Abstract
X-ray chest radiography is an inexpensive and broadly available tool for initial assessment of the lung in clinical routine, but typically lacks diagnostic sensitivity for detection of pulmonary diseases in their early stages. Recent X-ray dark-field (XDF) imaging studies on mice have shown significant improvements in imaging-based lung diagnostics. Especially in the case of early diagnosis of chronic obstructive pulmonary disease (COPD), XDF imaging clearly outperforms conventional radiography. However, a translation of this technique towards the investigation of larger mammals and finally humans has not yet been achieved. In this letter, we present the first in-vivo XDF full-field chest radiographs (32 × 35 cm2) of a living pig, acquired with clinically compatible parameters (40 s scan time, approx. 80 µSv dose). For imaging, we developed a novel high-energy XDF system that overcomes the limitations of currently established setups. Our XDF radiographs yield sufficiently high image quality to enable radiographic evaluation of the lungs. We consider this a milestone in the bench-to-bedside translation of XDF imaging and expect XDF imaging to become an invaluable tool in clinical practice, both as a general chest X-ray modality and as a dedicated tool for high-risk patients affected by smoking, industrial work and indoor cooking.
Highlights
Recent small-animal studies demonstrated that XDF imaging enhances pulmonary diagnosis, e.g. for the early detection and staging of COPD2–4, pulmonary fibrosis[5], pneumothoraces[6] and neonatal lung injury associated with mechanical ventilation[7]
Among these, grating-based imaging (GBI) methods are most promising for clinical applications, as they are compatible with conventional X-ray sources and detectors
GBI has the advantage of simultaneously acquiring a conventional attenuation image alongside the XDF signal, providing the radiologists with both functional (XDF) and anatomical imaging by means of a single scan only
Summary
X-ray chest radiography is an inexpensive and broadly available tool for initial assessment of the lung in clinical routine, but typically lacks diagnostic sensitivity for detection of pulmonary diseases in their early stages. We present the first XDF chest radiographs with a FOV of 32 × 35 cm[2] of a living pig acquired with a novel high-energy XDF scanner (illustrated in Fig. 1a) in 40 seconds scan time. In order to demonstrate the potential of the complementarity between XDF imaging and conventional radiography, Fig. 3 shows two regions of interest with similar attenuation but different XDF characteristics: healthy lung tissue with a large number of alveolar interfaces yielding a strong XDF signal versus the air-filled stomach with no inherent microstructure and no XDF contrast. The results presented address the major challenges of chest XDF imaging, namely: achieving a large FOV, high visibility at clinically compatible X-ray energies, a short acquisition time, and a clinically acceptable radiation dose. This could include other medical applications such as improved osteoporosis fracture risk assessment[27] and novel XDF micro-bubble contrast agents[28], as well as non-medical fields like airport security and material or food science
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