Phase Imaging Using Focused Polycapillary Optics.

Conventional radiographic techniques depend on attenuation, which provides low contrast between soft tissues. However, X rays can accumulate large differential phase delays even in weakly absorbing materials. This can produce significantly higher contrast. One technique for taking advantage of phase effects, propagation-based phase imaging, can yield marked edge enhancement but requires spatially coherent intense sources. Microfocus sources have sizes on the order of tens of microns but necessarily are low power and hence require long exposures. In this project, X-ray optical and computational techniques were explored to develop both edge-enhancement and phase imaging using a large spot conventional source. A polycapillary optic was employed to create a small secondary source from a large spot rotating anode X-ray generator. The secondary spot created by the focusing polycapillary optic was 114 µm ± 50 µm. Images of a 1.6 mm polyethylene rod were taken at varying distances from the optic. Edge enhancement was observed with a maximum edge-enhancement-to-noise ratio of 6.5. Insect images were also acquired and analyzed. Phase reconstructions were computed using two different approaches, weak attenuation and phase attenuation duality. Pure phase images were successfully reconstructed from the phase contrast images by employing the weak attenuation model.

Monochromatic X-ray imaging using a combination of doubly curved crystal and polycapillary X-ray lens.

A monochromatic X-ray imaging setup based on a combination of a doubly curved crystal and a polycapillary focusing X-ray lens was designed. In this setup, the bent crystal optic was used not only to monochromatize but also to focus the divergent X-ray beam from a conventional X-ray source to form a monochromatic X-ray focal spot with a size of 426 × 467 µm2 at 17.5 keV. The beam expanding from this focal point was focused by the polycapillary optic to obtain a focal spot which was then used as the monochromatic X-ray imaging virtual source. The output focal spot size of the focusing polycapillary optic at 17.5 keV was 97 µm. Compared with the beam expansion after the focal spot of the bent crystal optic, the beam expansion after the focal spot of the focusing polycapillary optic was relatively large. This was helpful for magnifying the X-ray image of the sample. The focused beam was helpful to decrease the exposure time for imaging small samples.

Measurements and simulations of focused beam for orthovoltage therapy.

PURPOSE: Megavoltage photon beams are typically used for therapy because of their skin-sparing effect. However, a focused low-energy x-ray beam would also be skin sparing, and would have a higher dose concentration at the focal spot. Such a beam can be produced with polycapillary optics. MCNP5 was used to model dose profiles for a scanned focused beam, using measured beam parameters. The potential of low energy focused x-ray beams for radiation therapy was assessed. METHODS: A polycapillary optic was used to focus the x-ray beam from a tungsten source. The optic was characterized and measurements were performed at 50 kV. PMMA blocks of varying thicknesses were placed between optic and the focal spot to observe any variation in the focusing of the beam after passing through the tissue-equivalent material. The measured energy spectrum was used to model the focused beam in MCNP5. A source card (SDEF) in MCNP5 was used to simulate the converging x-ray beam. Dose calculations were performed inside a breast tissue phantom. RESULTS: The measured focal spot size for the polycapillary optic was 0.2 mm with a depth of field of 5 mm. The measured focal spot remained unchanged through 40 mm of phantom thickness. The calculated depth dose curve inside the breast tissue showed a dose peak several centimeters below the skin with a sharp dose fall off around the focus. The percent dose falls below 10% within 5 mm of the focus. It was shown that rotating the optic during scanning would preserve the skin-sparing effect of the focused beam. CONCLUSIONS: Low energy focused x-ray beams could be used to irradiate tumors inside soft tissue within 5 cm of the surface.

The oxidative costs of territory quality and offspring provisioning.

The costs of reproduction are an important constraint that shapes the evolution of life histories, yet our understanding of the proximate mechanism(s) leading to such life-history trade-offs is not well understood. Oxidative stress is a strong candidate measure thought to mediate the costs of reproduction, yet empirical evidence supporting that increased reproductive investment leads to oxidative stress is equivocal. We investigated whether territory quality and offspring provisioning increase oxidative stress in male snow buntings (Plectrophenax nivalis) using a repeated sampling design. We show that arrival oxidative stress is not a constraint on territory quality or the number of offspring fledged. Nevertheless, owners of higher-quality territories experienced an oxidative cost, with this cost increasing more rapidly in younger males. Males that provisioned offspring at a high rate also experienced increased oxidative stress. Together, these findings support the potential role of oxidative stress in mediating life-history trade-offs. Future work should consider that reproductive workload is not limited to offspring care, and other activities - including territory defence - may contribute significantly to the costs of reproduction.

Full-field transmission x-ray imaging with confocal polycapillary x-ray optics.

A transmission x-ray imaging setup based on a confocal combination of a polycapillary focusing x-ray optic followed by a polycapillary collimating x-ray optic was designed and demonstrated to have good resolution, better than the unmagnified pixel size and unlimited by the x-ray tube spot size. This imaging setup has potential application in x-ray imaging for small samples, for example, for histology specimens.

The worm that turned.

When a patient presents with acute myelopathy in the developed world, helminthic infection is not routinely considered in the differential diagnosis. We report the case of a 34-year-old South African male who presented with acute urinary retention and lower leg paraesthesiae. Subsequently, myeloradiculopathy secondary to Schistosoma mansoni was diagnosed on the basis of typical magnetic resonance imaging changes in the conus medullaris and positive stool microscopy. Prior to this presentation the patient had lived in urban western South Africa and more recently in New Zealand, without exposure to infected water for 22 years. His symptoms and signs resolved following treatment with praziquantel and methylprednisolone. Spinal schistosomiasis is a rare but serious cause of myelopathy and should be considered in any patient who has ever visited or lived in an endemic area.

Curved crystal x-ray optics for monochromatic imaging with a clinical source.

Monochromatic x-ray imaging has been shown to increase contrast and reduce dose relative to conventional broadband imaging. However, clinical sources with very narrow energy bandwidth tend to have limited intensity and field of view. In this study, focused fan beam monochromatic radiation was obtained using doubly curved monochromator crystals. While these optics have been in use for microanalysis at synchrotron facilities for some time, this work is the first investigation of the potential application of curved crystal optics to clinical sources for medical imaging. The optics could be used with a variety of clinical sources for monochromatic slot scan imaging. The intensity was assessed and the resolution of the focused beam was measured using a knife-edge technique. A simulation model was developed and comparisons to the measured resolution were performed to verify the accuracy of the simulation to predict resolution for different conventional sources. A simple geometrical calculation was also developed. The measured, simulated, and calculated resolutions agreed well. Adequate resolution and intensity for mammography were predicted for appropriate source/optic combinations.

Microscintigraphy with high resolution collimators and radiographic detectors.

The potential use of high resolution collimators with standard radiographic detectors in place of conventional gamma cameras for high resolution microscintigraphy is presented. Polycapillary multiple hole collimators are shown to provide 10-100 micron scale spatial resolution. A series of images from arrays of 125I brachytherapy seeds in Lucite phantoms display resolution better than 0.1 mm with good sensitivity and a 30 mm field of view. In addition to application to brachytherapy seed localization, such "cellular" level resolution is necessary for high-resolution in vivo imaging in mouse models. The system could also enable the use of a wider variety of isotopes, including much lower photon energy isotopes in nuclear medicine, as the high resolution collimator allows more flexibility in detector constraints.

Beam collimation with polycapillary x-ray optics for high contrast high resolution monochromatic imaging.

Monochromatic imaging can provide better contrast and resolution than conventional broadband radiography. In broadband systems, low energy photons do not contribute to the image, but are merely absorbed, while high energy photons produce scattering that degrades the image. By tuning to the optimal energy, one can eliminate undesirable lower and higher energies. Monochromatization is achieved by diffraction from a single crystal. A crystal oriented to diffract at a particular energy, in this case the characteristic line energy, diffracts only those photons within a narrow range of angles. The resultant beam from a divergent source is nearly parallel, but not very intense. To increase the intensity, collimation was performed with polycapillary x-ray optics, which can collect radiation from a divergent source and redirect it into a quasi parallel beam. Contrast and resolution measurements were performed with diffracting crystals with both high and low angular acceptance. Testing was first done at 8 keV with an intense copper rotating anode x-ray source, then 17.5 keV measurements were made with a low power molybdenum source. At 8 keV, subject contrast was a factor of five higher than for the polychromatic case. At 17.5 keV, monochromatic contrast was two times greater than the conventional polychromatic contrast. The subject contrasts measured at both energies were in good agreement with theory. An additional factor of two increase in contrast, for a total gain of four, is expected at 17.5 keV from the removal of scatter. Scatter might be simply removed using an air gap, which does not degrade resolution with a parallel beam.

The dependence of ultrasound contrast agents backscatter on acoustic pressure: theory versus experiment.

Experimental investigations have not fully explored the interaction between ultrasound beams and microbubble contrast agents. Moreover theoretical investigations have not solved the problem of the microbubble oscillation. A simple in-vitro system based on a commercial scanner (ATL UM9) was used to insonate (3 MHz transmission) diluted contrast suspensions of Definity and Quantison at different acoustic pressures (0.27-1.52 MPa). The experimental data were referred to a blood mimicking fluid in order to extract an estimate of their scattering cross-section. The results were compared with the solutions of the three main bubble oscillatidn models, Rayleigh-Plesset, Herring and Gilmore. Non-linear solutions of the above models were produced numerically using the Mathematica Package Software. The experiments showed that both agents provided a linear increase in scattering cross-section with increasing acoustic pressure. The thick shelled Quantison provided an increasing number of scatterers with increasing acoustic pressure, which proved that free bubbles leaked out of the shell. At high acoustic pressures both Quantison and Definity scattering cross-sections were almost identical, and were probably that of a free bubble. The Rayleigh-Plesset model provided a scattering cross-section almost independent of acoustic pressure. On the contrary the scattering cross-sections calculated by the Herring and Gilmore models solutions displayed a definite dependence on acoustic pressure of an order higher than one, which is slightly higher than the order of dependence exhibited by the experimental data. However, the increase of the experimentally measured scattering cross-section with acoustic pressure was sharper than the calculated one by the above two models. This is most probably due to the fact that the models simulated damped and not free bubble oscillations. In conclusion the Rayleigh-Plesset model was inadequate in describing the bubble oscillations even at small diagnostic acoustic pressures. The Herring and Gilmore models could simulate the dependence of the scattering cross-section of encapsulated microbubbles on acoustic pressure. However the contribution of free bubble oscillations has still to be modelled.

X-ray optics for better diagnostic imaging.

Polycapillary x-ray optics provide an innovative new way to control x-ray beams. Placing these optics after the object to be imaged provides very efficient rejection of Compton scatter, while allowing image magnification without loss of resolution, image demagnification, or image shaping to match with digital detectors. Measured scatter rejection optics had primary transmissions greater than 50% and scatter transmission of less than 1%. For a 5-cm thick Lucite phantom, this resulted in a contrast enhancement of nearly a factor of two at 20 keV and three at 40 keV. The magnification from the tapered capillary optics improved the MTF at all frequencies out to 1.8 times the original system resolution. Increases below the system resolution are most important because clinically relevant structures generally occupy lower spatial frequencies. Alternatively, placing a collimating optic and diffracting crystal before the patient provides sufficient monochromatic beam intensity for medical imaging. Contrast, resolution, and intensity measurements were performed with both high and low angular acceptance crystals. At 8 keV, contrast enhancement was a factor of 5 relative to the polychromatic case, in good agreement with theoretical values. At 17.5 keV, monochromatic subject contrast was more than a factor of 2 times greater than the conventional polychromatic contrast. An additional factor of two increase in contrast, for a total factor of four, is expected from the removal of scatter in a large beam clinical system. The measured angular resolution after the crystal was 0.4 mrad for a silicon crystal.

The Newfoundland and Labrador Heart Health Program dissemination story: the formation and functioning of effective coalitions.

Newfoundland and Labrador is the most easterly province of Canada (O'Loughlin et al., Figure 1) with a population of 537,000. Rural in nature, 50% of the population resides in widely-dispersed communities of less than 2500 people. The economy traditionally relied on the fishing industry, but with the closure of the once lucrative cod fishery in 1991, the poorest province in Canada faced a difficult economic climate with up to 20% unemployment rates. With little funding available to supplement or sustain expensive initiatives, the Demonstration Phase of the Newfoundland and Labrador Heart Health Program (1990-1996) focused on how community-based programs are developed and sustained, with a view to diffusion throughout the province. The whole province was defined as the demonstration site for the project, and a community mobilization strategy was used with extensive reliance on community health professionals and volunteer contributions.

Imaging characteristics of x-ray capillary optics in digital mammography.

Computed radiography (CR) has shown promise in digital mammographic screening due to its good low spatial frequency MTF and its relatively wide exposure latitude. The CR image format has not gained acceptance clinically because of reduced high spatial frequency resolution as compared to film-screen images. X-ray capillary optics, aligned between the breast and CR phosphor imaging plate, will capture primary x-ray photons almost exclusively. Due to the very small angle of acceptance, scattered photons angled more than about 1.6 x 10(-3) radians from primary trajectory will not be accepted at the capillary optic entrance. The virtual elimination of detected scatter means almost 100% of the possible primary contrast should be visible in the image. In addition, the image can be magnified without focal spot blurring. Effective resolution of CR images can be increased by a factor equal to that magnification. Clinical implementation of future capillary optics are expected to be either in the form of a large, stationary, post-patient optic that accepts primary from the entire breast or a fan-shaped optic that is scanned across the breast. Measurements of a test capillary optic showed a reduction of scatter fraction to 0.018. Images of a lucite contrast detail phantom revealed a corresponding increase in image contrast when compared to anti-scatter grid and no grid methods. Spectral transmission measurements using a high-purity germanium detector showed good primary transmission (45%-50%) in the mammographic energy range. The MTF measurements of both stationary and scanned capillary optics showed improvement at the 5% MTF level to 8.4 mm-1 for scanned optics and 9.2 mm-1 for stationary optics representing a 68% and 84% respective increase over the CR MTF without magnification or capillary optics.

Applications and measurements of polycapillary x-ray optics.

The recent invention of Kumakhov polycapillary x-ray and neutron optics has expanded the ways x-ray beams can be controlled. X rays incident on the interior of glass tubes at small angles can be guided down the tubes by total external reflection. Now, arrays of curved tapered capillaries can be used to focus, collimate, and filter x-ray radiation. Extensive research is being conducted on the performance and potential applications of these optics. Potential medical applications include mammography, digital energy subtraction angiography, and focused beam therapy. Other applications are x-ray lithography, x-ray astronomy, crystal diffraction, x-ray fluorescence, and neutron prompt gamma analysis.

Measurements of capillary x-ray optics with potential for use in mammographic imaging.

Capillary optic arrays are bundles of hollow glass capillaries which guide x rays in a manner similar to the way fiber optics guide light. Focused postpatient capillary optic arrays have the potential to significantly improve both contrast and resolution of mammographic images compared to conventional antiscatter grids. Contrast can be improved by the nearly total scatter rejection of the optic. Effective resolution can be improved by geometric magnification without increased focal spot blurring. The best results were found for borosilicate glasses, with transmissions in excess of 60% for 22-cm-long fibers. To evaluate the scatter rejection properties, the transmission of off-axis radiation was measured. Transmission drops to < 1% at an angular displacement of 2.7 mrad. Transmission of a bulk capillary array dropped to near zero if the source was at an angle of 2.5 mrad. This implies excellent scatter rejection capabilities. To evaluate whether unchanneled photons might still reach the detector, absorption measurements were also performed on fibers and arrays. Absorption was found to be adequate for scatter rejection. All of the data agreed well with numerical simulations. Performance calculations for two potential optics geometries gave promising results.

Influence of time separation on variability estimates of topographic measurements with confocal scanning laser tomography.

PURPOSE: Confocal scanning laser tomography is a new technique with significant potential in the treatment of glaucoma. Before new techniques are widely implemented in clinical practice, factors that affect the variability of measurements should be identified. The purpose of this study was to determine the influence of various time separations between images on test-retest variability of topographic measurements. SUBJECTS AND METHODS: Our sample contained 10 healthy subjects whose mean age was 46.30 years (range 25-60 years). For each subject we obtained six sets of three images each with the Heidelberg Retina Tomograph. The images in set 1 were obtained in one sitting, in set 2 separated by 1 h each, in set 3 by 1 day each, in set 4 by 1 week each, in set 5 by 2 weeks each, and in set 6 by 4 weeks each. RESULTS: The mean (+/-1 standard deviation) test-retest variability, estimated in terms of the 90% confidence interval, ranged from 55.63 (+/-24.37) mum in set 1 to 64.37 (+/-28.00) mum in set 4. The differences between the variability estimates were not statistically significantly different among the six sets of images. CONCLUSIONS: Our results show that the short-term and long-term variability of topographic measurements with scanning laser tomography are not different. Since variability was not influenced by images obtained at different sittings, our study suggests that the alignment algorithms used by the Heidelberg Retina Tomograph are robust.

Use of capillary optics as a beam intensifier for a Compton x-ray source.

The use of Kumakhov capillary optics will significantly enhance the performance of near-monochromatic, Compton backscattered x-ray programs. The Vanderbilt University Medical Free-Electron Laser Center is developing the capability to create these tunable x rays for medical imaging. The present transport has only reflection optics, and the beam is quite large in diameter at the laboratory. Low loss collimation of this beam would allow higher x-ray intensities after transport. This article describes experimental and computer simulation results which predict the expected performance for a multifiber Kumakhov collimator for use in the x-ray beam transport. Estimates from our research are that a multifiber optic formed of individual polycapillary fibers could be used to capture the full 7 mrad of the Vanderbilt x-ray beam and collimate it to a 1-2 mrad divergence with approximately 40%-50% transmission efficiency. This optic should increase the x-ray intensity at the laboratory level by a factor of > or = 5 by decreasing the beam divergence and subsequent spot size. Additionally, analysis of monolithic optics of fused multicapillary fibers predicts an increase in the intensity of the x rays at the laboratory by a factor of 55. These optics can have tapered channels that greatly decrease their exit divergence. This will greatly enhance the capabilities of this unique x-ray source. This article reports the initial results from a collaboration between Vanderbilt, The Center for X-Ray Optics at University at Albany, SUNY, and X-Ray Optical Systems in Albany, NY.

Evaluation of Questor urine screening system for bacteriuria and pyuria.

AIMS: To evaluate the Questor automated bacteriuria and pyuria screening system; to compare its performance with that of a reference method; and to assess its usefulness in a routine clinical laboratory. METHODS: The Questor urine screening system was compared with a comprehensive regimen to detect urinary tract infection, using pour-plate viable counts to determine the numbers of bacteria present in urine samples, a wide range of other cultural methods, microscopic findings and clinical information. RESULTS: The optimal performance in detecting significant growths was a sensitivity of 93%, a specificity of 74%, a positive predictive value of 43% and a negative predictive value of 98%. The list price per test is 0.17 pounds and the capital cost of the system is 39,950 pounds. Questor can test 50 samples an hour and can be operated by one member of the laboratory staff, who is not required to make interpretative judgments--for example, a medical laboratory assistant. CONCLUSIONS: The sensitivity and specificity of the Questor was better than that obtained from other screening systems using the same protocol. The system was easy to use and is a useful addition to the methods available for screening for bacteriuria.