Radiologist evaluation of an X-ray tube-based diffraction-enhanced imaging prototype using full-thickness breast...

Area of Science:

• Medical Imaging
• Radiology
• Biophysics

Background:

• Conventional mammography relies on X-ray absorption for contrast, limiting visualization of breast structures.
• Diffraction-Enhanced Imaging (DEI) offers higher contrast and lower radiation dose using monochromatic X-rays and refraction-based contrast.
• A major barrier to DEI clinical translation has been its reliance on synchrotron radiation.

Purpose of the Study:

• To evaluate a novel Diffraction-Enhanced Imaging prototype (DEI-PR) utilizing a conventional tungsten X-ray tube.
• To compare the performance of DEI-PR with synchrotron-based DEI (DEI-SR) and digital mammography for breast tissue imaging.
• To assess the clinical feasibility of DEI-PR for breast cancer detection.

Main Methods:

• A DEI prototype (DEI-PR) was developed with a tungsten X-ray source and crystal optics, operating at 60 keV.
• Human breast tissue specimens were imaged using DEI-SR, DEI-PR, and digital mammography.
• Expert radiologists assessed lesion visibility and pathological correlation after training in refraction contrast interpretation.

Main Results:

• DEI-PR demonstrated comparable performance to DEI-SR for mammographic features like masses and calcifications.
• Radiologists perceived benign lesions as better visualized with DEI-SR than DEI-PR at [111] reflectivity.
• No significant differences were found between DEI-SR and DEI-PR for atypical or cancerous lesions at either crystal reflectivity.

Conclusions:

• The DEI-PR system's performance is largely equivalent to traditional DEI, excluding benign lesion characterization.
• This development represents a significant stride towards the clinical adoption of DEI for breast cancer imaging.
• DEI-PR offers a promising alternative for enhanced mammographic contrast with reduced radiation exposure.