Burkhardt Rico, Gora Thomas, Fingerle Alexander A, Sauter Andreas P, Meurer Felix, Umkehrer Stephan, von Teuffenbach Maximilian, Kampfer Severin, Schilling Daniela, Feuchtinger Annette, Walch Axel K, Rummeny Ernst, Combs Stephanie E, Schmid Thomas E, Pfeiffer Franz, Wilkens Jan J, Herzen Julia
Department of Radiation Oncology, Technical University of Munich, School of Medicine and Klinikum rechts der Isar, Munich, Germany.
Institute of Radiation Medicine (IRM), Helmholtz Zentrum München, Neuherberg, Germany.
Eur Radiol. 2021 Jun;31(6):4175-4183. doi: 10.1007/s00330-020-07459-4. Epub 2020 Nov 19.
Assessing the advantage of x-ray dark-field contrast over x-ray transmission contrast in radiography for the detection of developing radiation-induced lung damage in mice.
Two groups of female C57BL/6 mice (irradiated and control) were imaged obtaining both contrasts monthly for 28 weeks post irradiation. Six mice received 20 Gy of irradiation to the entire right lung sparing the left lung. The control group of six mice was not irradiated. A total of 88 radiographs of both contrasts were evaluated for both groups based on average values for two regions of interest, covering (irradiated) right lung and healthy left lung. The ratio of these average values, R, was distinguished between healthy and damaged lungs for both contrasts. The time-point when deviations of R from healthy lung exceeded 3σ was determined and compared among contrasts. The Wilcoxon-Mann-Whitney test was used to test against the null hypothesis that there is no difference between both groups. A selection of 32 radiographs was assessed by radiologists. Sensitivity and specificity were determined in order to compare the diagnostic potential of both contrasts. Inter-reader and intra-reader accuracy were rated with Cohen's kappa.
Radiation-induced morphological changes of lung tissue caused deviations from the control group that were measured on average 10 weeks earlier with x-ray dark-field contrast than with x-ray transmission contrast. Sensitivity, specificity, and accuracy doubled using dark-field radiography.
X-ray dark-field radiography detects morphological changes of lung tissue associated with radiation-induced damage earlier than transmission radiography in a pre-clinical mouse model.
• Significant deviations from healthy lung due to irradiation were measured after 16 weeks with x-ray dark-field radiography (p = 0.004). • Significant deviations occur on average 10 weeks earlier for x-ray dark-field radiography in comparison to x-ray transmission radiography. • Sensitivity and specificity doubled when using x-ray dark-field radiography instead of x-ray transmission radiography.
评估在小鼠发育性辐射诱导肺损伤检测的X线摄影中，X线暗场对比度相对于X线透射对比度的优势。
两组雌性C57BL/6小鼠（辐照组和对照组）在辐照后28周内每月成像获取两种对比度图像。六只小鼠接受20 Gy的全右肺辐照，左肺未受辐照。六只小鼠的对照组未接受辐照。基于两个感兴趣区域（覆盖辐照的右肺和健康的左肺）的平均值，对两组的88张两种对比度的X光片进行评估。对于两种对比度，分别确定健康肺和受损肺的这些平均值之比R。确定R值偏离健康肺超过3σ的时间点，并在两种对比度之间进行比较。使用Wilcoxon-Mann-Whitney检验来检验两组之间无差异的零假设。由放射科医生评估32张X光片。确定敏感性和特异性以比较两种对比度的诊断潜力。使用Cohen's kappa评估阅片者间和阅片者内的准确性。
辐射诱导的肺组织形态学变化导致与对照组出现偏差，使用X线暗场对比度测量比使用X线透射对比度平均早10周。使用暗场X线摄影时，敏感性、特异性和准确性提高了一倍。
在临床前小鼠模型中，X线暗场摄影比透射摄影更早检测到与辐射诱导损伤相关的肺组织形态学变化。
• 使用X线暗场摄影，辐照后16周可检测到与健康肺的显著偏差（p = 0.004）。• 与X线透射摄影相比，X线暗场摄影平均早10周出现显著偏差。• 使用X线暗场摄影而非X线透射摄影时，敏感性和特异性提高了一倍。
