X-ray Dark-field Radiography - In-Vivo Diagnosis of Lung Cancer in Mice

Deniz Ali Bölükbas,Felix G Meinel,Margarita Braunagel,Katharina Hellbach,Lukas B Gromann,Franz Pfeiffer,Andre Yaroshenko,Kai Scherer,Silke Meiners,Jens Von Berg,Maximilian F Reiser,Oliver Eickelberg,Julia Herzen

doi:10.1038/s41598-017-00489-x

Abstract

Accounting for about 1.5 million deaths annually, lung cancer is the prevailing cause of cancer deaths worldwide, mostly associated with long-term smoking effects. Numerous small-animal studies are performed currently in order to better understand the pathogenesis of the disease and to develop treatment strategies. Within this letter, we propose to exploit X-ray dark-field imaging as a novel diagnostic tool for the detection of lung cancer on projection radiographs. Here, we demonstrate in living mice bearing lung tumors, that X-ray dark-field radiography provides significantly improved lung tumor detection rates without increasing the number of false-positives, especially in the case of small and superimposed nodules, when compared to conventional absorption-based imaging. While this method still needs to be adapted to larger mammals and finally humans, the technique presented here can already serve as a valuable tool in evaluating novel lung cancer therapies, tested in mice and other small animal models.

Highlights

With approximately 1.5 million deaths a year worldwide, lung cancer is the leading cause of cancer-induced deaths[1, 2]
The detection of lung cancer using X-ray dark-field radiography was assessed in two steps
We presented the very first dose-compatible in-vivo dark-field measurements of mice with lung cancer and found a superior diagnostic performance compared to conventional radiography

Summary

Introduction

With approximately 1.5 million deaths a year worldwide, lung cancer is the leading cause of cancer-induced deaths[1, 2]. The average size of missed lung nodules on a X-ray radiography is no less than 15 mm[5] These results may explain why conventional x-ray chest radiography is not optimal as a mortality reducing screening program for (early) detection of lung cancer[6]. In order to better understand the pathogenesis and develop treatment strategies numerous small-animal studies are currently being performed. In these studies, it is essential to be able to precisely detect and track the development of lung nodules in vivo. To address the aforementioned shortcomings, we propose to utilize the recently developed technique called X-ray dark-field radiography for the improved in-vivo assessment of lung cancer[8, 9]. Correspondence and requests for materials should be addressed to K.S

Methods

Results

Conclusion