Dark-field chest x-ray takes step forward

German developers of dark-field chest x-ray appear to have overcome a technical limitation of the technology โ€“ namely, adjusting for photon scattering caused by interferometers used in the experimental system.

This scattering is picked up by the systemโ€™s detector (so-called โ€œdetector cross talkโ€) and leads to unwanted artifacts on patient chest x-rays, noted study lead and doctoral candidate Theresa Urban, of the Technical University of Munich, and colleagues. Ultimately, the group described a method to correct the phenomenon to produce better images.

โ€œWith the corrections presented here โ€ฆ the obtained dark-field signal is due to the microstructure of the tissue, and differences between the dark-field signal of different patients can be attributed to their lung condition rather than scatter or crosstalk artifacts,โ€ the group wrote. The article was published on 7 March in IEEE Transactions on Medical Imaging.

Initial results from currently ongoing clinical studies suggest that dark-field chest x-ray can be useful for detecting and quantification of pulmonary emphysema, and for assessing COVID-19 pneumonia, the authors wrote.

The technology uses three interferometers in the path of an x-ray beam from a conventional system to focus photons on the lungโ€™s alveoli, or microscopic structures located at the end of the respiratory tree. Yet photon scattering and detector cross talk cause artifacts in the dark-field x-ray image, which impairs image appearance and prevents a quantitative analysis of the dark-field signal, the team wrote.

To overcome this limitation, the researchers developed a deconvolution-based correction method for the induced artifacts.

In brief, Urban and colleagues developed a method to calculate what are known as scattering โ€œkernels,โ€ or mathematical descriptions of how the photons scatter when they interact with molecules. These kernels were then used as input for an algorithm that corrected for them in the output โ€“ in other words, ultimately sharpening the resolution of the x-ray, they explained.

With the physics elucidated, the researchers then validated the correction method with a water phantom and finally obtained successful correction on dark-field images of a human thorax.

โ€œThis ensures an unobstructed qualitative evaluation, and enables a quantitative evaluation of dark-field radiographs,โ€ Urban et al wrote.

Dark-field chest x-ray has just recently been translated to the clinical stage and its diagnostic value is currently being investigated with a clinical prototype, the authors wrote. They noted that the overall scatter that reaches the detector depends on the beam spectrum and the distance from the x-ray beam to the target, and the influence of changes in these parameters will require further investigations, they wrote.

โ€œHowever, the general concepts behind the corrections presented here are applicable for all grating-based radiography systems, including even the recently presented clinical dark-field CT system,โ€ the researchers concluded.

Access to the full article is available here.

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