128 research outputs found
A new breast tomosynthesis imaging method : Continuous Sync-and-Shoot - technical feasibility and initial experience
Background Digital breast tomosynthesis (DBT) is gaining popularity in breast imaging. There are several different technical approaches for conducting DBT imaging. Purpose To determine optimal imaging parameters, test patient friendliness, evaluate the initial diagnostic performance, and describe diagnostic advances possible with the new Continuous Sync-and-Shoot method. Material and Methods Thirty-six surgical breast specimens were imaged with digital mammography (DM) and a prototype of a DBT system (Planmed Oy, Helsinki, Finland). We tested the patient friendliness of the sync-and-shoot movement without radiation exposure in eight volunteers. Different imaging parameters were tested with 20 specimens to identify the optimal combination: angular range 30 degrees, 40 degrees, and 60 degrees; pixel binning; Rhodium (Rh) and Silver (Ag) filtrations; and different kV and mAs values. Two breast radiologists evaluated 16 DM and DBT image pairs and rated six different image properties. Imaging modalities were compared with paired t-test. Results The Continuous Sync-and-Shoot method produced diagnostically valid images. Five out of eight volunteers felt no/minimal discomfort, three experienced mild discomfort from the tilting movement of the detector, with the motion being barely recognized. The combination of 30 degrees, Ag filtering, and 2 x 2 pixel binning produced the best image quality at an acceptable dose level. DBT was significantly better in all six evaluated properties (P <0.05). Mean Dose(DBT)/Dose(DM) ratio was 1.22 (SD = 0.42). Conclusion The evaluated imaging method is feasible for imaging and analysing surgical breast specimens and DBT is significantly better than DM in image evaluation.Peer reviewe
Calculation of the X-ray spectrum of a mammography system with various voltages and different anode-filter combinations using MCNP code
Introduction One of the best methods in the diagnosis and control of breast cancer is mammography. The importance of mammography is directly related to its value in the detection of breast cancer in the early stages, which leads to a more effective treatment. The purpose of this article was to calculate the X-ray spectrum in a mammography system with Monte Carlo codes, including MCNPX and MCNP5. Materials and Methods The device, simulated using the MCNP code, was Planmed Nuance digital mammography device (Planmed Oy, Finland), equipped with an amorphous selenium detector. Different anode/filter materials, such as molybdenum-rhodium (Mo-Rh), molybdenum-molybdenum (Mo-Mo), tungsten-tin (W-Sn), tungsten-silver (W-Ag), tungsten-palladium (W-Pd), tungsten-aluminum (W-Al), tungsten-molybdenum (W-Mo), molybdenum-aluminum (Mo-Al), tungsten-rhodium (W-Rh), rhodium-aluminum (Rh-Al), and rhodium-rhodium (Rh-Rh), were simulated in this study. The voltage range of the X-ray tube was between 24 and 34 kV with a 2 kV interval. Results The charts of changing photon flux versus energy were plotted for different types of anode-filter combinations. The comparison with the findings reported by others indicated acceptable consistency. Also, the X-ray spectra, obtained from MCNP5 and MCNPX codes for W-Ag and W-Rh combinations, were compared. We compared the present results with the reported data of MCNP4C and IPEM report No. 78 for Mo-Mo, Mo-Rh, and W-Al combinations. Conclusion The MCNPX calculation outcomes showed acceptable results in a low-energy X-ray beam range (10-35 keV). The obtained simulated spectra for different anode/filter combinations were in good conformity with the finding of previous research
Selection and Evaluation of a Silver Nanoparticle Imaging Agent for Dual-Energy Mammography
Over the past decade, contrast-enhanced (CE) dual-energy (DE) x-ray breast imaging has emerged as an exciting, new modality to provide high quality anatomic and functional information of the breast. The combination of these data in a single imaging procedure represents a powerful tool for the detection and diagnosis of breast cancer. The most widely used implementation of CEDE imaging is k-edge imaging, whereby two x-ray spectra are placed on either side of the k-edge of the contrast material. Currently, CEDE imaging is performed with iodinated contrast agents. The lower energies used in clinical DE breast imaging systems compared to imaging systems for other organs suggest that an alternative material may be better suited. We developed an analytical model to compare the contrast of various elements in the periodic table. The model predicts that materials with atomic numbers from 42 to 52 should provide the best contrast in DE breast imaging while still providing high-quality anatomical images. Upon consideration, silver was chosen for more detailed study. Through simulation and experimental validation, we determined that not only does silver perform better than iodine when imaged at their respective optimal conditions, but silver is able to provide higher levels of contrast than iodine when imaged with current protocols that are optimal for iodine. Therefore, a silver agent could be translated to the clinic without modification of existing imaging systems or techniques. A prototype silver agent was designed. The agent consists of (i) a silver core for DE contrast, (ii) a silica shell to prevent the release of toxic silver cations, and (iii) a polyethylene glycol layer to improve the biocompatibility of the entire nanostructure. DE imaging with the particles showed a 9-fold increase in contrast when injected into mice, while displaying no acutely toxic effects. The prototype silica-silver nanoparticles represent a first step in developing a biologically stable contrast agent that is specifically suited for DE breast imaging
A new breast tomosynthesis imaging method: Continuous Sync-and-Shoot - technical feasibility and initial experience
Background Digital breast tomosynthesis (DBT) is gaining popularity in breast imaging. There are several different technical approaches for conducting DBT imaging. Purpose To determine optimal imaging parameters, test patient friendliness, evaluate the initial diagnostic performance, and describe diagnostic advances possible with the new Continuous Sync-and-Shoot method. Material and Methods Thirty-six surgical breast specimens were imaged with digital mammography (DM) and a prototype of a DBT system (Planmed Oy, Helsinki, Finland). We tested the patient friendliness of the sync-and-shoot movement without radiation exposure in eight volunteers. Different imaging parameters were tested with 20 specimens to identify the optimal combination: angular range 30 degrees, 40 degrees, and 60 degrees; pixel binning; Rhodium (Rh) and Silver (Ag) filtrations; and different kV and mAs values. Two breast radiologists evaluated 16 DM and DBT image pairs and rated six different image properties. Imaging modalities were compared with paired t-test. Results The Continuous Sync-and-Shoot method produced diagnostically valid images. Five out of eight volunteers felt no/minimal discomfort, three experienced mild discomfort from the tilting movement of the detector, with the motion being barely recognized. The combination of 30 degrees, Ag filtering, and 2 x 2 pixel binning produced the best image quality at an acceptable dose level. DBT was significantly better in all six evaluated properties (P < 0.05). Mean Dose(DBT)/Dose(DM) ratio was 1.22 (SD = 0.42). Conclusion The evaluated imaging method is feasible for imaging and analysing surgical breast specimens and DBT is significantly better than DM in image evaluation
Imaging of the Breast
Early detection of breast cancer combined with targeted therapy offers the best outcome for breast cancer patients. This volume deal with a wide range of new technical innovations for improving breast cancer detection, diagnosis and therapy. There is a special focus on improvements in mammographic image quality, image analysis, magnetic resonance imaging of the breast and molecular imaging. A chapter on targeted therapy explores the option of less radical postoperative therapy for women with early, screen-detected breast cancers
Development of X-ray phase-contrast imaging techniques for medical diagnostics
The X-Ray phase-contrast techniques are innovative imaging methods allowing overtaking the limitations of classic radiology. In addition to the differential X-ray absorption on which standard radiology relies, in phase-contrast imaging the contrast is given by the effects of the refraction of X-rays inside the tissues. The combination of phase-contrast with quantitative computer tomography (CT) allows for a highly accurate reconstruction of the tissues’ index of refraction. Thanks to the high sensitivity of the method, tomographic images can be obtained at clinically compatible dose. For all these reasons phase-contrast imaging is a very promising approach, which can potentially revolutionize diagnostic X-Ray imaging. Several techniques are classified under the name of X-Ray phase-contrast imaging. This Thesis focused on the so-called analyzer-based imaging (ABI) method. ABI uses a perfect crystal, placed between the sample and the detector, to visualize the phase effects occurred within the sample. The quantitative reconstruction of the refraction index from CT data is not trivial and before this Thesis work it was documented only for small size objects. This Thesis has focused on two main scientific problems: (1) the development of theoretical and calculation strategies to determine the quantitative map of the refraction index of large biological tissues/organs (>10 cm) using the ABI technique; and (2) the preparation of accurate and efficient tools to estimate and simulate the dose deposited in CT imaging of large samples.
For the determination of the refraction index, two CT geometries were considered and studied: the out-of-plane and the in-plane configurations. The first one, the most used in the works reported in the literature, foresees that the rotation axis of the sample occurs in a plane parallel to that of the sensitivity of the analyzer crystal; while, in the second CT geometry, the rotation axis is perpendicular to that plane. The theoretical study, technical design and experimental implementation of the in-plane geometry have been main tasks of this Thesis. A first experiment has been performed in order to compare the results obtained with in-plane quantitative phase contrast CT with the absorption-based CT ones. An improved accuracy and a better agreement with the theoretical density values have been obtained by exploiting the refraction effect while keeping the dose to sample low.
A second campaign of experiments has been performed on large human breasts to investigate the efficiency of the in-plane and out-of-plane CT geometries and the performances of the associated image reconstruction procedures. The same experimental conditions were also studied by numerical simulations and the results were compared. This analysis shows that the in-plane geometry allows producing more accurate quantitative three dimensional maps of the index of refraction, while the out-of-plane case is preferable for qualitative investigations.
A study for developing advanced procedures for improving the quality of the obtained CT images has been also conducted. As a result, a two-step procedure has been tested and identified: first the noise level of the experimental images is reduced by applying a wavelet decomposition algorithm and then a deconvolution procedure. The obtained images show an enhanced sharpness of the interfaces and of the object edges and high signal to noise ratio values are preserved.
The second problem of this Thesis was to find strategies to calculate, in a fast way, the delivered dose in CT imaging of complex biological samples. For this purpose an acceleration method to speed-up the convergence of Monte Carlo simulations based on the Track Length Estimator method has been computed and included in the open-source software GATE. Results show that this method can lead to the same accuracy of conventional Monte Carlo methods while reducing the required computation time of up to two orders of magnitude, with the respect to the considered geometry. A database of dose curves for the case of monochromatic breast CT has been produced: it allows for a quick estimation of the delivered dose. A way to choose the best energy and the optimal photon flux was also proposed, which leads to a significant reduction of the delivered dose without any loss in terms of image quality.
Most of the experimental and data reconstruction methods developed within this Thesis work can be applied also to other phase-contrast techniques. This Thesis shows that high resolution three dimensional diagnostic imaging of large and complex biological organs can, in principle, be performed at clinical compatible doses; this is the most significant contribution of the Thesis towards the clinical implementation of phase-contrast CT.Auf Phasenkontrast basierende Röntgentechniken sind innovative bildgebende Methoden, welche die Limitierungen der klassischen Radiologie überschreiten. Auβer der differentiellen Röntgenabsorption, auf der die herkömmliche Radiologie beruht, ist der Kontrast bei Phasenkontrast-Bildgebung durch die Brechungseffekte der Röntgenstrahlen innerhalb eines Gewebes gegeben. Die Kombination zwischen Phasenkontrast und quantitativer Computertomographie (CT) erlaubt eine höchstgenaue Rekonstruktion der Brechzahl der Gewebe. Aufgrund der hohen Empfindlichkeit dieser Methode, können tomographische Bilder mit einer klinisch verträglichen Dosis erzeugt werden. Aus all diesen Gründen, stellt Phasenkontrast-Bildgebung einen vielversprechenden Ansatz dar, welcher die diagnostische Röntgenbildgebung revolutionieren könnte. Verschiedene röntgenbildgebende Techniken werden als Phasenkontrast-Verfahren bezeichnet. Die vorliegende Doktorarbeit befasst sich mit der sogenannten Bildgebungsmethode mithilfe eines Analysatorkristalls (auf englisch: analyser-based imaging (ABI) ). ABI benutzt ein perfektes, zwischen der Probe und dem Detektor angeordnetes Kristall, um in der Probe stattfindenden Phaseneffekte zu veranschaulichen. Die quantitative Rekonstruktion des Brechungsindizes aus den CT-Daten ist jedoch nicht trivial und war vor dieser Arbeit nur für kleine Gegenstände beschrieben. Im Mittelpunkt dieser Dissertation stehen folgende wissenschaftliche Fragestellungen: (1) die Entwicklung theoretischer und rechnerischer Strategien, um die quantitative räumliche Verteilung des Brechungsindizes in größeren Organen aus biologischen Geweben (10 cm) unter Verwendung der ABI-Technik zu bilden und (2) die Vorbereitung von genauen und leistungsfähigen Rechenmitteln zur Abschätzung und Simulation der in größeren Proben bei einem CT-Bildgebungsversuch abgelagerten Strahlendosis zu treffen.
Für die Bestimmung des Brechungsindizes wurden zwei geometrische Anordnungen in Betracht gezogen und untersucht, und zwar die Konfiguration auβerhalb (out-of-plane) bzw. in der Ebene (in-plane) der Probe. Erstere wird am häufigsten in der Fachliteratur zitiert und sieht vor, dass die Probe-Drehachse sich in der parallelen Ebene zur Achse des Analysatorkristalls befindet, wobei in der zweiteren Geometrie die Drehachse orthogonal zu jener Ebene ist. Die theoretische Studie, der technische Entwurf und die experimentelle Umsetzung der geometrischen Anordnung in der Probe-Ebene stellen die Hauptaufgaben dieser Arbeit dar. Ein erstes Experiment wurde durchgeführt, um die durch quantitative Phasenkontrast-CT nach in-plane-Modus erlangten Ergebnisse mit entsprechenden, auf Absorption basierenden CT-Versuchen zu vergleichen. Eine höhere Genauigkeit sowie eine bessere Übereinstimmung mit den theoretischen Dichtewerten
wurden dadurch erzielt, dass man sich die Brechungseffekte zunutze macht, indem man die an die Probe gelieferte Dosis niedrig hält.
Eine zweite Versuchsreihe wurde auβerdem auf menschliche Brüste ausgeführt, um die Effizienz sowohl der in-plane- als auch der out-of-plane-CT-Geometrien sowie die Leistungsfähigeit der entsprechenden Bildrekonstruktionsverfahren zu überprüfen. Die gleichen Experimentalbedingungen wurden auch anhand von numerischen Simulationen untersucht und die Ergebnisse miteinander verglichen. Diese Analyse zeigt, dass die in-plane-Geometrie die Erstellung genauerer dreidimensionaler Verteilungen der Brechzahl ermöglicht, während der out-of-plane-Fall eher für die Zwecke qualitativer Untersuchungen vorzuziehen ist.
Fortschrittliche Prozeduren zur Verbesserung der Qualität von aufgezeichneten CT-Bildern wurden im Rahmen dieser Doktorarbeit konzipiert und entwickelt. Das Fazit: eine zweistufige Vorgehensweise wurde ermittelt und geprüft. Zunächst wird der Rauschpegel der Meβdaten über die Anwendung eines Zerlegungsalgorithmus mittels Wavelets gesenkt, anschlieβend gefolgt von einem Entfaltung-Verfahren. Die damit gewonnenen Bilder weisen eine erhöhte Schärfe der Schnittstellen auf. Die Objektkanten und das Signal-zu-Rausch-Verhältnis bleiben damit erhalten.
Die zweite Fragestellung dieser Arbeit war es, Lösungansätze zu erarbeiten, um die während CT-Bildgebung-Messungen über complexe biologische Proben abgegebene Dosis möglichst rapide zu berechnen. Zu diesem Zweck wurde ein Verfahren zur Beschleunigung der Konvergenz von Monte-Carlo-Simulationen auf der Grundlage der Track-Length-Estimator-Methode entwickelt und in die Open-Source-Software GATE eingegliedert. Die bisherigen Ergebnisse zeigen, dass dieses Verfahren zur selben Genauigkeit der herkömmlichen Monte-Carlo-Methoden bei gleichzeitiger Minderung bis zu zwei Gröβenordnungen der zur Berechnung einer und der selben Geometrie notwendigen Rechenzeit führt. Eine Datenbank von Dosiskurven für den Fall von monochromatischer Brust-CT ist erzeugt worden, die eine schnelle Schätzung der abgegebenen Dosis erlaubt. Darüber hinaus wurde ein Lösungsweg zur Auswahl der besten Energie und des optimalen Photonenflusses vorgeschlagen, welcher eine bedeutende Abnahme der abgelieferten Dosis zur Folge hat, und zwar ohne Bildqualitätsverluste.
Die meisten, im Rahmen dieser Doktorarbeit entwickelten Experimental- und Datenrekonstruktion-Verfahren können freilich auch an andere Phasenkontrast-Techniken angewendet werden. Es wird hiermit gezeigt, dass hochauflösende dreidimensionale bildgebende Verfahren zur Diagnostik gröβerer und komplexer biologischer Gegenstände bei klinisch verträglichen Dosen grundsätzlich eingesetzt werden können. Dies ist der nennenwerteste Beitrag dieser Dissertation zur klinischen Umsetzung der Phasenkontrast-CT
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