Purpose: About one third of all deaths worldwide can be traced to some form of cardiovascular disease. The gold standard for the diagnosis and interventional treatment of blood vessels is digital subtraction angiography (DSA). An alternative to DSA is K-edge subtraction (KES) imaging, which has been shown to be advantageous for moving organs and for eliminating image artifacts caused by patient movement. As highly brilliant, monochromatic x-rays are required for this method, it has been limited to synchrotron facilities so far, restraining the applicability in the clinical routine. Over the past decades, compact synchrotron x-ray sources based on inverse Compton scattering have been evolving; these provide x-rays with sufficient brilliance and meet spatial and financial requirements for laboratory settings or university hospitals.
Approach: We demonstrate a proof-of-principle KES imaging experiment using the Munich Compact Light Source (MuCLS), the first user-dedicated installation of a compact synchrotron x-ray source worldwide. A series of experiments were performed both on a phantom and an excised human carotid to demonstrate the ability of the proposed KES technique to separate the iodine contrast agent and calcifications.
Results: It is shown that the proposed filter-based KES method allows for the iodine-contrast agent and calcium to be clearly separated, thereby providing x-ray images only showing one of the two materials.
Conclusions: The results show that the quasimonochromatic spectrum of the MuCLS enables filter-based KES imaging and can become an important tool in preclinical research and possible future clinical diagnostics.
Inverse Compton scattering of infrared photons from relativistic electrons generates brilliant quasi-monochromatic X-rays with an electron accelerator with dimensions of only a few meters, e.g. at the storage ring based inverse Compton scattering X-ray source employed at the Munich Compact Light Source. Availability of synchrotron light in a laboratory comes along with broader access to synchrotron techniques, especially in - but not limited to - clinical imaging and pre-clinical biomedical applications. We have been exploring the latter in daily user operation since commissioning of the MuCLS. So far, the focus has been on dynamic in vivo small-animal respiratory imaging, grating-based phase-contrast imaging, e.g. for quantitative material decomposition, and spectroscopic imaging, e.g. for angiography.
About one third of all deaths worldwide can be traced back to some form of cardiovascular disease. The gold standard for the diagnosis and interventional treatment of blood vessels is digital subtraction angiography (DSA). An alternative to DSA is K-edge subtraction (KES) imaging, which has been shown to be advantageous for moving organs and to eliminate image artifacts caused by patient movement. As highly brilliant, monochromatic X-rays are required for this method, it has been limited to synchrotron facilities so far, restraining the applicability in clinical routine. Over the past decades, compact synchrotron X-ray sources based on inverse Compton scattering have been evolving, which provide X-rays with sufficient brilliance and that meet spatial and financial requirements affordable in laboratory settings or for university hospitals. In this study, we demonstrate a proofof-principle KES imaging experiment using the Munich Compact Light Source (MuCLS), the first user-dedicated installation of a compact synchrotron X-ray source worldwide. It is shown that the proposed filter-based KES method allows for iodine-contrast agent and calcium to be clearly separated, thereby providing X-ray images only showing one of the two materials. The results show that the quasi-monochromatic spectrum of the MuCLS enables filter-based K-edge subtraction imaging and can become an important tool in pre-clinical research and possible future clinical diagnostics.
While conventional x-ray tube sources reliably provide high-power x-ray beams for everyday clinical practice, the broad spectra that are inherent to these sources compromise the diagnostic image quality. For a monochromatic x-ray source on the other hand, the x-ray energy can be adjusted to optimal conditions with respect to contrast and dose. However, large-scale synchrotron sources impose high spatial and financial demands, making them unsuitable for clinical practice. During the last decades, research has brought up compact synchrotron sources based on inverse Compton scattering, which deliver a highly brilliant, quasi-monochromatic, tunable x-ray beam, yet fitting into a standard laboratory. One application that could benefit from the invention of these sources in clinical practice is coronary angiography. Being an important and frequently applied diagnostic tool, a high number of complications in angiography, such as renal failure, allergic reaction, or hyperthyroidism, are caused by the large amount of iodine-based contrast agent that is required for achieving sufficient image contrast. Here we demonstrate monochromatic angiography of a porcine heart acquired at the MuCLS, the first compact synchrotron source. By means of a simulation, the CNR in a coronary angiography image achieved with the quasi-mono-energetic MuCLS spectrum is analyzed and compared to a conventional x-ray-tube spectrum. The results imply that the improved CNR achieved with a quasi-monochromatic spectrum can allow for a significant reduction of iodine contrast material.
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