Slot Scanning Research Articles

Simulation of Slot-Scan imaging system with GATE and images quality evaluation

Interest in slot scanning imaging system has been increased recently because of its advantages such as high image resolution, reduction in patient dose and reduction in image distortion. The purpose of this study is to simulate a slot scanning imaging system using GATE multi-purpose Monte Carlo code and design an object phantom to evaluate image quality. The energy spectrum of X-ray in the radiological diagnostic range was simulated by GATE Monte Carlo code. An object phantom consisting of stripes with different thicknesses of copper was then designed to determine CNR and line pairs per millimeter to determine spatial resolution.The results showed that the simulated energy spectrum were in accordance with experiment. The evaluated parameters of image quality obtained from the simulations were compared with X-ray images using standard image quality criteria to determine the capabilities of the slot scanning imaging method. The spatial resolution of the simulated images was obtained to be 1.6 lp / mm for the slot scanning method, which is in the range of clinical radiology images. Therefore, this simulated model can be used to investigate and optimize other influential parameters such as filtration effect and collimator slit width effect, object distance to the detector ... in slot scanning imaging system.

Influence of lumbosacral transitional vertebrae on spinopelvic parameters using biplanar slot scanning full body stereoradiography―analysis of 291 healthy volunteers

BackgroundProper identification of lumbosacral transitional vertebrae (LSTV) is important to characterize the relationship between the transitional segment and adjacent levels. Classical classification schemes are inaccurate with respect to the whole spine. We propose a precise vertebral numbering method and investigated the relationship between LSTV and whole-body sagittal alignment. MethodsA total of 291 healthy adult volunteers with no history of spinal disease were evaluated with biplanar slot scanning full body stereoradiography to determine the prevalence of LSTV. Vertebrae were counted from the first cervical vertebra using both coronal and sagittal plane images. We then investigated the influence of LSTV on whole-body sagittal alignment in 279 participants. Whole-body key parameters descriptive statistics were compared among groups according to the number of vertebrae (L4, L5, and L6). Statistical analysis was performed between normal and LSTV cases using the Steel-Dwass analysis. ResultsOf the 291 subjects, 14 (4.8%) had 23 vertebrae and 16 (5.5%) had 25 vertebrae. Eleven (3.8%) had Th11, 3 (1.0%) had L4, and 1 (0.3%) had Th11 + L6, 16 (5.5%) had L6. Compared with the normal group, the sacral base in relation to the pelvis was higher in the L4 group and lower in the L6 group. The C2–C7 angle and lumbar lordosis (LL) were increased in both the L4 and L6 groups. All remaining parameters were decreased in the L4 group and increased in the L6 group. The relationship between LL and PI was similar in the normal and LSTV groups, despite the difference in the sacral base location. ConclusionsWe propose a precise method for numbering the vertebrae using coronal and sagittal full body images. The spinopelvic parameters of the LSTV population significantly differed from those in the normal spine population due to differences in the sacral base location.

A phantom study on dose efficiency for orthopedic applications: Comparing slot-scanning radiography using ultra-small-angle tomosynthesis to conventional radiography.

This paper studies the abilities of a twin-robotic x-ray slot-scanning system for orthopedic imaging to reduce dose by scatter rejection compared to conventional digital radiography. We investigate the dose saving capabilities, especially in terms of the signal- and the contrast-to-noise ratio, as well as the scatter-to-primary ratio of the proposed slot-scanning method in comparison to the state-of-the-art method for length-extended imaging. As a baseline, we use x-ray parameters of two clinically established acquisition protocols that provide the same detector entrance dose but are profoundly different in patient dose. To obtain an estimate of the photon-related noise directly from an x-ray image, we implement a Poisson-Gaussian noise model. This model is used to compare the dose efficiency of two settings and combined with the well-known to determine the transmission parameters. We present a method with an associated measurement protocol, utilizing the robotic capabilities of the used system to automatically obtain quasi-scatter-free ground-truth data with exact geometric correspondence to full-field and slot acquisitions. In total, we investigate two body regions (thoracic spine and lumbar spine) in anterior-posterior view with two patient sizes (BMI = 22 and 30) in two acquisition modes (conventional and slot scan with a flat-panel detector) with and without anti-scatter grid using an anthropomorphic upper-body phantom. We have shown that it is feasible to combine the proposed approach with the for the determination of scatter rejection parameters. The use of an anti-scatter grid is indicated for full-field acquisitions allowing for dose savings up to 46% compared to their gridless counterparts. When changing the acquisition mode to the investigated slot scan, the use of an anti-scatter grid has no major impact on the image quality in terms of dose efficiency, in particular for patients with a BMI of 22. However, an increased contrast improvement factor was found. For normal-sized patients, up to 53% of dose can be saved additionally in comparison to full-field acquisitions with grid. Moreover, we could demonstrate that a slot size of 5cm and air gap of 10cm is sufficient to achieve scatter-to-primary ratios, which are equal or better compared to those of the full-field acquisitions with a grid. We have shown, that the slot-scanning approach is always superior to the conventional full-field acquisition in terms of signal-to-noise and scatter-to-primary ratios. Compared to the state-of-the-art acquisition protocols with a grid, dose savings up to 53% are possible due to the scatter rejection without compromising the SNR. Hence, the use of the slot-scanning method is indicated, especially when it comes to regularly carried-out follow-up acquisitions, for example, in the case of scoliosis monitoring.

Long-length tomosynthesis and 3D-2D registration for intraoperative assessment of spine instrumentation

Purpose. A system for long-length intraoperative imaging is reported based on longitudinal motion of an O-arm gantry featuring a multi-slot collimator. We assess the utility of long-length tomosynthesis and the geometric accuracy of 3D image registration for surgical guidance and evaluation of long spinal constructs. Methods. A multi-slot collimator with tilted apertures was integrated into an O-arm system for long-length imaging. The multi-slot projective geometry leads to slight view disparity in both long-length projection images (referred to as ‘line scans’) and tomosynthesis ‘slot reconstructions’ produced using a weighted-backprojection method. The radiation dose for long-length imaging was measured, and the utility of long-length, intraoperative tomosynthesis was evaluated in phantom and cadaver studies. Leveraging the depth resolution provided by parallax views, an algorithm for 3D-2D registration of the patient and surgical devices was adapted for registration with line scans and slot reconstructions. Registration performance using single-plane or dual-plane long-length images was evaluated and compared to registration accuracy achieved using standard dual-plane radiographs. Results. Longitudinal coverage of ∼50–64 cm was achieved with a single long-length slot scan, providing a field-of-view (FOV) up to (40 × 64) cm2, depending on patient positioning. The dose-area product (reference point air kerma × x-ray field area) for a slot scan ranged from ∼702–1757 mGy·cm2, equivalent to ∼2.5 s of fluoroscopy and comparable to other long-length imaging systems. Long-length scanning produced high-resolution tomosynthesis reconstructions, covering ∼12–16 vertebral levels. 3D image registration using dual-plane slot reconstructions achieved median target registration error (TRE) of 1.2 mm and 0.6° in cadaver studies, outperforming registration to dual-plane line scans (TRE = 2.8 mm and 2.2°) and radiographs (TRE = 2.5 mm and 1.1°). 3D registration using single-plane slot reconstructions leveraged the ∼7–14° angular separation between slots to achieve median TRE ∼2 mm and <2° from a single scan. Conclusion. The multi-slot configuration provided intraoperative visualization of long spine segments, facilitating target localization, assessment of global spinal alignment, and evaluation of long surgical constructs. 3D-2D registration to long-length tomosynthesis reconstructions yielded a promising means of guidance and verification with accuracy exceeding that of 3D-2D registration to conventional radiographs.

New Quantitative Calculation method of Contrast Values in Slot Scan Image

New Quantitative Calculation method of Contrast Values in Slot Scan Image

CORR Synthesis: Can Guided Growth for Angular Deformity Correction Be Applied to Management of Pediatric Patellofemoral Instability?

CORR Synthesis: Can Guided Growth for Angular Deformity Correction Be Applied to Management of Pediatric Patellofemoral Instability?

Image Distortion in Biplanar Slot Scanning: Part 2 Technology-specific Factors.

Biplanar digital slot scanning technology has become the standard of care in the treatment of scoliosis. Yet, the amount of distortion and reproducibility of this type of imaging modality has yet to be fully investigated. In our paper "Image distortion in biplanar slot scanning: part 1 patient-specific factors" we found that there was potentially clinically impactful interimage distortion. The purpose of this study was to evaluate the degree to which this image distortion was secondary to the image acquisition process. Four 25 mm radio-opaque markers were placed at C3, T1, T12, and L5 on a full-length skeleton model. The skeleton was imaged in 10 different positions within the scanner. Five posteroanterior and 5 lateral images were obtained in each position. Two orthopaedic attending physicians and 3 orthopaedic resident physicians measured the markers for a total of 3200 measurements. Intraclass correlation coefficients (ICCs) and 95% confidence intervals were used to examine image distortion. Average marker size was 24.77, with a standard error of measurement of 0.00493. Image distortion and standard error of measurement accounted for ∼0.5% to 1.5% of total the measurement. Overall, there was good reliability and consistency when looking at markers in different views (ICC 0.790), planes, and locations within the image. Horizontal measurements were found to be more consistent and have better reliability (ICC 0.881) than vertical measurements (ICC 0.386). Position within the scanner had minimal impact on the accuracy of the measurements. This study demonstrates that there is minimal error due to image acquisition and measurement when using a biplanar slot scanner. Biplanar slot scanning technology tended to underestimate the size of the marker; however, the least accurate measurements only erred by 1.5% from the true length. This indicates that unlike traditional radiographs the sources of error in biplanar slot scanning images are not due to parallax and are likely due to patient-specific factors and rather than the technology itself.

Image Distortion in Biplanar Slot Scanning: Patient-specific Factors.

Error within imaging measurements can be due to processing, magnification, measurement performance, or patient-specific factors. Previous length measurement studies based on radiographs have shown good intraclass correlation coefficients (ICCs) on single images; but have not assessed interimage distortion. In our study, "image distortion in biplanar slot scanning: technology-specific factors" we determined that there is minimal image distortion due to the image acquisition when using biplanar slot scanning. In this study, we aim to determine the role of patient-specific factors in image distortion, specifically evaluating interimage distortion. Digital radiographs and biplanar slot scanner images were reviewed in 43 magnetically controlled growing rod (MCGR) patients. Fifty-five postoperative anteroposterior digital radiographs, 184 follow-up biplanar slot-scanner scanner posteroanterior and 76 biplanar slot-scanner scanner laterals were measured by 2 residents and 1 attending. The manufacturer reported average actuator diameter of 9.02 mm was used as our reference width. Overall, within image interobserver ICC were moderate to excellent (0.635 to 0.983), but the interimage ICCs were poor (0.332). Digital radiographs consistently overestimated the MCGR actuator width (mean=9.655) and biplanar slot-scanner scanner images underestimated it (mean=8.935). The measurement range was large with biplanar slot-scanner scanner posteroanterior (up to 15%) and lateral (22%) measurements and with digital radiographs (39%). Patients with abnormal muscle tone had higher degrees of measurement variability. We found that neither biplanar slot scanning nor digital radiography was precise or accurate. Digital radiographs consistently overestimated MCGR actuator width and biplanar slot scanning underestimated it. The poor ICC's within and between image subtypes and large standard error of measurement reflected a magnitude of distortion that needs to be accounted for when using length measurements clinically. Unlike the clinically insignificant error that we noted in our previous study "image distortion in biplanar slot scanning: technology-specific factors" (0.5% to 1.5% of the measurement), the error noted in this study (0.2% to 38.5% of the measurement) has the potential to be clinically significant. Patients who have abnormal muscle tone had larger measurement errors, likely stemming from motion during the slot scanning process. Level III.

Development and Evaluation of a Subject-Specific Lower Limb Model With an Eleven-Degrees-of-Freedom Natural Knee Model Using Magnetic Resonance and Biplanar X-Ray Imaging During a Quasi-Static Lunge.

Musculoskeletal (MS) models can be used to study the muscle, ligament, and joint mechanics of natural knees. However, models that both capture subject-specific geometry and contain a detailed joint model do not currently exist. This study aims to first develop magnetic resonance image (MRI)-based subject-specific models with a detailed natural knee joint capable of simultaneously estimating in vivo ligament, muscle, tibiofemoral (TF), and patellofemoral (PF) joint contact forces and secondary joint kinematics. Then, to evaluate the models, the predicted secondary joint kinematics were compared to in vivo joint kinematics extracted from biplanar X-ray images (acquired using slot scanning technology) during a quasi-static lunge. To construct the models, bone, ligament, and cartilage structures were segmented from MRI scans of four subjects. The models were then used to simulate lunges based on motion capture and force place data. Accurate estimates of TF secondary joint kinematics and PF translations were found: translations were predicted with a mean difference (MD) and standard error (SE) of 2.13 ± 0.22 mm between all trials and measures, while rotations had a MD ± SE of 8.57 ± 0.63 deg. Ligament and contact forces were also reported. The presented modeling workflow and the resulting knee joint model have potential to aid in the understanding of subject-specific biomechanics and simulating the effects of surgical treatment and/or external devices on functional knee mechanics on an individual level.

High-speed slot-scanning radiography using small-angle tomosynthesis: Investigation of spatial resolution.

This paper studies spatial resolution that is achievable with a fast slot-scanning tomosynthesis approach for orthopedic examinations. Hereby, we use parallel scanning motion implemented in a twin robotic x-ray system. We have measured and analyzed the modulation transfer function (MTF) for various combinations of scanning speed, x-ray tube voltage, pulse length, the nominal focal spot size as well as source-to-object distances. Moreover, we present a theoretical model which describes the system in terms of the MTF. The system was equipped with newly developed linear trajectory prototypes for slot scanning. The acquired images form the basis for a small-angle tomosynthesis reconstruction. In total, three different scanning speeds (27, 14, 8cm/s), pulse lengths (1, 2, 4ms), tube voltages (80, 100, 120kV), two nominal focal spot sizes (0.6, 1.0), and three source-to-object distances (950, 1050, 1150mm) were investigated. To determine the resolution capabilities, we measured the MTF for the given parameter space. The results were then used to design a filter that yields a desired resolution in the reconstructed image. In addition, we also measured the noise power spectrum (NPS) to show the influence of the aforementioned filters on the noise distribution. We have shown that the presented model is in good agreement with the performed measurements. Scanning speed and pulse width have an impact on the MTF in the scanning direction. Up to a travel distance of 0.3mm during an x-ray pulse, an isotropic resolution can be achieved. Longer pulse width or higher scanning speed cause anisotropic resolution. Moreover, it is shown that none of the investigated parameters have an influence on the MTF perpendicular to the scanning direction (slot direction). The 10% MTF value ranges between 9 and 18lp/cm in the scanning direction and about 18lp/cm in slot direction. Tube voltage, nominal focal spot size as well as the source-to-object distance showed no major impact on the system MTF. In terms of the anisotropic resolution capabilities, we have shown that limiting the resolution in the slot direction to obtain isotropic resolution is possible yet at the cost of an inhomogeneous noise pattern. However, maintaining the resolution in slot direction will provide a better edge response and a more homogeneous noise texture at the cost of an inhomogeneous image resolution. We have demonstrated the feasibility of the slot-scanning technique using a twin-robotic x-ray system. Even the fastest scanning mode (27cm/s) yields image resolution on a level that is sufficient for typical orthopedic examinations in terms of musculoskeletal (MSK) measurements. Moreover, it could be shown that the application of specifically designed target MTFs on two-dimensional x-ray images is feasible.

Re: Identification of Ureteral Stones at Reduced Radiation Exposure: A Pilot Study Comparing Conventional versus Digital Low-Dosage Linear Slot Scanning (Lodox®) Radiography.

Re: Identification of Ureteral Stones at Reduced Radiation Exposure: A Pilot Study Comparing Conventional versus Digital Low-Dosage Linear Slot Scanning (Lodox®) Radiography.

Radiation in Spine Deformity: State-of-the-Art Reviews

Study Design/MethodsReview article. ObjectivesThis article will provide an overview regarding measurement of radiation exposure and effects on patients with spinal deformity. Summary of Background Data/ResultsPediatric and adult spinal deformity patients are frequently exposed to diagnostic studies exposing them to ionizing radiation. There is a concern that medical radiation can result in increased cancer risk, particularly in children who will live for a long period of time in which cancer may develop and who have rapidly dividing cells that may be more susceptible to DNA damage. CT imaging imparts 10–100 times higher radiation dosing than standard radiographs. Usage of CT imaging studies is growing in the United States and represents 50% of medical imaging exposure. In addition to the 3 millisieverts (mSv) mean natural background exposure, in the United States, the average American experiences an additional 3 mSv of exposure primarily due to medical diagnostic imaging. Early-onset scoliosis patients are at risk of high cumulative radiation exposure given the young age at diagnosis and frequency of multiorgan system involvement in the case of neuromuscular, congenital, and syndromic patients. Biplanar slot scanning reduces patient radiation exposure, and overall levels of exposure from radiographic imaging is quite low compared with CT imaging or historic radiographs. Specialized pediatric CT dosing protocols result in lower patient absorbed dose. Surgeon and team intraoperative exposure to radiation should always be a concern. Appropriate shielding with a lead apron and minimizing radiation exposure are appropriate strategies. ConclusionsThis article will help guide surgeons to make appropriate decisions regarding the need for imaging studies and advocate for low-dose imaging protocols within their facilities. Level of EvidenceV.

The technique of investigation of space-time parameters of the master oscillator with fiber optical smoothing based on the slip photo recorder

The basic goal of this work is the development of investigation technique of space-time parameters of broadband oscillator of the powerful Luch Facility of the Russian Federal Nuclear Center designed to smooth radiation profile during passage of fiber optical line. The smoothing is achieved by means of modes mixing because of wave length dispersion in fiber optics, as a result the speckled radiation structure is removed. The optical scheme for recording radiation and the photochronograph with slot scan have been prepared to carry out measurements. The measurements of duration, impulse shape and space-time heterogeneity of laser radiation at output of formation system of reference radiation with fiber optical smoothing were carried out using that developed technique.

025. - Scattered dose measurements around a Lodox Linear Slot Scanning X-Ray Unit

025. - Scattered dose measurements around a Lodox Linear Slot Scanning X-Ray Unit

Coherent scatter imaging Monte Carlo simulation.

Conventional mammography can suffer from poor contrast between healthy and cancerous tissues due to the small difference in attenuation properties. Coherent scatter slot scan imaging is an imaging technique which provides additional information and is compatible with conventional mammography. A Monte Carlo simulation of coherent scatter slot scan imaging was performed to assess its performance and provide system optimization. Coherent scatter could be exploited using a system similar to conventional slot scan mammography system with antiscatter grids tilted at the characteristic angle of cancerous tissues. System optimization was performed across several parameters, including source voltage, tilt angle, grid distances, grid ratio, and shielding geometry. The simulated carcinomas were detectable for tumors as small as 5 mm in diameter, so coherent scatter analysis using a wide-slot setup could be promising as an enhancement for screening mammography. Employing coherent scatter information simultaneously with conventional mammography could yield a conventional high spatial resolution image with additional coherent scatter information.

Femoral neck anteversion measurement using linear slot scanning radiography

Measurements between anatomical landmarks on radiographs are useful for diagnosis and treatment planning in the orthopedic field. Direct measurement on single radiographic images, however, does not truly reflect spatial relationships, as depth information is lost. We used stereo images from a slot scanning X-ray machine to estimate coordinates of three-dimensional (3D) bony landmarks for femoral neck anteversion (FNA) measurement. A set of 7 landmarks consisting of the centre of the femoral head; the centre of the base of the femoral neck; the medial and lateral condyles; the medial and lateral posterior condyles; and finally the centre of the knee; were found to be identifiable and suitable for radiographic measurement. The reconstructed 3D coordinates were then used to define the 3D geometry of the anatomical axes required to estimate FNA. Stereophotogrammetric measurements on a sample of 30 dry right adult femurs were compared to reference values obtained using the Kingsley Olmstead method applied to photographic images. A strong positive correlation (0.998) was found and the mean ± standard deviation of the stereophotogrammetric approach (13.08 ± 6.87)° was comparable to that of the Kingsley Olmstead method (13.14 ± 6.88)°. Intra- and inter-observer reliability were high, with the lower bound of the 95% confidence interval above 0.98 for the intra-class correlation coefficient. The results merit further validation against three dimensional imaging technology such as computed tomography, to confirm stereophotogrammetry as a suitable alternative for FNA measurement.

1F15 脊椎アライメントの三次元評価におけるsterEOSを用いた精度検証

The sterEOS X-ray machine is capable of a simultaneous capture of biplanar X-ray images by slot scanning of the whole body in physiological load-bearing position. The simultaneous capture of spatially calibrated anteroposterior and lateral images provides a three-dimensional (3D) surface modelling of the skeletal system using sterEOS 3D software. The relevant clinical parameter such as spinal and vertebral parameters are supposed to be measured. The aim of this study is to evaluate an accuracy of EOS measurement of spinal alignment. A phantom for X-ray imaging was used for CT scanning and sterEOS X-ray imaging. 3D surface models of a phantom were reconstructed from its CT images. The same clinical parameters measured from CT-derived 3D surface models and sterEOS 3D software were compared.

Upright Biplanar Slot Scanning in Pediatric Orthopedics: Applications, Advantages, and Artifacts.

Digital slot scanning is a relatively new technology that has been used for imaging of pediatric orthopedic conditions such as scoliosis and leg-length discrepancies. This article will review the clinical applications, advantages, and unique artifacts of this new technology. Upright biplanar slot scanners acquire high-resolution radiographs simultaneously in two orthogonal planes with reduced radiation dose. Other advantages include a more physiologic weightbearing imaging position, improved Cobb angle measurements, and 3D modeling.

Parallel-scanning tomosynthesis using a slot scanning technique: fixed-focus reconstruction and the resulting image quality.

Parallel-scanning tomosynthesis (PS-TS) is a novel technique that fuses the slot scanning technique and the conventional tomosynthesis (TS) technique. This approach allows one to obtain long-view tomosynthesis images in addition to normally sized tomosynthesis images, even when using a system that has no linear tomographic scanning function. The reconstruction technique and an evaluation of the resulting image quality for PS-TS are described in this paper. The PS-TS image-reconstruction technique consists of several steps (1) the projection images are divided into strips, (2) the strips are stitched together to construct images corresponding to the reconstruction plane, (3) the stitched images are filtered, and (4) the filtered stitched images are back-projected. In the case of PS-TS using the fixed-focus reconstruction method (PS-TS-F), one set of stitched images is used for the reconstruction planes at all heights, thus avoiding the necessity of repeating steps (1)-(3). A physical evaluation of the image quality of PS-TS-F compared with that of the conventional linear TS was performed using a R/F table (Sonialvision safire, Shimadzu Corp., Kyoto, Japan). The tomographic plane with the best theoretical spatial resolution (the in-focus plane, IFP) was set at a height of 100 mm from the table top by adjusting the reconstruction program. First, the spatial frequency response was evaluated at heights of -100, -50, 0, 50, 100, and 150 mm from the IFP using the edge of a 0.3-mm-thick copper plate. Second, the spatial resolution at each height was visually evaluated using an x-ray test pattern (Model No. 38, PTW Freiburg, Germany). Third, the slice sensitivity at each height was evaluated via the wire method using a 0.1-mm-diameter tungsten wire. Phantom studies using a knee phantom and a whole-body phantom were also performed. The spatial frequency response of PS-TS-F yielded the best results at the IFP and degraded slightly as the distance from the IFP increased. A visual evaluation of the spatial resolution using the x-ray test pattern indicated that the resolution was 1.8 lp/mm at the IFP and 1.2 lp/mm at heights of -100 and 100 mm from the IFP. The authors demonstrated that a spatial resolution of 1.2-1.8 lp/mm could be obtained within heights of 200 mm of the IFP. The slice sensitivity varied between 11.1 and 13.8 mm for heights between -50 and 100 mm, and there was no critical change in the slice sensitivity within a height range of 150 mm around the IFP. The phantom results demonstrated that tomosynthesis and long-view images could be reconstructed. PS-TS-F provides tomosynthesis images while using low-cost systems that have no tomographic scanning function, such as tableside-controlled universal R/F systems or universal radiographic systems.

SU‐E‐I‐64: X‐Ray Coherent Scatter Mammography Simulation

Purpose:Conventional mammography has poor contrast between healthy and cancerous tissues due to the small difference in attenuation properties. Coherent scatter potentially provides more information because interference of coherently scattered radiation depends on the average intermolecular spacing, and can be used to characterize tissue types. However, typical coherent scatter analysis techniques are not compatible with rapid low dose screening modalities. Coherent scatter slot scan imaging is a novel imaging technique which provides new information with higher contrast. In this work a simulation was performed of coherent scatter slot scan imaging to assess its performance and provide system optimization.Methods:In coherent scatter imaging, the coherent scatter is exploited using a conventional slot scan mammography system with anti‐scatter grids tilted at the characteristic angle of cancerous tissues. A Monte Carlo simulation was used to simulate the coherent scatter imaging. System optimization was performed across several parameters, including source voltage and filtration, tilt angle, source and grid distances, grid ratio, and shielding geometry.Results:The contrast was high and increased as the grid tilt angle was increased beyond the characteristic angle for the modeled carcinoma, and as the source voltage increased. Source filtration did not have a significant effect on contrast. Increasing grid ratio improved contrast at the expense of decreasing the signal to noise ratio (SNR). As the tumor size is decreased, additional shields to block the fat signal are necessary in order to detect the cancer signal.Conclusion:Coherent scatter analysis using a wide slot setup is promising as an enhancement for screening mammography.This work was supported by National Institutes of Health, # 7 R01EB009715