A Pilot Study to Assess the Performance of Phase-Sensitive Breast Tomosynthesis.

Background A new modality, phase-sensitive breast tomosynthesis (PBT), may have similar diagnostic performance to conventional breast tomosynthesis but with a reduced radiation dose. Purpose To perform a pilot study of the performance of a novel PBT system compared with conventional digital breast tomosynthesis (DBT) in patients undergoing additional diagnostic imaging workup for breast lesions. Materials and Methods In a prospective study from June 2020 to March 2021, participants with suspicious breast lesions detected at screening DBT or MRI were recruited for additional PBT imaging before additional diagnostic workup or biopsy. In this pilot study, nine radiologists independently evaluated image quality and assessed the likelihood of lesion malignancy by retrospectively evaluating DBT and PBT images in two separate reading sessions. Image quality was rated subjectively using a Likert scale from 1 to 5. Areas under the receiver operating characteristic curve (AUCs) were used to compare the lesion classification (malignant vs benign) performance of the radiologists. Results Images in 50 patients (mean age, 56 years ± 12 [SD]; 49 women) with 52 evaluable lesions (28 malignant) were assessed. For image appearance and general feature visibility, DBT images had a higher total mean image quality score (3.8) than PBT images (2.9), with P < .002 for each comparison. For classification of lesions as benign or malignant, the AUCs were 0.74 for both PBT and DBT. PBT images were acquired at a 24% mean radiation dose reduction (mean, 1.78 mGy vs 2.34 mGy for DBT; P < .001). Conclusion The phase-sensitive breast tomosynthesis system had a 24% lower mean radiation dose compared with digital breast tomosynthesis, although with lower image quality. Diagnostic performance of the system remains to be determined in larger studies. © RSNA, 2022 Online supplemental material is available for this article. See also the editorial by Gao and Moy in this issue.

Evaluation and comparison of a CdTe based photon counting detector with an energy integrating detector for X-ray phase sensitive imaging of breast cancer.

PURPOSE: To compare imaging performance of a cadmium telluride (CdTe) based photon counting detector (PCD) with a CMOS based energy integrating detector (EID) for potential phase sensitive imaging of breast cancer. METHODS: A high energy inline phase sensitive imaging prototype consisting of a microfocus X-ray source with geometric magnification of 2 was employed. The pixel pitch of the PCD was 55µm, while 50µm for EID. The spatial resolution was quantitatively and qualitatively assessed through modulation transfer function (MTF) and bar pattern images. The edge enhancement visibility was assessed by measuring edge enhancement index (EEI) using the acrylic edge acquired images. A contrast detail (CD) phantom was utilized to compare detectability of simulated tumors, while an American College of Radiology (ACR) accredited phantom for mammography was used to compare detection of simulated calcification clusters. A custom-built phantom was employed to compare detection of fibrous structures. The PCD images were acquired at equal, and 30% less mean glandular dose (MGD) levels as of EID images. Observer studies along with contrast to noise ratio (CNR) and signal to noise ratio (SNR) analyses were performed for comparison of two detection systems. RESULTS: MTF curves and bar pattern images revealed an improvement of about 40% in the cutoff resolution with the PCD. The excellent spatial resolution offered by PCD system complemented superior detection of the diffraction fringes at boundaries of the acrylic edge and resulted in an EEI value of 3.64 as compared to 1.44 produced with EID image. At equal MGD levels (standard dose), observer studies along with CNR and SNR analyses revealed a substantial improvement of PCD acquired images in detection of simulated tumors, calcification clusters, and fibrous structures. At 30% less MGD, PCD images preserved image quality to yield equivalent (slightly better) detection as compared to the standard dose EID images. CONCLUSION: CdTe-based PCDs are technically feasible to image breast abnormalities (low/high contrast structures) at low radiation dose levels using the high energy inline phase sensitive imaging technique.

A phase sensitive x-ray breast tomosynthesis system: Preliminary patient images with cancer lesions.

Phase-sensitive x-ray imaging continues to attract research for its ability to visualize weakly absorbing details like those often encountered in biology and medicine. We have developed and assembled the first inline-based high-energy phase sensitive breast tomosynthesis (PBT) system, which is currently undergoing patient imaging testing at a clinical site. The PBT system consists of a microfocus polychromatic x-ray source and a direct conversion-based flat panel detector coated with a 1 mm thick amorphous selenium layer allowing a high detective quantum efficiency at high energies. The PBT system scans a compressed breast over 15° with 9 angular projection views. The high-energy scan parameters are carefully selected to ensure similar or lower mean glandular dose levels to the clinical standard of care systems. Phase retrieval and data binning are applied to the phase contrast angular projection views and a filtered back-projection algorithm is used to reconstruct the final images. This article reports the distributions of radiation dose versus thickness of the compressed breasts at 59 and 89 kV and sample PBT images acquired from 3 patients. Preliminary PBT images demonstrate the feasibility of this new imaging modality to acquire breast images at lower radiation dose as compared to the clinical digital breast tomosynthesis system with enhanced lesion characteristics (i.e. lesion spiculation and margins).

Dual-energy phase retrieval algorithm for inline phase sensitive x-ray imaging system.

Phase retrieval is vital for quantitative x-ray phase contrast imaging. This work presents an iterative method to simultaneously retrieve the x-ray absorption and phase images from a single x-ray exposure. The proposed approach uses the photon-counting detectors' energy-resolving capability in providing multiple spectrally resolved phase contrast images from a single x-ray exposure. The retrieval method is derived, presented, and experimentally tested with a multi-material phantom in an inline phase contrast imaging setup. By separating the contributions of photoelectric absorption and Compton scattering to the attenuation, the authors divide the phase contrast image into two portions, the attenuation map arises from photoelectric absorption and a pseudo phase contrast image generated by electron density. This way one can apply the Phase Attenuation Dualiby (PAD) algorithm and Fresnel propagation for the iteration. The retrieval results from the experimental images show that this iterative method is fast, accurate, robust against noise, and thus yields noticeable enhancement in contrast to noise ratios.

Mathematical estimation of half-value layer thicknesses.

OBJECTIVE: The objective of this article is to introduce a simplified and swift method to satisfactorily estimate the half-value layers (HVL), quarter-value layer (QVL), and tenth-value layer (TVL) from the x-ray spectra emitted by any diagnostic radiology or kV radiotherapy x-ray tubes. METHODS: A CdTe x-ray and Gamma detector (X-123 CdTe, AmpTek Inc.) is used to measure the x-ray spectra at four different x-ray energies (low, mid, high energy x-rays) with different external filtering. The software "SpekCalc GUI" (Developed in McGill University, Montreal, Canada) is also used to obtain the simulated x-ray spectra. Both measured and simulated spectra are used to compute the HVL thicknesses of Aluminum by a mathematical method presented in this article. Next, the HVL thicknesses for corresponding tube potentials are also measured by calibrated ionization chamber and varying thicknesses of aluminum plates. Finally, the computed and measured HVL, QVL, and TVL thicknesses are compared to evaluate the efficacy of the presented method. RESULTS: The results show acceptable concordance between computed and measured quantities. The disagreement rates between measured HVL and the values derived mathematically from the x-ray spectra are 10 to 90 micrometers of Aluminum at tube potentials of 31 kV to 120 kV. As it is shown, a negligible discrepancy is observed between the analytical estimation and the experimental assessments. CONCLUSION: The HVL is an essential component in the evaluation of the quality of an x-ray beam. However, its measurement could occasionally be challenging, time-consuming, or uncertain due to some technical difficulties. Although the scope of this study is not to undermine the value of conventional and widely accepted practice to determine the HVL thickness, the introduced method provides the fast, more convenient, and comparably reliable technique to estimate the HVL, QVL, and TVL by employing the given x-ray spectrum.

Development and preclinical evaluation of a patient-specific high energy x-ray phase sensitive breast tomosynthesis system.

BACKGROUND: This article reports the first x-ray phase sensitive breast tomosynthesis (PBT) system that is aimed for direct translation to clinical practice for the diagnosis of breast cancer. PURPOSE: To report the preclinical evaluation and comparison of the newly built PBT system with a conventional digital breast tomosynthesis (DBT) system. METHODS AND MATERIALS: The PBT system is developed based on a comprehensive inline phase contrast theoretical model. The system consists of a polyenergetic microfocus x-ray source and a flat panel detector mounted on an arm that is attached to a rotating gantry. It acquires nine projections over a 15° angular span in a stop-and-shoot manner. A dedicated phase retrieval algorithm is integrated with a filtered back-projection method that reconstructs tomographic slices. The American College of Radiology (ACR) accreditation phantom, a contrast detail (CD) phantom and mastectomy tissue samples were imaged at the same glandular dose levels by both the PBT and a standard of care DBT system for image quality characterizations and comparisons. RESULTS: The PBT imaging scores with the ACR phantom are in good to excellent range and meet the quality assurance criteria set by the Mammography Quality Standard Act. The CD phantom image comparison and associated statistical analyses from two-alternative forced-choice reader studies confirm the improvement offered by the PBT system in terms of contrast resolution, spatial resolution, and conspicuity. The artifact spread function (ASF) analyses revealed a sizable lateral spread of metal artifacts in PBT slices as compared to DBT slices. Signal-to-noise ratio values for various inserts of the ACR and CD phantoms further validated the superiority of the PBT system. Mastectomy sample images acquired by the PBT system showed a superior depiction of microcalcifications vs the DBT system. CONCLUSION: The PBT imaging technology can be clinically employed for improving the accuracy of breast cancer screening and diagnosis.

Impact of a single distance phase retrieval algorithm on spatial resolution in X-ray inline phase sensitive imaging.

A single-projection based phase retrieval method based on the phase attenuation duality principle (PAD) was used to compare the spatial resolution of the acquired phase sensitive and PAD processed phase retrieved images. An inline phase sensitive prototype was used to acquire the phase sensitive images. The prototype incorporates a micro-focus x-ray source and a flat panel detector with a 50 µm pixel pitch. A phantom composed of a 2 cm thick 50-50 adipose-glandular mimicking slab sandwiched with a 0.82 cm thick slanted PMMA sharp edge was used. Phase sensitive image of the phantom was acquired at 120 kV, 3.35 mAs with a 16 µm tube focal spot size under a geometric magnification (M) of 2.5. The PAD based method was applied to the acquired phase sensitive image for the retrieval of phase values. With necessary data processing, modulation transfer function (MTF) curves were determined for the estimation and comparison of the spatial resolution. The PAD processed phase retrieved values of the phantom were in good agreement with the theoretically calculated values. Phase sensitive images showed higher spatial resolution at all spatial frequencies compared to the phase retrieved images. It was noted that the high-frequency signal components in the retrieved image were suppressed that resulted in lower MTF values. When compared to the phase sensitive image, the cutoff resolution (10% MTF) for phase retrieved image dropped 32% from 15.6 lp/mm (32µm) to 10.6 lp/mm (47µm). The resolution offered by this phase sensitive prototype is radiographically enough to detect breast cancer.

Evaluation of ADAM33 gene's single nucleotide polymorphism variants against asthma and the unique pattern of inheritance in Northern and Central Punjab, Pakistan.

OBJECTIVES: To investigate the relationship of 3 single nucleotide polymorphism (SNP) variants of ADAM33 with asthma susceptibility in patients from Northern and Central Punjab, Punjab, Pakistan. Methods: In this case-control study, healthy and asthmatic participants were recruited between 2015 and 2017. The SNPs of ADAM33 gene, rs2280089, rs2280090, and rs2280091 were analyzed in 296 asthma patients and 343 healthy controls, as well as linkage disequilibrium and haplotype analysis. RESULTS: The non-significant differences were observed in allele and genotype frequencies of the SNPs in asthmatic and healthy persons even after population stratification based on age, caste, gender, family history, and environment. Although these SNPs were non-significant for disease susceptibility among children and adults, a fixed unique pattern of inheritance was nevertheless observed for the studied SNPs. Linkage disequilibrium analysis presented a very strong linkage between the SNP variants to predict their co-inheritance in study population. However, none of the haplotypes were found to be associated with asthma disease development. CONCLUSION: The studied SNPs of ADAM33 appeared to be non-significant for asthma susceptibility in  Northern and Central Punjabi population. The fixed allele combination inheritance pattern was a unique observation contrary to findings in other global populations.

Image quality assessment of a photon counting detector in x-ray projection imaging.

The recent advancements in the photon counting detection have created a significant growing research interest in the x-ray imaging. It is essential to objectively understand the image quality parameters of a photon counting detector before developing imaging applications. In this work, we have assessed the imaging quality of a cadmium telluride (CdTe) based PCD in projection imaging mode. The detector is 70.4 mm × 6.6 mm dimensions. The detector has a pixel array of 64×4 with a pixel pitch of 1.1 mm×1.65 mm. With each pixel having 4 channels in its corresponding ASIC, this PCD can create three bin images from a single projection. With a microfocus x-ray source, the imaging quality in each bin image was measured in terms of the spatial resolution, noise, and contrast to noise ratio (CNR). We used 70 kV, 50µA, 10 s (0.5mAs) with 0.5mm thick aluminum (Al) filter for the acquisition of each image. The MTF curves indicated that the spatial resolution for the bin-1, bin-2, and bin-3 was almost identical. The NNPS curves indicated that the noise in bin 1 and bin 2 images was almost the same for all frequencies while bin 3 image had relatively less noise. The CNR analyses showed that the bin-1 image had the highest CNR. As the flux was increased from 0.5 to 1 mAs, the number of detected counts also increased that resulted in the CNR increase. Beyond this flux, the pulse pileup occurred due to which multiple counts were read as single that resulted in few detected counts and lower CNR. The knowledge of the spatial resolution, noise, and CNR in terms of energy binning allows the determination and optimization of imaging techniques necessary for various applications.

Detectability comparison of simulated tumors in digital breast tomosynthesis using high-energy X-ray inline phase sensitive and commercial imaging systems.

This study compared the detectability of simulated tumors using a high-energy X-ray inline phase sensitive digital breast tomosynthesis (DBT) prototype and a commercial attenuation-based DBT system. Each system imaged a 5-cm thick modular breast phantom with 50-50 adipose-glandular percentage density containing contrast-detail (CD) test objects to simulate different tumor sizes. A commercial DBT system acquired 15 projection views over 15 degrees (15d-15p) was used to acquire the attenuation-based projection views and to reconstruct the conventional DBT slices. Attenuation-based projection views were acquired at 32 kV, 46 mAs with a mean glandular dose (Dg) of 1.6 mGy. For acquiring phase sensitive projection views, the prototype utilized two acquisition geometries: 11 projection views were acquired over 15 degrees (15d-11p), and 17 projection views were acquired over 16 degrees (16d-17p) at 120 kV, 5.27 mAs with 1.51 mGy under the magnification (M) of 2. A phase retrieval algorithm based on the phase-attenuation duality (PAD) was applied to each projection view, and a modified Feldkamp-Davis-Kress (FDK) algorithm was used to reconstruct the phase sensitive DBT slices. Simulated tumor margins were rated as more conspicuous and better visualized for both phase sensitive acquisition geometries versus conventional DBT imaging. The CD curves confirmed the improvement in both contrast and spatial resolutions with the phase sensitive DBT imaging. The superiority of the phase sensitive DBT imaging was further endorsed by higher contrast to noise ratio (CNR) and figure-of-merit (FOM) values. The CNR improvements provided by the phase sensitive DBT prototype were sufficient to offset the noise reduction provided by the attenuation-based DBT imaging.

Characterization of Continuous and Pulsed Emission modes of a Hybrid Micro Focus X-ray Source for Medical Imaging Applications.

The aim of this study was to quantitatively characterize a micro focus x-ray tube that can operate in both continuous and pulsed emission modes. The micro focus x-ray source (Model L9181-06, Hamamatsu Photonics, Japan) has a varying focal spot size ranging from 16-50 µm as the source output power changes from 10-39 W. We measured the source output, beam quality, focal spot sizes, kV accuracy, spectra shapes and spatial resolution. Source output was measured using an ionization chamber for various tube voltages (kVs) with varying current (µA) and distances. The beam quality was measured in terms of half value layer (HVL), kV accuracy was measured with a non-invasive kV meter, and the spectra was measured using a compact integrated spectrometer system. The focal spot sizes were measured using a slit method with a CCD detector with a pixel pitch of 22 µm. The spatial resolution was quantitatively measured using the slit method with a CMOS flat panel detector with a 50 µm pixel pitch, and compared to the qualitative results obtained by imaging a contrast bar pattern. The focal spot sizes in the vertical direction were smaller than that of the horizontal direction, the impact of which was visible when comparing the spatial resolution values. Our analyses revealed that both emission modes yield comparable imaging performances in terms of beam quality, spectra shape and spatial resolution effects. There were no significantly large differences, thus providing the motivation for future studies to design and develop stable and robust cone beam imaging systems for various diagnostic applications.

Detectability comparison between a high energy x-ray phase sensitive and mammography systems in imaging phantoms with varying glandular-adipose ratios.

The objective of this study was to demonstrate the potential benefits of using high energy x-rays in comparison with the conventional mammography imaging systems for phase sensitive imaging of breast tissues with varying glandular-adipose ratios. This study employed two modular phantoms simulating the glandular (G) and adipose (A) breast tissue composition in 50 G-50 A and 70 G-30 A percentage densities. Each phantom had a thickness of 5 cm with a contrast detail test pattern embedded in the middle. For both phantoms, the phase contrast images were acquired using a micro-focus x-ray source operated at 120 kVp and 4.5 mAs, with a magnification factor (M) of 2.5 and a detector with a 50 µm pixel pitch. The mean glandular dose delivered to the 50 G-50 A and 70 G-30 A phantom sets were 1.33 and 1.3 mGy, respectively. A phase retrieval algorithm based on the phase attenuation duality that required only a single phase contrast image was applied. Conventional low energy mammography images were acquired using GE Senographe DS and Hologic Selenia systems utilizing their automatic exposure control (AEC) settings. In addition, the automatic contrast mode (CNT) was also used for the acquisition with the GE system. The AEC mode applied higher dose settings for the 70 G-30 A phantom set. As compared to the phase contrast images, the dose levels for the AEC mode acquired images were similar while the dose levels for the CNT mode were almost double. The observer study, contrast-to-noise ratio and figure of merit comparisons indicated a large improvement with the phase retrieved images in comparison to the AEC mode images acquired with the clinical systems for both density levels. As the glandular composition increased, the detectability of smaller discs decreased with the clinical systems, particularly with the GE system, even at higher dose settings. As compared to the CNT mode (double dose) images, the observer study also indicated that the phase retrieved images provided similar or improved detection for all disc sizes except for the disk diameters of 2 mm and 1 mm for the 50 G-50 A phantom and 3 mm and 0.5 mm for the 70 G-30 A phantom. This study demonstrated the potential of utilizing a high energy phase sensitive x-ray imaging system to improve lesion detection and reduce radiation dose when imaging breast tissues with varying glandular compositions.

Noise Power Characteristics of a Micro-Computed Tomography System.

OBJECTIVE: The aim of this study was to investigate the noise power properties of a micro-computed tomography (micro-CT) system under different operating conditions. METHODS: A commercial micro-CT was used in the study that used a flat panel detector with a 127-µm-pixel pitch and a micro-focus x-ray tube. Conical tubes of various diameters were used under different acquisition conditions. Multidimensional noise power spectrums were used as a metric to investigate the noise properties of the system. Noise power spectrum was calculated from the difference data generated by subtraction of 2 identical scans. The noise properties with respect to various parameters that include the impact of number of projections, x-ray spectra, milliampere-second, slice location, object diameter, voxel size, geometric magnification (M), back-projection filters, and reconstruction magnification (Mrecon) were studied. RESULTS: At a same isocentric exposure rate of 270 mR/s, the noise power was much lower for the image reconstructed with 3672 views (122 seconds) as compared with the 511 views (17 seconds), whereas at a fixed isocentric exposure of 4600 mR, the noise power levels were almost similar. Image noise with a 50-kV beam was higher as compared with the 90-kV beam at a same isocentric exposure. Image noise from a 16-mm-diameter conical tube was much lower as compared with the 28- and 56-mm tubes under identical isocentric exposures. The choice of back-projection filter influences noise power spectrum curves in terms of width and amplitudes. Reconstruction magnification applied during the reconstruction process increased the noise power at lower spatial frequencies but reduced the noise power at higher spatial frequencies. It can be established that, for small details corresponding to high spatial frequencies, reconstruction magnification can provide an improved signal-to-noise ratio. At all spatial frequencies, the in-plane images had lower noise power levels as compared with the z-plane images. CONCLUSIONS: The noise power properties investigated in this study provide important image quality references for refined cone beam system development, optimization, and operations.

The impact of spectral filtration on image quality in micro-CT system.

This paper aims to evaluate the impact of spectral filtration on image quality in a microcomputed tomography (micro-CT) system. A mouse phantom comprising 11rods for modeling lung, muscle, adipose, and bones was scanned with 17 s and 2min, respectively. The current (µA) for each scan was adjusted to achieve identical entrance exposure to the phantom, providing a baseline for image quality evaluation. For each region of interest (ROI) within specific composition, CT number variations, noise levels, and contrast-to-noise ratios (CNRs) were evaluated from the reconstructed images. CT number variations and CNRs for bone with high density, muscle, and adipose were compared with theoretical predictions. The results show that the impact of spectral filtration on image quality indicators, such as CNR in a micro-CT system, is significantly associated with tissue characteristics. The findings may provide useful references for optimizing the scanning parameters of general micro-CT systems in future imaging applications.

Investigation of spatial resolution characteristics of an in vivo micro computed tomography system.

The spatial resolution characteristics of an in vivo micro computed tomography (CT) system was investigated in the in-plane (x-y), cross plane (z) and projection imaging modes. The micro CT system utilized in this study employs a flat panel detector with a 127 µm pixel pitch, a micro focus x-ray tube with a focal spot size ranging from 5-30 µm, and accommodates three geometric magnifications (M) of 1.72, 2.54 and 5.10. The in-plane modulation transfer function (MTF) curves were measured as a function of the number of projections, geometric magnification (M), detector binning and reconstruction magnification (MRecon). The in plane cutoff frequency (10% MTF) ranged from 2.31 lp/mm (M=1.72, 2×2 binning) to 12.56 lp/mm (M=5.10, 1×1 binning) and a bar pattern phantom validated those measurements. A slight degradation in the spatial resolution was observed when comparing the image reconstruction with 511 and 918 projections, whose effect was visible at the lower frequencies. Small value of MRecon has little or no impact on the in-plane spatial resolution owning to a stable system. Large value of MRecon has implications on the spatial resolution and it was evident when comparing the bar pattern images reconstructed with MRecon=1.25 and 2.5. The cross plane MTF curves showed that the spatial resolution increased as the slice thickness decreased. The cutoff frequencies in the projection imaging mode yielded slightly higher values as compared to the in-plane and cross plane modes at all the geometric magnifications (M). At M=5.10, the cutoff resolution of the projection and cross plane on an ultra-high contrast resolution bar chip phantom were 14.9 lp/mm and 13-13.5 lp/mm. Due to the finite focal spot size of the x-ray tube, the detector blur and the reconstruction kernel functions, the system's spatial resolution does not reach the limiting spatial resolution as defined by the Nyquist's detector criteria with an ideal point source. The geometric magnification employed in the micro CTs provide a tradeoff between field of view and spatial resolution for a wide range of applications.

Improving the accuracy of MTF measurement at low frequencies based on oversampled edge spread function deconvolution.

The modulation transfer function (MTF) of a radiographic system is often evaluated by measuring the system's edge spread function (ESF) using edge device. However, the numerical differentiation procedure of the traditional slanted edge method amplifies noises in the line spread function (LSF) and limits the accuracy of the MTF measurement at low frequencies. The purpose of this study is to improve the accuracy of low-frequency MTF measurement for digital x-ray imaging systems. An edge spread function (ESF) deconvolution technique was developed for MTF measurement based on the degradation model of slanted edge images. Specifically, symmetric oversampled ESFs were constructed by subtracting a shifted version of the ESF from the original one. For validation, the proposed MTF technique was compared with conventional slanted edge method through computer simulations as well as experiments on two digital radiography systems. The simulation results show that the average errors of the proposed ESF deconvolution technique were 0.11% ± 0.09% and 0.23% ± 0.14%, and they outperformed the conventional edge method (0.64% ± 0.57% and 1.04% ± 0.82% respectively) at low-frequencies. On the experimental edge images, the proposed technique achieved better uncertainty performance than the conventional method. As a result, both computer simulation and experiments have demonstrated that the accuracy of MTF measurement at low frequencies can be improved by using the proposed ESF deconvolution technique.

Low dose high energy x-ray in-line phase sensitive imaging prototype: Investigation of optimal geometric conditions and design parameters.

The objective of this study was to investigate the optimization of a high energy in-line phase sensitive x-ray imaging prototype under different geometric and operating conditions for mammography application. A phase retrieval algorithm based on phase attenuation duality (PAD) was applied to the phase contrast images acquired by the prototype. Imaging performance was investigated at four magnification values of 1.67, 2, 2.5 and 3 using an acrylic edge, an American College of Radiology (ACR) mammography phantom and contrast detail (CD) phantom with tube potentials of 100, 120 and 140 kVp. The ACR and CD images were acquired at the same mean glandular dose (MGD) of 1.29 mGy with a computed radiography (CR) detector of 43.75 µm pixel pitch at a fixed source to image distance (SID) of 170 cm. The x-ray tube focal spot size was kept constant as 7 µm while a 2.5 mm thick aluminum (Al) filter was used for beam hardening. The performance of phase contrast and phase retrieved images were compared with computer simulations based on the relative phase contrast factor (RPF) at high x-ray energies. The imaging results showed that the x-ray tube operated at 100 kVp under the magnification of 2.5 exhibits superior imaging performance which is in accordance to the computer simulations. As compared to the phase contrast images, the phase retrieved images of the ACR and CD phantoms demonstrated improved imaging contrast and target discrimination. We compared the CD phantom images acquired in conventional contact mode with and without the anti-scatter grid using the same prototype at 1.295 mGy and 2.59 mGy using 40 kVp, a 25 µm rhodium (Rh) filter. At the same radiation dose, the phase sensitive images provided improved detection capabilities for both the large and small discs, while compared to the double dose image acquired in conventional mode, the observer study also indicated that the phase sensitive images provided improved detection capabilities for the large discs. This study therefore validates the potential of using high energy phase contrast x-ray imaging to improve lesion detection and reduce radiation dose for clinical applications such as mammography.

Method for determining the modulation transfer function of X-ray fluorescence mapping system.

A method for determining the modulation transfer function (MTF) in direct X-ray fluorescence mapping (XFM) system is reported. With a standard container filled with homogeneous gold nanoparticle (GNP) solution (1% by weight), sharp edges are made and utilized to acquire the data for edge spread function (ESF). Through necessary data processing such as signal extraction, attenuation correction and curve fitting and proper calculations of differentiating and Fourier transform, MTF can be determined. Influencing factors of MTF determination in XFM system are thoroughly discussed in theory and validated by experiments. The results show that different mapping steps do not noticeably affect the measured MTF, while MTF is greatly degraded as the collimator-to-object distance increases. The theoretical analyses and experimental validations of the MTF determination are useful and helpful for imaging performance evaluation, system design and optimal operations. The presented methodology could be applied in other XRF based systems with modified imaging trajectories.

Monotone spline regression for accurate MTF measurement at low frequencies.

The modulation transfer function (MTF) of radiographic systems is frequently evaluated by the system's line spread function (LSF) using narrow slits. The conventional slit method requires LSF tail approximation, which is achieved by exponentially extrapolating the LSF tails beyond 1% of peak value. However, the estimated MTF at low frequencies from extrapolation may not reflect the true performance of the system. In this study, a monotone spline regression technique for LSF tail approximation is developed to improve the accuracy of MTF estimation at low frequencies. This technique is based on the underlying physical principles of the system response. The advantages of this technique are demonstrated with simulated examples of which the true MTFs are known. The application of this measurement technique is also demonstrated.