A Phase-Contrast breast CT facility based on a high-resolution CdTe photon-counting detector is under development at Elettra, the Italian Synchrotron Radiation (SR) facility in Trieste. The CT system exploits propagation-based phasecontrast imaging and phase-retrieval algorithm. The voxel size is 57×57×50 μm3 and the delivered MGDs, about 5 mGy, are comparable with clinical breast CT systems. In the present contribution, the comparisons between histological breast cancers and full breast CT images are presented from samples of breast mastectomy. The high resolution of the breast CT images and low noise due to the phase contrast allow a very fine matching between x-ray CT and histology at acceptable delivered doses.
A program devoted to performing the first in vivo synchrotron radiation (SR) breast computed tomography (BCT) is ongoing at the Elettra facility. Using the high spatial coherence of SR, phase-contrast (PhC) imaging techniques can be used. The latest high-resolution BCT acquisitions of breast specimens, obtained with the propagation-based PhC approach, are herein presented as part of the SYRMA-3D collaboration effort toward the clinical exam. Images are acquired with a 60-μm pixel dead-time-free single-photon-counting CdTe detector. The samples are imaged at 32 and 38 keV in a continuous rotating mode, delivering 5 to 20 mGy of mean glandular dose. Contrast-to-noise ratio (CNR) and spatial resolution performances are evaluated for both PhC and phase-retrieved images, showing that by applying the phase-retrieval algorithm a five-time CNR increase can be obtained with a minor loss in spatial resolution across soft tissue interfaces. It is shown that, despite having a poorer CNR, PhC images can provide a sharper visualization of microcalcifications, thus being complementary to phase-retrieved images. Furthermore, the first full-volume scan of a mastectomy sample (9 × 9 × 3 cm3) is reported. This investigation into surgical specimens indicates that SR BCT in terms of CNR, spatial resolution, scan duration, and scan volume is feasible.
An accurate measurement of the breast glandular fraction, or glandularity, is important for many research and clinical applications, such as breast cancer risk assessment. We propose a method to estimate the loss of glandular tissue detail due to the limited voxel size in tomographic images of the breast. CT images of a breast tissue specimen were acquired using a CdTe single photon counting detector (nominal pixel size of 60 μm) and using a monochromatic synchrotron radiation x-ray beam. Images were reconstructed using a filtered backprojection algorithm at seven different voxel sizes (range 60-420 μm, with a 60 μm step) and twelve groups of Regions of Interest (ROIs) with different percentage and patterns of glandular tissue were extracted. All ROIs within each group contained the same portion of the image (and therefore the same glandular fraction) reconstructed at a different voxel size. The glandular tissue was segmented and the glandularity calculated for all ROIs. A machine learning algorithm was trained on the glandularity values as a function of reconstruction voxel size. After the training was completed, the algorithm could estimate, given a tomographic breast image reconstructed at a given voxel size with a certain glandularity, the increase (or decrease) of glandularity if the same image were reconstructed with a smaller (or larger) voxel dimension. The algorithm was tested on six additional groups of ROIs, resulting in an average relative standard error between the calculated and estimated glandularity of 0.02 ± 0.016.
A program devoted to perform the first in-vivo monochromatic breast computed tomography (BCT) is ongoing at the Elettra Synchrotron Facility. Since the synchrotron radiation provides high energy resolution and spatial coherence, phase-contrast (PhC) imaging techniques can be used. The latest high resolution BCT acquisitions of breast specimens, obtained with the propagation-based PhC approach, are herein presented as part of a wider framework, devoted to the optimization of acquisition and reconstruction parameters towards the clinical exam. Images are acquired with a state-of-the-art dead-time-free single-photon-counting CdTe detector with a 60 µm pixel size. The samples are imaged at 32 and 38 keV in continuous rotating mode, delivering 5-20 mGy of mean glandular dose (MGD). Contrast-to-noise ratio (CNR) and spatial resolution performances are evaluated for both absorption and phase-retrieved images considering tumor/adipose tissue interfaces. We discuss two different phase-retrieval approaches, showing that a remarkable CNR increase (from 0.5 to 3.6) can be obtained without a significant loss in spatial resolution. It is shown that, even if the non-phase-retrieved image has a poorer CNR, it is useful for evaluating the spiculation of a microcalcification: in this context, absorption and phase-retrieved images have to be regarded as complementary information. Furthermore, the first full volume acquisition of a mastectomy, with a 9 cm diameter and 3 cm height, is reported. This investigation on surgical specimens indicates that monochromatic BCT with synchrotron radiation in terms of CNR, spatial resolution, scan duration and scan volume is feasible.
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