrast agent and the calcium-rich tissue could also be detected and thus facilitated visualization of the vasculature and bones (skeleton), respectively, during a single scanning examination. Microscopy revealed Au-HDL to be primarily localized in the macrophages on the aorta sections; hence, the multicolor CT images provided information about the macrophage burden. CONCLUSION: Spectral CT used with carefully chosen contrast agents may yield valuable information about atherosclerotic plaque composition.

Focal cystic high-attenuation lesions: characterization in renal phantom by using photon-counting spectral CT--improved differentiation of lesion composition.

PURPOSE: To evaluate the capability of spectral computed tomography (CT) to improve the characterization of cystic high-attenuation lesions in a renal phantom and to test the hypothesis that spectral CT will improve the differentiation of cystic renal lesions with high protein content and those that have undergone hemorrhage or malignant contrast-enhancing transformation. MATERIALS AND METHODS: A renal phantom that contained cystic lesions grouped in nonenhancing cyst and hemorrhage series and an iodine-enhancing series was developed. Spectral CT is based on new detector designs that may possess energy-sensitive photon-counting abilities, thereby facilitating the assessment of quantitative information about the elemental and molecular composition of tissue or contrast materials. Imaging of the renal phantom was performed with a prototype scanner at 20 mAs and 70 keV, allowing characterization of x-ray photons at 25-34, 34-39, 39-44, 44-49, 49-55, and more than 55 keV. Region of interest analysis was used to determine lesion attenuation values at various x-ray energies. Statistical analysis was performed to assess attenuation patterns and identify distinct levels of attenuation on the basis of curve regression analysis with analysis of variance tables. RESULTS: Spectral CT depicted linear clusters for the cyst (P < .001, R(2) > 0.940) and hemorrhage (P < .001, R(2) > 0.962) series without spectral overlap. A distinct linear attenuation profile without spectral overlap was also detected for the iodine-enhancing series (P < .001, R(2) > 0.964), with attenuation values attained in the 34-39-keV energy bin statistically identified as outliers (mean slope variation, >37%), corresponding with iodine k-edge effects at 33.2 keV. CONCLUSION: Spectral CT has the potential to enable distinct characterization of hyperattenuating fluids in a renal phantom by helping identify proteinaceous and hemorrhagic lesions through assessment of their distinct levels of attenuation as well as by revealing iodine-containing lesions through analysis of their specific k-edge discontinuities.

Spectral-detector based x-ray absorptiometry (SDXA): in-vivo bone mineral density measurements in patients with and without osteoporotic fractures.

OBJECTIVES: To study whether a dual-layer spectral CT scout scan-based areal BMD estimation method, called Spectral-detector based x-ray absorptiometry (SDXA), can differentiate patients with versus without osteoporotic fractures. METHODS: The ability of the method to differentiate patients with osteoporosis was evaluated by assessing the areal BMD at the spine (L1 to L4) in a group of 19 patients presenting at least one fracture and comparing these results to the areal BMD of age- and gender-matched controls (57 patients). Finally, the reproducibility of SDXA was evaluated in-vivo through the calculation of coefficients of variation (CV), using three repeated analyses performed on each patient. RESULTS: The average areal BMD of patients presenting fractures, measured with the scout scan-based method (0.86 ± 0.17 g cm-2), was found to be significantly lower than the average BMD of the control group (1.00 ± 0.17 g cm-2, p = 0.043). The reproducibility of the method in-vivo was found to be reasonable, with CVs ranging between 3.1 and 6.9%. CONCLUSIONS: The results illustrate that the SDXA method for DXA-equivalent areal BMD estimation -delivers the ability to distinguish patients presenting osteoporotic fractures. Considering the total number of CT examinations worldwide, SDXA could develop to be a useful tool for truly opportunistic osteoporosis screening for a future clinical day-to-day routine.

Gold Nanoparticle Mediated Multi-Modal CT Imaging of Hsp70 Membrane-Positive Tumors.

Imaging techniques such as computed tomographies (CT) play a major role in clinical imaging and diagnosis of malignant lesions. In recent years, metal nanoparticle platforms enabled effective payload delivery for several imaging techniques. Due to the possibility of surface modification, metal nanoparticles are predestined to facilitate molecular tumor targeting. In this work, we demonstrate the feasibility of anti-plasma membrane Heat shock protein 70 (Hsp70) antibody functionalized gold nanoparticles (cmHsp70.1-AuNPs) for tumor-specific multimodal imaging. Membrane-associated Hsp70 is exclusively presented on the plasma membrane of malignant cells of multiple tumor entities but not on corresponding normal cells, predestining this target for a tumor-selective in vivo imaging. In vitro microscopic analysis revealed the presence of cmHsp70.1-AuNPs in the cytosol of tumor cell lines after internalization via the endo-lysosomal pathway. In preclinical models, the biodistribution as well as the intratumoral enrichment of AuNPs were examined 24 h after i.v. injection in tumor-bearing mice. In parallel to spectral CT analysis, histological analysis confirmed the presence of AuNPs within tumor cells. In contrast to control AuNPs, a significant enrichment of cmHsp70.1-AuNPs has been detected selectively inside tumor cells in different tumor mouse models. Furthermore, a machine-learning approach was developed to analyze AuNP accumulations in tumor tissues and organs. In summary, utilizing mHsp70 on tumor cells as a target for the guidance of cmHsp70.1-AuNPs facilitates an enrichment and uniform distribution of nanoparticles in mHsp70-expressing tumor cells that enables various microscopic imaging techniques and spectral-CT-based tumor delineation in vivo.

Multienergy photon-counting K-edge imaging: potential for improved luminal depiction in vascular imaging.

The purpose of this study was to investigate whether spectral computed tomography (CT) has the potential to improve luminal depiction by differentiating among intravascular gadolinium-based contrast agent, calcified plaque, and stent material by using the characteristic k edge of gadolinium. A preclinical spectral CT scanner with a photon-counting detector and six energy threshold levels was used to scan a phantom vessel. A partially occluded stent was simulated by using a calcified plaque isoattenuated to a surrounding gadolinium chelate solution. The reconstructed images showed an effective isolation of the gadolinium with subsequent clear depiction of the perfused vessel lumen. The calcified plaque and the stent material are suppressed.

Evaluation of a preclinical photon-counting CT prototype for pulmonary imaging.

The purpose of this study was to investigate a preclinical spectral photon-counting CT (SPCCT) prototype compared to conventional CT for pulmonary imaging. A custom-made lung phantom, including nodules of different sizes and shapes, was scanned with a preclinical SPCCT and a conventional CT in standard and high-resolution (HR-CT) mode. Volume estimation was evaluated by linear regression. Shape similarity was evaluated with the Dice similarity coefficient. Spatial resolution was investigated via MTF for each imaging system. In-vivo rabbit lung images from the SPCCT system were subjectively reviewed. Evaluating the volume estimation, linear regression showed best results for the SPCCT compared to CT and HR-CT with a root mean squared error of 21.3 mm3, 28.5 mm3 and 26.4 mm3 for SPCCT, CT and HR-CT, respectively. The Dice similarity coefficient was superior for SPCCT throughout nodule shapes and all nodule sizes (mean, SPCCT: 0.90; CT: 0.85; HR-CT: 0.85). 10% MTF improved from 10.1 LP/cm for HR-CT to 21.7 LP/cm for SPCCT. Visual investigation of small pulmonary structures was superior for SPCCT in the animal study. In conclusion, the SPCCT prototype has the potential to improve the assessment of lung structures due to higher resolution compared to conventional CT.

X-ray dark-field imaging of the human lung-A feasibility study on a deceased body.

Disorders of the lungs such as chronic obstructive pulmonary disease (COPD) are a major cause of chronic morbidity and mortality and the third leading cause of death in the world. The absence of sensitive diagnostic tests for early disease stages of COPD results in under-diagnosis of this treatable disease in an estimated 60-85% of the patients. In recent years a grating-based approach to X-ray dark-field contrast imaging has shown to be very sensitive for the detection and quantification of pulmonary emphysema in small animal models. However, translation of this technique to imaging systems suitable for humans remains challenging and has not yet been reported. In this manuscript, we present the first X-ray dark-field images of in-situ human lungs in a deceased body, demonstrating the feasibility of X-ray dark-field chest radiography on a human scale. Results were correlated with findings of computed tomography imaging and autopsy. The performance of the experimental radiography setup allows acquisition of multi-contrast chest X-ray images within clinical boundary conditions, including radiation dose. Upcoming clinical studies will have to demonstrate that this technology has the potential to improve early diagnosis of COPD and pulmonary diseases in general.

Depiction of pneumothoraces in a large animal model using x-ray dark-field radiography.

The aim of this study was to assess the diagnostic value of x-ray dark-field radiography to detect pneumothoraces in a pig model. Eight pigs were imaged with an experimental grating-based large-animal dark-field scanner before and after induction of a unilateral pneumothorax. Image contrast-to-noise ratios between lung tissue and the air-filled pleural cavity were quantified for transmission and dark-field radiograms. The projected area in the object plane of the inflated lung was measured in dark-field images to quantify the collapse of lung parenchyma due to a pneumothorax. Means and standard deviations for lung sizes and signal intensities from dark-field and transmission images were tested for statistical significance using Student's two-tailed t-test for paired samples. The contrast-to-noise ratio between the air-filled pleural space of lateral pneumothoraces and lung tissue was significantly higher in the dark-field (3.65 ± 0.9) than in the transmission images (1.13 ± 1.1; p = 0.002). In case of dorsally located pneumothoraces, a significant decrease (-20.5%; p > 0.0001) in the projected area of inflated lung parenchyma was found after a pneumothorax was induced. Therefore, the detection of pneumothoraces in x-ray dark-field radiography was facilitated compared to transmission imaging in a large animal model.

On the influence of noise correlations in measurement data on basis image noise in dual-energylike x-ray imaging.

In conventional dual-energy systems, two transmission measurements with distinct spectral characteristics are performed. These measurements are used to obtain the line integrals of two basis material densities. Usually, the measurement process is such that the two measured signals can be treated as independent and therefore uncorrelated. Recently, however, a readout system for x-ray detectors has been introduced for which this is no longer the case. The readout electronics is designed to obtain simultaneous measurements of the total number of photons N and the total energy E they deposit in the sensor material. Practically, this is realized by a signal replication and separate counting and integrating processing units. Since the quantities N and E are (electronically) derived from one and the same physical sensor signal, they are statistically correlated. Nevertheless, the pair N and E can be used to perform a dual-energy processing following the well-known approach by Alvarez and Macovski. Formally, this means that N is to be identified with the first dual-energy measurement M1 and E with the second measurement M2. In the presence of input correlations between M1 = N and M2 = E, however, the corresponding analytic expressions for the basis image noise have to be modified. The main observation made in this paper is that for positively correlated data, as is the case for the simultaneous counting and integrating device mentioned above, the basis image noise is suppressed through the influence of the covariance between the two signals. We extend the previously published relations for the basis image noise to the case where the original measurements are not independent and illustrate the importance of the input correlations by comparing dual-energy basis image noise resulting from the device mentioned above and a device measuring the photon numbers and the deposited energies consecutively.

Circular CT in combination with a helical segment.

The combination of circular CT with a helical trajectory segment results in a mathematically complete data set. We present a reconstruction algorithm which is mathematically exact and of the filtered back-projection type. The algorithm ensures that only Radon planes which are not covered along the circle are taken into account, when data from the helical segment are back-projected. Therefore, the helical segment contributes only to low-frequency parts of trans-axial slices. Data along the helix can be obtained with a very low acquisition dose.