Istituto di Cristallografia-Consiglio Nazionale delle Ricerche, via Amendola 122/O, I-70125 Bari, Italy.
Med Phys. 2009 Oct;36(10):4644-53. doi: 10.1118/1.3213086.
The x-ray transmitted beam from any material/tissue depends on the complex refractive index (n= 1-delta+ibeta), where delta is responsible for the phase shift and beta is for the beam attenuation. Although for human tissues, the delta cross section is about 1000 times greater than the beta ones in the x-ray energy range from 10 to 150 keV, the gain in breast tumor visualization of phase-contrast mammography (PCM) with respect to absorption contact imaging (AI) is limited by the maximum dose that can be delivered to the patient. Moreover, in-line PC imaging (PCI) is the simplest experimental mode among all available x-ray PCI techniques since no optics are needed. The latter is a fundamental requirement in order to transfer the results of laboratory research into hospitals. Alternative to synchrotron radiation sources, the implementation of relativistic Thomson-scattering (TS) x-ray sources is particularly suitable for hospital use because of their high peak brightness within a relatively compact and affordable system. In this work, the possibility to realize PCM using a TS source in a hospital environment is studied, accounting for the effect of a finite deliverable dose on the PC visibility enhancement with respect to AI.
The contrast-to-noise ratio of tumor-tissue lesions in PCM has been studied on the bases of a recent theoretical model, describing image contrast formation by means of both wave-optical theory and the mutual coherence formalism. The latter is used to describe the evolution, during wave propagation, of the coherence of the wave field emitted by a TS source. The contrast-to-noise ratio for both PCI and AI has been analyzed in terms of tumor size, beam energy, detector, and source distances, studying optimal conditions for performing PCM. Regarding other relevant factors which could influence "tumor" visibility, the authors have assumed simplified conditions such as a spherical shape description of the tumor inclusion, a constant surrounding background, ideal conditions for the calculus of the contrast-to-noise ratio.
The results show the possibility to enhance with PCI the signal-to-noise ratio for features in the submillimeter scale. This finding could give PCM a great advantage with respect to AI, opening the possibility to decrease the number of wrong diagnoses before histological exams. The results agree with experimental evidences obtained by Dreossi et al. [D. Dreossi et al., "The mammography project at the SYRMEP beamline," Eur. J. Radiol. 68, S58-S62 (2008)] with real PCM using synchrotron radiation.
The challenging characteristics of TS sources, suitable for PCM, should be fluxes of at least 10(11) photons/s emitted by very small sources of about 10 microm, together with moderate energy spreads (less than 10%) in order to realize both sufficient spatial coherence and enough fluence on the patient, collecting images in reasonable exposure times. These fluxes will be achieved by next generation TS sources which are already under development.
任何物质/组织的 X 射线透射束都取决于复杂折射率(n=1-delta+ibeta),其中 delta 负责相位偏移,beta 负责光束衰减。尽管对于人体组织,在 10 到 150keV 的 X 射线能量范围内,delta 截面大约比 beta 截面大 1000 倍,但相对于吸收接触成像(AI),相位对比乳腺摄影(PCM)的乳腺肿瘤可视化增益受到可以递送给患者的最大剂量的限制。此外,在线 PC 成像(PCI)是所有可用 X 射线 PCI 技术中最简单的实验模式,因为不需要光学器件。这是将实验室研究结果转移到医院的基本要求。替代同步辐射源,实施相对论汤姆逊散射(TS)X 射线源特别适合医院使用,因为它们在相对紧凑且负担得起的系统中具有较高的峰值亮度。在这项工作中,研究了在医院环境中使用 TS 源实现 PCM 的可能性,同时考虑了有限可交付剂量对相对于 AI 的 PC 可见度增强的影响。
基于最近的理论模型,研究了 PCM 中肿瘤组织病变的对比噪声比,该模型通过波动光学理论和互相干形式主义来描述图像对比度的形成。后者用于描述 TS 源发出的波场在波传播过程中相干性的演化。分析了 PCI 和 AI 的对比噪声比,研究了肿瘤大小、光束能量、探测器和源距离的最优条件,以进行 PCM。关于可能影响“肿瘤”可见度的其他相关因素,作者假设了肿瘤包含物的球形描述、恒定的周围背景、对比噪声比计算的理想条件等简化条件。
结果表明,PCM 有可能增强亚毫米级特征的信噪比。这一发现可能使 PCM 相对于 AI 具有巨大优势,从而有可能在组织学检查之前减少误诊的数量。结果与 Dreossi 等人[D. Dreossi 等人,“SYRMEP 光束线上的乳腺摄影项目”,Eur. J. Radiol. 68,S58-S62(2008)]使用同步辐射获得的实际 PCM 的实验证据一致。
适合 PCM 的 TS 源的挑战性特征应该是至少 10(11)个光子/s 的通量,由大约 10 微米的小源发射,并具有适度的能谱展宽(小于 10%),以便在合理的曝光时间内实现足够的空间相干性和足够的患者通量。这些通量将由正在开发的下一代 TS 源实现。