Digital x-ray tomosynthesis: current state of the art and clinical potential

Digital x-ray tomosynthesis is a technique for producing slice images using conventional x-ray systems. It is a refinement of conventional geometric tomography, which has been known since the 1930s. In conventional geometric tomography, the x-ray tube and image receptor move in synchrony on opposite sides of the patient to produce a plane of structures in sharp focus at the plane containing the fulcrum of the motion; all other structures above and below the fulcrum plane are blurred and thus less visible in the resulting image. Tomosynthesis improves upon conventional geometric tomography in that it allows an arbitrary number of in-focus planes to be generated retrospectively from a sequence of projection radiographs that are acquired during a single motion of the x-ray tube. By shifting and adding these projection radiographs, specific planes may be reconstructed. This topical review describes the various reconstruction algorithms used to produce tomosynthesis images, as well as approaches used to minimize the residual blur from out-of-plane structures. Historical background and mathematical details are given for the various approaches described. Approaches for optimizing the tomosynthesis image are given. Applications of tomosynthesis to various clinical tasks, including angiography, chest imaging, mammography, dental imaging and orthopaedic imaging, are also described.     

Imaging performance of an amorphous selenium digital mammography detector in a breast tomosynthesis system

In breast tomosynthesis a rapid sequence of N images is acquired when the x-ray tube sweeps through different angular views with respect to the breast. Since the total dose to the breast is kept the same as that in regular mammography, the exposure used for each image of tomosynthesis is 1/N. The low dose and high frame rate pose a tremendous challenge to the imaging performance of digital mammography detectors. The purpose of the present work is to investigate the detector performance in different operational modes designed for tomosynthesis acquisition, e.g., binning or full resolution readout, the range of view angles, and the number of views N. A prototype breast tomosynthesis system with a nominal angular range of +/-25 degrees was used in our investigation. The system was equipped with an amorphous selenium (a-Se) full field digital mammography detector with pixel size of 85 microm. The detector can be read out in full resolution or 2 x 1 binning (binning in the tube travel direction). The focal spot blur due to continuous tube travel was measured for different acquisition geometries, and it was found that pixel binning, instead of focal spot blur, dominates the detector modulation transfer function (MTF). The noise power spectrum (NPS) and detective quantum efficiency (DQE) of the detector were measured with the exposure range of 0.4-6 mR, which is relevant to the low dose used in tomosynthesis. It was found that DQE at 0.4 mR is only 20% less than that at highest exposure for both detector readout modes. The detector temporal performance was categorized as lag and ghosting, both of which were measured as a function of x-ray exposure. The first frame lags were 8% and 4%, respectively, for binning and full resolution mode. Ghosting is negligible and independent of the frame rate. The results showed that the detector performance is x-ray quantum noise limited at the low exposures used in each view of tomosynthesis, and the temporal performance at high frame rate (up to 2 frames per second) is adequate for tomosynthesis.     

Resolution at oblique incidence angles of a flat panel imager for breast tomosynthesis

Oblique incidence of x rays on an imaging detector causes blurring that reduces spatial resolution. For simple projection imaging this effect is small and often ignored. However, for breast tomosynthesis, the incidence angle can be larger (>20 degrees), leading to increased blur for some of the projections. The modulation transfer function (MTF) is measured for a typical phosphor-coupled flat-panel detector versus angular incidence of the x-ray beam for two x-ray spectra: 26 kV Mo/Mo and 40 kV Rh/Al. At an incidence angle of 40 degrees the MTF at 5 mm(-1) falls by 35% and 40% for each spectrum, respectively (and 65%/80% at 8 mm(-1)). Increasing the detector absorber thickness to achieve improved quantum efficiency will cause the blurring effect due to beam obliquity to become greater. The impact of this blur is likely to cause misregistration and increased relative noise in tomosynthesis reconstructed images.     

Evaluation of Back Projection Methods for Breast Tomosynthesis Image Reconstruction

Breast cancer is the most common cancer among women in the USA. Compared to mammography, digital breast tomosynthesis is a new imaging technique that may improve the diagnostic accuracy by removing the ambiguities of overlapped tissues and providing 3D information of the breast. Tomosynthesis reconstruction algorithms generate 3D reconstructed slices from a few limited angle projection images. Among different reconstruction algorithms, back projection (BP) is considered an important foundation of quite a few reconstruction techniques with deblurring algorithms such as filtered back projection. In this paper, two BP variants, including α-trimmed BP and principal component analysis-based BP, were proposed to improve the image quality against that of traditional BP. Computer simulations and phantom studies demonstrated that the α-trimmed BP may improve signal response performance and suppress noise in breast tomosynthesis image reconstruction.     

A comparison of reconstruction algorithms for breast tomosynthesis

Three algorithms for breast tomosynthesis reconstruction were compared in this paper, including (1) a back-projection (BP) algorithm (equivalent to the shift-and-add algorithm), (2) a Feldkamp filtered back-projection (FBP) algorithm, and (3) an iterative Maximum Likelihood (ML) algorithm. Our breast tomosynthesis system acquires 11 low-dose projections over a 50 degree angular range using an a-Si (CsI:Tl) flat-panel detector. The detector was stationary during the acquisition. Quality metrics such as signal difference to noise ratio (SDNR) and artifact spread function (ASF) were used for quantitative evaluation of tomosynthesis reconstructions. The results of the quantitative evaluation were in good agreement with the results of the qualitative assessment. In patient imaging, the superimposed breast tissues observed in two-dimensional (2D) mammograms were separated in tomosynthesis reconstructions by all three algorithms. It was shown in both phantom imaging and patient imaging that the BP algorithm provided the best SDNR for low-contrast masses but the conspicuity of the feature details was limited by interplane artifacts; the FBP algorithm provided the highest edge sharpness for microcalcifications but the quality of masses was poor; the information of both the masses and the microcalcifications were well restored with balanced quality by the ML algorithm, superior to the results from the other two algorithms.     

A computer simulation platform for the optimization of a breast tomosynthesis system

In breast tomosynthesis there is a compromise between resolution, noise, and acquisition speed for a given glandular dose. The purpose of the present work is to develop a simulation platform to investigate the potential imaging performance for the many possible tomosynthesis system configurations. The simulation platform was used to investigate the dependence of image blur and signal difference to noise ratio (SDNR) for several different tomosynthesis acquisition configurations. Simulated projections of a slanted thin tungsten wire placed in different object planes were modified according to the detector's modulation transfer function (MTF), with or without pixel binning. In addition, the focal spot blur (FSB), which depends on the location of the wire, the system geometry, the source-detector movement speed, and the exposure time, was also incorporated into the projections. Both expectation maximization (EM) and filtered back projection (FBP) based algorithms were used for 3D image reconstruction. The in-plane MTF was calculated from the reconstructed image of the wire. To evaluate the noise performance, simulated noiseless projections of calcification and tumor in uniform breast tissue were modified with the noise power spectrum (NPS) calculated from a cascaded linear system model for the detector for a given x-ray dose. The SDNR of the reconstructed images was calculated with different tomosynthesis configurations, e.g., pixel binning, view number, and angular range. Our results showed that for a source-to-imager distance (SID) of 66 cm, pixel binning (2 x 2) caused more degradation to the in-plane MTF than the blur caused by the moving focal spot and reconstruction. The in-depth resolution can be improved by increasing the angular range.     

Respiratory correlated cone-beam computed tomography on an isocentric C-arm

A methodology for 3D image reconstruction from retrospectively gated cone-beam CT projection data has been developed. A mobile x-ray cone-beam device consisting of an isocentric C-arm equipped with a flat panel detector was used to image a moving phantom. Frames for reconstruction were retrospectively selected from complete datasets based on the known rotation of the C-arm and a signal from a respiratory monitor. Different sizes of gating windows were tested. A numerical criterion for blur on the reconstructed image was suggested. The criterion is based on minimization of an Ising energy function, similar to approaches used in image segmentation or restoration. It is shown that this criterion can be used for the determination of the optimal gating window size. Images reconstructed from the retrospectively gated projection sequences using the optimal gating window data showed a significant improvement compared to images reconstructed from the complete projection datasets.     

A comparative study of limited-angle cone-beam reconstruction methods for breast tomosynthesis

Digital tomosynthesis mammography (DTM) is a promising new modality for breast cancer detection. In DTM, projection-view images are acquired at a limited number of angles over a limited angular range and the imaged volume is reconstructed from the two-dimensional projections, thus providing three-dimensional structural information of the breast tissue. In this work, we investigated three representative reconstruction methods for this limited-angle cone-beam tomographic problem, including the backprojection (BP) method, the simultaneous algebraic reconstruction technique (SART) and the maximum likelihood method with the convex algorithm (ML-convex). The SART and ML-convex methods were both initialized with BP results to achieve efficient reconstruction. A second generation GE prototype tomosynthesis mammography system with a stationary digital detector was used for image acquisition. Projection-view images were acquired from 21 angles in 3 degrees increments over a +/- 30 degrees angular range. We used an American College of Radiology phantom and designed three additional phantoms to evaluate the image quality and reconstruction artifacts. In addition to visual comparison of the reconstructed images of different phantom sets, we employed the contrast-to-noise ratio (CNR), a line profile of features, an artifact spread function (ASF), a relative noise power spectrum (NPS), and a line object spread function (LOSF) to quantitatively evaluate the reconstruction results. It was found that for the phantoms with homogeneous background, the BP method resulted in less noisy tomosynthesized images and higher CNR values for masses than the SART and ML-convex methods. However, the two iterative methods provided greater contrast enhancement for both masses and calcification, sharper LOSF, and reduced interplane blurring and artifacts with better ASF behaviors for masses. For a contrast-detail phantom with heterogeneous tissue-mimicking background, the BP method had strong blurring artifacts along the x-ray source motion direction that obscured the contrast-detail objects, while the other two methods can remove the superimposed breast structures and significantly improve object conspicuity. With a properly selected relaxation parameter, the SART method with one iteration can provide tomosynthesized images comparable to those obtained from the ML-convex method with seven iterations, when BP results were used as initialization for both methods.     

Scatter radiation in digital tomosynthesis of the breast

Digital tomosynthesis of the breast is being investigated as one possible solution to the problem of tissue superposition present in planar mammography. This imaging technique presents various advantages that would make it a feasible replacement for planar mammography, among them similar, if not lower, radiation glandular dose to the breast; implementation on conventional digital mammography technology via relatively simple modifications; and fast acquisition time. One significant problem that tomosynthesis of the breast must overcome, however, is the reduction of x-ray scatter inclusion in the projection images. In tomosynthesis, due to the projection geometry and radiation dose considerations, the use of an antiscatter grid presents several challenges. Therefore, the use of postacquisition software-based scatter reduction algorithms seems well justified, requiring a comprehensive evaluation of x-ray scatter content in the tomosynthesis projections. This study aims to gain insight into the behavior of x-ray scatter in tomosynthesis by characterizing the scatter point spread functions (PSFs) and the scatter to primary ratio (SPR) maps found in tomosynthesis of the breast. This characterization was performed using Monte Carlo simulations, based on the Geant4 toolkit, that simulate the conditions present in a digital tomosynthesis system, including the simulation of the compressed breast in both the cranio-caudal (CC) and the medio-lateral oblique (MLO) views. The variation of the scatter PSF with varying tomosynthesis projection angle, as well as the effects of varying breast glandular fraction and x-ray spectrum, was analyzed. The behavior of the SPR for different projection angle, breast size, thickness, glandular fraction, and x-ray spectrum was also analyzed, and computer fit equations for the magnitude of the SPR at the center of mass for both the CC and the MLO views were found. Within mammographic energies, the x-ray spectrum was found to have no appreciable effect on the scatter PSF and on the SPR. Glandular fraction and compressed breast size were found to have a small effect, while compressed breast thickness and projection angle, as expected, introduced large variations in both the scatter PSF and SPR. The presence of the breast support plate and the detector cover plate in the simulations introduced important effects on the SPR, which are also relevant to the scatter content in planar mammography.     

Micro-CT with respiratory and cardiac gating

Cardiopulmonary imaging in rodents using micro-computed tomography (CT) is a challenging task due to both cardiac and pulmonary motion and the limited fluence rate available from micro-focus x-ray tubes of most commercial systems. Successful imaging in the mouse requires recognition of both the spatial and temporal scales and their impact on the required fluence rate. Smaller voxels require an increase in the total number of photons (integrated fluence) used in the reconstructed image for constant signal-to-noise ratio. The faster heart rates require shorter exposures to minimize cardiac motion blur imposing even higher demands on the fluence rate. We describe a system with fixed tube/detector and with a rotating specimen. A large focal spot x-ray tube capable of producing high fluence rates with short exposure times was used. The geometry is optimized to match focal spot blur with detector pitch and the resolution limits imposed by the reproducibility of gating. Thus, it is possible to achieve isotropic spatial resolution of 100 microm with a fluence rate at the detector 250 times that of a conventional cone beam micro-CT system with rotating detector and microfocal x-ray tube. Motion is minimized for any single projection with 10 ms exposures that are synchronized to both cardiac and breathing motion. System performance was validated in vivo by studies of the cardiopulmonary structures in C57BL/6 mice, demonstrating the value of motion integration with a bright x-ray source.     

Voting strategy for artifact reduction in digital breast tomosynthesis

Artifacts are observed in digital breast tomosynthesis (DBT) reconstructions due to the small number of projections and the narrow angular range that are typically employed in tomosynthesis imaging. In this work, we investigate the reconstruction artifacts that are caused by high-attenuation features in breast and develop several artifact reduction methods based on a "voting strategy." The voting strategy identifies the projection(s) that would introduce artifacts to a voxel and rejects the projection(s) when reconstructing the voxel. Four approaches to the voting strategy were compared, including projection segmentation, maximum contribution deduction, one-step classification, and iterative classification. The projection segmentation method, based on segmentation of high-attenuation features from the projections, effectively reduces artifacts caused by metal and large calcifications that can be reliably detected and segmented from projections. The other three methods are based on the observation that contributions from artifact-inducing projections have higher value than those from normal projections. These methods attempt to identify the projection(s) that would cause artifacts by comparing contributions from different projections. Among the three methods, the iterative classification method provides the best artifact reduction; however, it can generate many false positive classifications that degrade the image quality. The maximum contribution deduction method and one-step classification method both reduce artifacts well from small calcifications, although the performance of artifact reduction is slightly better with the one-step classification. The combination of one-step classification and projection segmentation removes artifacts from both large and small calcifications.     

Tomosynthesis-based localization of radioactive seeds in prostate brachytherapy

Accurately assessing the quality of prostate brachytherapy intraoperatively would be valuable for improved clinical outcome by ensuring the delivery of a prescribed tumoricidal radiation dose to the entire prostate gland. One necessary step towards this goal is the robust and rapid localization of implanted seeds. Several methods have been developed to locate seeds from x-ray projection images, but they fail to detect completely-overlapping seeds, thus necessitating manual intervention. To overcome this limitation, we have developed a new method where (1) a three-dimensional volume is reconstructed from x-ray projection images using a brachytherapy-specific tomosynthesis reconstruction algorithm with built-in blur compensation and (2) the seeds are located in this reconstructed volume. In contrast to other projection-based methods, our method can detect completely overlapping seeds. Our simulation results indicate that we can locate all implanted seeds in the prostate using a tomosynthesis angle of 30 degrees and seven projection images. The mean localization error is 1.27 mm for a case with 100 seeds. We have also tested our method using a prostate phantom with 61 implanted seeds and succeeded in locating all seeds automatically. We believe this new method can be useful for the intraoperative quality assessment of prostate brachytherapy in the future.     

Filtered backprojection for modifying the impulse response of circular tomosynthesis

A filtering technique has been developed to modify the three-dimensional impulse response of circular motion tomosynthesis to allow the generation of images whose appearance is like those of some other imaging geometries. In particular, this technique can reconstruct images with a blurring function which is more homogeneous for off-focal plane objects than that from circular tomosynthesis. In this paper, we describe the filtering process, and demonstrate the ability to alter the impulse response in circular motion tomosynthesis from a ring to a disk. This filtering may be desirable because the blurred out-of-plane objects appear less structured.     

Computation of the glandular radiation dose in digital tomosynthesis of the breast

Tomosynthesis of the breast is currently a topic of intense interest as a logical next step in the evolution of digital mammography. This study reports on the computation of glandular radiation dose in digital tomosynthesis of the breast. Previously, glandular dose estimations in tomosynthesis have been performed using data from studies of radiation dose in conventional planar mammography. This study evaluates, using Monte Carlo methods, the normalized glandular dose (DgN) to the breast during a tomosynthesis study, and characterizes its dependence on breast size, tissue composition, and x-ray spectrum. The conditions during digital tomosynthesis imaging of the breast were simulated using a computer program based on the Geant4 toolkit. With the use of simulated breasts of varying size, thickness and tissue composition, the DgN to the breast tissue was computed for varying x-ray spectra and tomosynthesis projection angle. Tomosynthesis projections centered about both the cranio-caudal (CC) and medio-lateral oblique (MLO) views were simulated. For each projection angle, the ratio of the glandular dose for that projection to the glandular dose for the zero degree projection was computed. This ratio was denoted the relative glandular dose (RGD) coefficient, and its variation under different imaging parameters was analyzed. Within mammographic energies, the RGD was found to have a weak dependence on glandular fraction and x-ray spectrum for both views. A substantial dependence on breast size and thickness was found for the MLO view, and to a lesser extent for the CC view. Although RGD values deviate substantially from unity as a function of projection angle, the RGD averaged over all projections in a complete tomosynthesis study varies from 0.91 to 1.01. The RGD results were fit to mathematical functions and the resulting equations are provided.     

Thick Slices from Tomosynthesis Data Sets: Phantom Study for the Evaluation of Different Algorithms

PURPOSE  

Tomosynthesis is a 3-dimensional mammography technique that generates thin slices separated one to the other by typically 1 mm from source data sets. The relatively high image noise in these thin slices raises the value of 1-cm thick slices computed from the set of reconstructed slices for image interpretation. In an initial evaluation, we investigated the potential of different algorithms for generating thick slices from tomosynthesis source data (maximum intensity projection—MIP; average algorithm—AV, and image generation by means of a new algorithm, so-called softMip). The three postprocessing techniques were evaluated using a homogeneous phantom with one textured slab with a total thickness of about 5 cm in which two 0.5-cm-thick slabs contained objects to simulate microcalcifications, spiculated masses, and round masses. The phantom was examined by tomosynthesis (GE Healthcare). Microcalcifications were simulated by inclusion of calcium particles of four different sizes. The slabs containing the inclusions were examined in two different configurations: adjacent to each other and close to the detector and with the two slabs separated by two 1-cm thick breast equivalent material slabs. The reconstructed tomosynthesis slices were postprocessed using MIP, AV, and softMip to generate 1-cm thick slices with a lower noise level. The three postprocessing algorithms were assessed by calculating the resulting contrast versus background for the simulated microcalcifications and contrast-to-noise ratios (CNR) for the other objects. The CNRs of the simulated round and spiculated masses were most favorable for the thick slices generated with the average algorithm, followed by softMip and MIP. Contrast of the simulated microcalcifications was best for MIP, followed by softMip and average projections. Our results suggest that the additional generation of thick slices may improve the visualization of objects in tomosynthesis. This improvement differs from the different algorithms for microcalcifications, speculated objects, and round masses. SoftMip is a new approach combining features of MIP and average showing image properties in between MIP and AV.     

Dual-energy contrast-enhanced breast tomosynthesis: optimization of beam quality for dose and image quality

Dual-energy contrast-enhanced breast tomosynthesis is a promising technique to obtain three-dimensional functional information from the breast with high resolution and speed. To optimize this new method, this study searched for the beam quality that maximized image quality in terms of mass detection performance. A digital tomosynthesis system was modeled using a fast ray-tracing algorithm, which created simulated projection images by tracking photons through a voxelized anatomical breast phantom containing iodinated lesions. The single-energy images were combined into dual-energy images through a weighted log subtraction process. The weighting factor was optimized to minimize anatomical noise, while the dose distribution was chosen to minimize quantum noise. The dual-energy images were analyzed for the signal difference to noise ratio (SdNR) of iodinated masses. The fast ray-tracing explored 523?776 dual-energy combinations to identify which yields optimum mass SdNR. The ray-tracing results were verified using a Monte Carlo model for a breast tomosynthesis system with a selenium-based flat-panel detector. The projection images from our voxelized breast phantom were obtained at a constant total glandular dose. The projections were combined using weighted log subtraction and reconstructed using commercial reconstruction software. The lesion SdNR was measured in the central reconstructed slice. The SdNR performance varied markedly across the kVp and filtration space. Ray-tracing results indicated that the mass SdNR was maximized with a high-energy tungsten beam at 49 kVp with 92.5 μm of copper filtration and a low-energy tungsten beam at 49 kVp with 95 μm of tin filtration. This result was consistent with Monte Carlo findings. This mammographic technique led to a mass SdNR of 0.92 ± 0.03 in the projections and 3.68 ± 0.19 in the reconstructed slices. These values were markedly higher than those for non-optimized techniques. Our findings indicate that dual-energy breast tomosynthesis can be performed optimally at 49 kVp with alternative copper and tin filters, with reconstruction following weighted subtraction. The optimum technique provides best visibility of iodine against structured breast background in dual-energy contrast-enhanced breast tomosynthesis.     

Estimation of mean glandular dose for breast tomosynthesis: factors for use with the UK, European and IAEA breast dosimetry protocols

A formalism is proposed for the estimation of mean glandular dose for breast tomosynthesis, which is a simple extension of the UK, European and IAEA protocols for dosimetry in conventional projection mammography. The formalism introduces t-factors for the calculation of breast dose from a single projection and T-factors for a complete exposure series. Monte Carlo calculations of t-factors have been made for an imaging geometry with full-field irradiation of the breast for a wide range of x-ray spectra, breast sizes and glandularities. The t-factors show little dependence on breast glandularity and tables are provided as a function of projection angle and breast thickness, which may be used for all x-ray spectra simulated. The T-factors for this geometry depend upon the choice of projection angles and weights per projection, but various example calculations gave values in the range 0.93-1.00. T-factors are also provided for the Sectra tomosynthesis system, which employs a scanned narrow-beam imaging geometry. In this quite different configuration, the factor (denoted T(S)) shows an important dependence on breast thickness, varying between 0.98 and 0.76 for 20 and 110 mm thick breasts, respectively. Additional data are given to extend the current tabulations of g-, c- and s-factors used for dosimetry of conventional 2D mammography.     

Application of boundary detection information in breast tomosynthesis reconstruction

Digital tomosynthesis mammography (DTM) is one of the most promising techniques that can potentially improve early detection of breast cancers. DTM can provide three-dimensional (3D) structural information by reconstructing the whole imaged volume from a sequence of projection-view (PV) mammograms that are acquired at a small number of projection angles over a limited angular range. Our previous study showed that simultaneous algebraic reconstruction technique (SART) can produce satisfactory tomosynthesized image quality compared to maximum likelihood-type algorithms. To improve the efficiency of DTM reconstruction and address the problem of boundary artifacts, we have developed methods to incorporate both two-dimensional (2D) and 3D breast boundary information within the SART reconstruction algorithm in this study. A second generation GE prototype tomosynthesis mammography system with a stationary digital detector was used for PV image acquisition from 21 angles in 3 degrees increments over a +/- 30 degrees angular range. The 2D breast boundary curves on all PV images were obtained by automated segmentation and were used to restrict the SART reconstruction to be performed only within the breast volume. The computation time of SART reconstruction was reduced by 76.3% and 69.9% for cranio-caudal and mediolateral oblique views, respectively, for the chosen example. In addition, a 3D conical trimming method was developed in which the 2D breast boundary curves from all PVs were back projected to generate the 3D breast surface. This 3D surface was then used to eliminate the multiple breast shadows outside the breast volume due to reconstruction by setting these voxels to a constant background value. Our study demonstrates that, by using the 2D and 3D breast boundary information, all breast boundary and most detector boundary artifacts can be effectively removed on all tomosynthesized slices.     

Cone-beam x-ray microtomography of small specimens

Microtomography is a technique for creating three-dimensional images of the internal structure of objects with high spatial resolution. This can potentially allow inspection of the architecture of breast lumpectomy specimens and visualization of tumours in small animals and also has an application as a tool for non-destructive testing. An efficient method to perform microtomography is to use an area detector and cone-beam reconstruction techniques. In this paper we report on the development of an instrument for microtomography and show example images. The equipment consists of a microfocal x-ray tube (energies and currents up to 30 kVp, 0.2 mA, focal spot size < 5 microm), a rotating specimen stage and a high-resolution x-ray image intensifier optically coupled to a CCD video camera. Data acquisition and 3D image reconstruction are performed by a desktop computer. The well-known Feldkamp cone-beam reconstruction algorithm is used to produce tomographic images from the recorded x-ray projections. The instrument can image samples with diameters of 5-50 mm and create tomographic images with spatial resolution of the order 10-100 microm and signal-to-noise ratio of better than 5:1. This work is a continuation and improvement of an earlier instrument with a low-energy x-ray source and detector.