BioMedical quantitative X-Ray Imaging. Emmanuel Brun Researcher Inserm Université Grenoble Alpes
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1 BioMedical quantitative X-Ray Imaging Emmanuel Brun Researcher Inserm Université Grenoble Alpes 1
2 Outline Introduction K-Edge Imaging Patient imaging at the European synchrotron Medical Phase Contrast Imaging High Resolution Phase Contrast Imaging for medical research Conclusion 2 Emmanuel Brun Medical Imaging - Hercules specialized course May 19 th
3 A brief history of time in medical imaging Tesla s discovery of rotating magnetic field Spin echo (Hahn) Lauterbur invents MRI Damadian shows that tumors has a different NMR signature MRI 1882 Curie(Brachy)Therapy Becquerel discovery of uranium natural radioactivity First scintigraphy Joliot-Curies artificial radioactivity discovery Positron emission tomography Nuclear Medecine Johan Radon publishes his Radon Transform Cormack first paper 1971 First Clinical Scan (Hounsfield and Ambrose) 1980 s st µct 1 st Human Synchrotron CT X-ray Crooks tubes Cathode rays 1 st Synchrotron project Rayleigh s Theory of sound First RADAR First medical application of ultra sound Ultra-sound
4 A variety of imaging modalities UltraSound 4 X-ray CT MRI PET CT Emmanuel Brun Medical Imaging - Hercules specialized course May 19th
5 Why developing new imaging modalities? Spatial resolution Contrast sensitivity Temporal resolution 5 Emmanuel Brun Medical Imaging - Hercules specialized course May 19 th
6 K-edge subtraction (KES) imaging (Iodine infusion) ID17, ESRF: Ag (80.72 KeV),, Gd, Ba, Ho, Yb,, Au (80.72 KeV) Mass attenuation μ/ρ (cm 2 /g) Ek = kev Iodine Bone Tissue Bayat et al. Phys Med Biol 2001 Negligible absorption for Iodine Subtraction image Marked absorption for Iodine 6 Emmanuel Brun Medical Imaging - Hercules specialized course May 19 th
7 KES imaging in vivo rabbit Tissue Density Xenon Iodine 7 Emmanuel Brun Medical Imaging - Hercules specialized course May 19 th
8 Applications of KES imaging High brilliance of synchrotron x-rays Direct quantification of contrast elements within organs Access to data on organ function: Regional lung ventilation : Xenon Perfusion (organ, tissue): Iodine, Gadolinium Spatial resolution : current resolution on ESRF-ID17 : 1 µm; in vivo ~3 µm IV Coronary Angiography Human Brain Perfusion (rat) 1500 ml 100 g -1 Lung Blood Volume (Rabbit) 0 ml 100 g -1 Bertrand et Coll. Eur Heart J Adam JF et Coll. J Cereb Blood Flow Metab Suhonen H et Coll. PMB Emmanuel Brun Medical Imaging - Hercules specialized course May 19 th
9 Dynamic KES-CT: regional lung ventilation Lung Xe washin: Image Image Image Image Image Xe/O 2 Débit (ml/s) P TR (mmhg) Respirateur Porra et al. J Appl Physiol 96: , Time (s) 9 Emmanuel Brun Medical Imaging - Hercules specialized course May 19 th
10 Dynamic KES-CT: regional lung ventilation Time constant (t) of Xe wash-in: C Xe =C 0 (1-e -t /t ) Specific ventilation (sv) = ventilation/v voxel : sv = 1/t Xe (mg/cm 3 ) Time (s) Simon BA, J of Clin Mon Comp 16: , 2000 Porra et al. J Appl Physiol 96: , Emmanuel Brun Medical Imaging - Hercules specialized course May 19 th
11 Regional ventilation distribution Bayat S. et al. Am J Respir Crit Care Med 180: , Emmanuel Brun Medical Imaging - Hercules specialized course May 19 th
12 Spatial Resolution Best spatial resolution currently available for imaging regional lung function Baseline Tissue Xenon KES sv n 200 % sv mean cm Pixel: 47 µm; 1800 projections; Acquisition time : 10 s OVA Layachi, S. et al. J Appl Physiol 115: , Emmanuel Brun Medical Imaging - Hercules specialized course May 19th
13 Results: regional ventilation Sample composite KES Iomeprol aerosol deposition in 2 representative animals Image voxel : µm Acquisition time: 2 sec/image MMAD : 2.6 ± 0.1 μm 13 Emmanuel Brun Medical Imaging - Hercules specialized course May 19 th
14 KES-CT of within-tidal changes in regional lung blood and gas Gas Fraction (Xe) Blood Fraction (I) Porra L et al. European Respiratory Journal 44.Suppl 58 (2014): P Emmanuel Brun Medical Imaging - Hercules specialized course May 19th
15 Patient Imaging at the European Synchrotron 15 Emmanuel Brun Medical Imaging - Hercules specialized course May 19 th
16 Dose Issue 62 million CT exams performed each year in the USA the most frequently used 3D medical diagnostic tool Recent studies estimated that 3% of the cancers may be attributable to diagnostic CT 2 Cumulative dose of 50 mgy in childhood triples the risk of brain tumor and leukemia 3 1 Brenner DJ, Hall EJ. Computed tomography--an increasing source of radiation exposure. N. Engl. J. Med. 2007;357(22): De González AB, Darby S. Risk of cancer from diagnostic X-rays: Estimates for the UK and 14 other countries. Lancet. 2004;363(9406): Pearce MS, Salotti JA, Little MP, et al. Radiation exposure from CT scans in childhood and subsequent risk of leukaemia and brain tumours: A retrospective cohort study. Lancet. 2012;380(9840): Emmanuel Brun Medical Imaging - Hercules specialized course May 19 th
17 Imaging conditions Patient positioning tomography +/- post injection +/- 3D Same beam used for radiotherapy Monochromatic (80 kev ) Same flux but attenuated (14.5 cm PMMA) Integration detector (HPGe) Pixel size 350µm * 1cm Bem collimated to 2mm (high) * 15 cm (width) Distance between patient and detector: 6m 17 Emmanuel Brun Medical Imaging - Hercules specialized course May 19 th
18 Geometry of acquisition 18 Emmanuel Brun Medical Imaging - Hercules specialized course May 19th
19 Comparison with hospital scanner Acquisition protocols Energy PMMA thickness (cm) Slice thickness (mm) Pixel size (mm) Number of projections (-) Dose CTDI (mgy) Hospital Standard head (patient) Inner ear (phantom) 120 kvp 250 ma 120 kvp 350 ma n.a n.a 33 n.a n.a 183 GE Revolution scanner ESRF Patient acquisition 80 kev 191 ma Low dose (phantom) 80 kev Catphan Phantom 19 Emmanuel Brun Medical Imaging - Hercules specialized course May 19 th
20 Comparison with hospital CT Hospital (183mGy) ESRF (14.8mGy) 20 Emmanuel Brun Medical Imaging - Hercules specialized course May 19 th
21 Quantitative Comparison Acquisition protocols CNR SNR MTF (pl/mm) CTDI (mgy) Conventional CT Standard head Inner ear Patient acquisition ESRF Low dose Emmanuel Brun Medical Imaging - Hercules specialized course May 19 th
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