Optimization of the matrix inversion tomosynthesis (MITS) impulse response and modulation transfer function characteristics for chest imaging

Matrix inversion tomosynthesis (MITS) uses linear systems theory, along with a priori knowledge of the imaging geometry, to deterministically distinguish between true structure and overlying tomographic blur in a set of conventional tomosynthesis planes. In this paper we examine the effect of total scan angle (ANG), number of input projections (N), and plane separation/number of reconstructed planes (NP) on the MITS impulse response (IR) and modulation transfer function (MTF), with the purpose of optimizing MITS imaging of the chest. MITS IR and MTF data were generated by simulating the imaging of a very thin wire, using various combinations of ANG, N, and NP. Actual tomosynthesis data of an anthropomorphic chest phantom were acquired with a prototype experimental system, using the same imaging parameter combinations as those in the simulations. Thoracic projection data from two human subjects were collected for corroboration of the system response analysis in vivo. Results suggest that ANG=20 degrees, N=71, NP=69 is the optimal combination for MITS chest imaging given the inherent constraints of our prototype system. MITS chest data from human subjects demonstrates that the selected imaging strategy can effectively produce high-quality MITS thoracic images in vivo.     

Assessment of the Capacity of the ProGraf-7000 X-Ray Apparatus for Tomosynthesis

Slices of density of an object reconstructed using tomosynthesis from a limited-angle projection are attractive as a medical diagnostic tool due to high resolution of such slices and much smaller, compared to full-angle CT, required radiation dose and cost of instrument manufacture. However, the incompleteness of the projection sets leads to reconstruction artifacts that look like smeared (or repeated) and faded images of actual objects lying in other slices and requires reconstruction methods tolerant to such incompleteness and convenient for possible use of additional information about the object for the suppression of artifacts. The reconstruction method of folded projections, which is advantageous for limited-angle projection sets, is suggested. Examples of reconstructed slices are given for scanning angles 40, 60, and 90 degrees. A specially designed plastic phantom containing metallic inclusions producing strong artifacts was used. The study of these and other reconstruction results in various geometric and noise conditions indicates that the tomosynthesis option producing images of acceptable quality can be implemented in the standard ProGraph-7000 X-ray apparatus and may have considerable area of application.     

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.     

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.     

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.     

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.     

Digital tomosynthesis of the chest for lung nodule detection: interim sensitivity results from an ongoing NIH-sponsored trial

The authors report interim clinical results from an ongoing NIH-sponsored trial to evaluate digital chest tomosynthesis for improving detectability of small lung nodules. Twenty-one patients undergoing computed tomography (CT) to follow up lung nodules were consented and enrolled to receive an additional digital PA chest radiograph and digital tomosynthesis exam. Tomosynthesis was performed with a commercial CsI/a-Si flat-panel detector and a custom-built tube mover. Seventy-one images were acquired in 11 s, reconstructed with the matrix inversion tomosynthesis algorithm at 5-mm plane spacing, and then averaged (seven planes) to reduce noise and low-contrast artifacts. Total exposure for tomosynthesis imaging was equivalent to that of 11 digital PA radiographs (comparable to a typical screen-film lateral radiograph or two digital lateral radiographs). CT scans (1.25-mm section thickness) were reviewed to confirm presence and location of nodules. Three chest radiologists independently reviewed tomosynthesis images and PA chest radiographs to confirm visualization of nodules identified by CT. Nodules were scored as: definitely visible, uncertain, or not visible. 175 nodules (diameter range 3.5-25.5 mm) were seen by CT and grouped according to size: < 5, 5-10, and > 10 mm. When considering as true positives only nodules that were scored definitely visible, sensitivities for all nodules by tomosynthesis and PA radiography were 70% (+/- 5%) and 22% (+/- 4%), respectively, (p < 0.0001). Digital tomosynthesis showed significantly improved sensitivity of detection of known small lung nodules in all three size groups, when compared to PA chest radiography.     

Neural network based algorithm to quantify joint space width in joints of the hand for arthritis assessment

Arthritis diseases are widespread with enormous societal costs. The two most common forms, rheumatoid arthritis and osteoarthritis, affect joints of the hand and cause narrowing of the joint spaces as the disease destroys the articular cartilage. Radiographic assessment is one of the most promising tools to detect subtle changes in joint space width (JSW), and therefore disease progression. Currently radiographic assessment of arthritis in joints of the hand is accomplished though semiquantitative subjective scoring systems which do not provide a quantitative measurement of the JSW. We describe here an automated method which calculates the average JSW of the metacarpophalangeal (MCP), proximal interphalangeal (PIP), and distal interphalangeal (DIP) joint spaces for fingers 2 to 5 (index, middle, ring, and little) on digitized hand radiographs. The method was tested with a set of 54 hand radiographs on joints with mild to moderate rheumatoid arthritis. Performance was evaluated by comparing algorithm measured JSW to a gold standard determined from expertly hand-drawn joint margins. The agreement was quantified by a measurement of root mean square deviation, 0.148 mm, 0.089 mm, and 0.114 mm for the MCP, PIP, and DIP joints, respectively. In addition, the algorithm measured JSW strongly correlated with the gold standard: R2=0.80 (MCP), R2= 0.82 (PIP), and R2= 0.84 (DIP). This is an accurate and robust algorithm and should provide a more quantitative measure of disease progression than current methods.     

Characteristics of megavoltage cone-beam digital tomosynthesis

This article reports on the image characteristics of megavoltage cone-beam digital tomosynthesis (MVCB DT). MVCB DT is an in-room imaging technique, which enables the reconstruction of several two-dimensional slices from a set of projection images acquired over an arc of 20 degrees-40 degrees. The limited angular range reduces the acquisition time and the dose delivered to the patient, but affects the image quality of the reconstructed tomograms. Image characteristics (slice thickness, shape distortion, and contrast-to-noise ratio) are studied as a function of the angular range. Potential clinical applications include patient setup and the development of breath holding techniques for gated imaging.     

Importance of point-by-point back projection correction for isocentric motion in digital breast tomosynthesis: relevance to morphology of structures such as microcalcifications

Digital breast tomosynthesis is a three-dimensional imaging technique that provides an arbitrary set of reconstruction planes in the breast from a limited-angle series of projection images acquired while the x-ray tube moves. Traditional shift-and-add (SAA) tomosynthesis reconstruction is a common mathematical method to line up each projection image based on its shifting amount to generate reconstruction slices. With parallel-path geometry of tube motion, the path of the tube lies in a plane parallel to the plane of the detector. The traditional SAA algorithm gives shift amounts for each projection image calculated only along the direction of x-ray tube movement. However, with the partial isocentric motion of the x-ray tube in breast tomosynthesis, small objects such as microcalcifications appear blurred (for instance, about 1-4 pixels in blur for a microcalcification in a human breast) in traditional SAA images in the direction perpendicular to the direction of tube motion. Some digital breast tomosynthesis algorithms reported in the literature utilize a traditional one-dimensional SAA method that is not wholly suitable for isocentric motion. In this paper, a point-by-point back projection (BP) method is described and compared with traditional SAA for the important clinical task of evaluating morphology of small objects such as microcalcifications. Impulse responses at different three-dimensional locations with five different combinations of imaging acquisition parameters were investigated. Reconstruction images of microcalcifications in a human subject were also evaluated. Results showed that with traditional SAA and 45 degrees view angle of tube movement with respect to the detector, at the same height above the detector, the in-plane blur artifacts were obvious for objects farther away from x-ray source. In a human subject, the appearance of calcifications was blurred in the direction orthogonal to the tube motion with traditional SAA. With point-by-point BP, the appearance of calcifications was sharper. The point-by-point BP method demonstrated improved rendition of microcalcifications in the direction perpendicular to the tube motion direction. With wide angles or for imaging of larger breasts, this point-by-point BP rather than the traditional SAA should also be considered as the basis of further deblurring algorithms that work in conjunction with the BP method.     

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.     

A novel digital tomosynthesis (DTS) reconstruction method using a deformation field map

We developed a novel digital tomosynthesis (DTS) reconstruction method using a deformation field map to optimally estimate volumetric information in DTS images. The deformation field map is solved by using prior information, a deformation model, and new projection data. Patients' previous cone-beam CT (CBCT) or planning CT data are used as the prior information, and the new patient volume to be reconstructed is considered as a deformation of the prior patient volume. The deformation field is solved by minimizing bending energy and maintaining new projection data fidelity using a nonlinear conjugate gradient method. The new patient DTS volume is then obtained by deforming the prior patient CBCT or CT volume according to the solution to the deformation field. This method is novel because it is the first method to combine deformable registration with limited angle image reconstruction. The method was tested in 2D cases using simulated projections of a Shepp-Logan phantom, liver, and head-and-neck patient data. The accuracy of the reconstruction was evaluated by comparing both organ volume and pixel value differences between DTS and CBCT images. In the Shepp-Logan phantom study, the reconstructed pixel signal-to-noise ratio (PSNR) for the 60 degrees DTS image reached 34.3 dB. In the liver patient study, the relative error of the liver volume reconstructed using 60 degrees projections was 3.4%. The reconstructed PSNR for the 60 degrees DTS image reached 23.5 dB. In the head-and-neck patient study, the new method using 60 degrees projections was able to reconstruct the 8.1 degrees rotation of the bony structure with 0.0 degrees error. The reconstructed PSNR for the 60 degrees DTS image reached 24.2 dB. In summary, the new reconstruction method can optimally estimate the volumetric information in DTS images using 60 degrees projections. Preliminary validation of the algorithm showed that it is both technically and clinically feasible for image guidance in radiation therapy.     

Quantification of Joint Space Width Difference on Radiography Via Phase-Only Correlation (POC) Analysis: a Phantom Study Comparing with Various Tomographical Modalities Using Conventional Margin-Contouring

Several visual scoring methods are currently used to assess progression of rheumatoid arthritis (RA) on radiography. However, they are limited by its subjectivity and insufficient sensitivity. We have developed an original measurement system which uses a technique called phase-only correlation (POC). The purpose of this study is to validate the system by using a phantom simulating the joint of RA patients.A micrometer measurement apparatus that can adjust arbitrary joint space width (JSW) in a phantom joint was developed to define true JSW. The phantom was scanned with radiography, 320 multi detector CT (MDCT), high-resolution peripheral quantitative CT (HR-pQCT), cone beam CT (CBCT), and tomosynthesis. The width was adjusted to the average size of a women’s metacarpophalangeal joint, from 1.2 to 2.2 mm with increments of 0.1 mm and 0.01 mm. Radiographical images were analyzed by the POC-based system and manual method, and images from various tomographical modalities were measured via the automatic margin detection method. Correlation coefficients between true JSW difference and measured JSW difference were all strong at 0.1 mm intervals with radiography (POC-based system and manual method), CBCT, 320MDCT, HR-pQCT, and tomosynthesis. At 0.01 mm intervals, radiography (POC-based system), 320MDCT, and HR-pQCT had strong correlations, while radiography (manual method) and CBCT had low correlations, and tomosynthesis had no statistically significant correlation. The smallest detectable changes for radiography (POC-based system), radiography (manual method), 320MDCT, HR-pQCT, CBCT, and tomosynthesis were 0.020 mm, 0.041 mm, 0.076 mm, 0.077 mm, 0.057 mm, and 0.087 mm, respectively. We conclude that radiography analyzed with the POC-based system might sensitively detect minute joint space changes of the finger joint.     

Region-of-interest image reconstruction in circular cone-beam microCT

Cone-beam microcomputed tomography (microCT) is one of the most popular choices for small animal imaging which is becoming an important tool for studying animal models with transplanted diseases. Region-of-interest (ROI) imaging techniques in CT, which can reconstruct an ROI image from the projection data set of the ROI, can be used not only for reducing imaging-radiation exposure to the subject and scatters to the detector but also for potentially increasing spatial resolution of the reconstructed images. Increasing spatial resolution in microCT images can facilitate improved accuracy in many assessment tasks. A method proposed previously for increasing CT image spatial resolution entails the exploitation of the geometric magnification in cone-beam CT. Due to finite detector size, however, this method can lead to data truncation for a large geometric magnification. The Feldkamp-Davis-Kress (FDK) algorithm yields images with artifacts when truncated data are used, whereas the recently developed backprojection filtration (BPF) algorithm is capable of reconstructing ROI images without truncation artifacts from truncated cone-beam data. We apply the BPF algorithm to reconstructing ROI images from truncated data of three different objects acquired by our circular cone-beam microCT system. Reconstructed images by use of the FDK and BPF algorithms from both truncated and nontruncated cone-beam data are compared. The results of the experimental studies demonstrate that, from certain truncated data, the BPF algorithm can reconstruct ROI images with quality comparable to that reconstructed from nontruncated data. In contrast, the FDK algorithm yields ROI images with truncation artifacts. Therefore, an implication of the studies is that, when truncated data are acquired with a configuration of a large geometric magnification, the BPF algorithm can be used for effective enhancement of the spatial resolution of a ROI image.     

On-board four-dimensional digital tomosynthesis: first experimental results

The purpose of this study is to propose four-dimensional digital tomosynthesis (4D-DTS) for on-board analysis of motion information in three dimensions. Images of a dynamic motion phantom were reconstructed using acquisition scan angles ranging from 20 degrees (DTS) to full 360 degrees cone-beam computed tomography (CBCT). Projection images were acquired using an on-board imager mounted on a clinical linear accelerator. Three-dimensional (3D) images of the moving target were reconstructed for various scan angles. 3D respiratory correlated phase images were also reconstructed. For phase-based image reconstructions, the trajectory of a radiopaque marker was tracked in projection space and used to retrospectively assign respiratory phases to projections. The projections were then sorted according phase and used to reconstruct motion correlated images. By using two sets of projections centered about anterior-posterior and lateral axes, this study demonstrates how phase resolved coronal and sagittal DTS images can be used to obtain 3D motion information. Motion artifacts in 4D-DTS phase images are compared with those present in four-dimensional CT (4DCT) images. Due to the nature of data acquisition for the two modalities, superior-inferior motion artifacts are suppressed to a greater extent in 4D-DTS images compared with 4DCT. Theoretical derivations and experimental results are presented to demonstrate how optimal selection of image acquisition parameters including the frequency of projection acquisition and the phase window depend on the respiratory period. Two methods for acquiring projections are discussed. Preliminary results indicate that 4D-DTS can be used to acquire valuable kinetic information of internal anatomy just prior to radiation treatment.     

Estimating structural properties of trabecular bone from gray-level low-resolution images

In this paper the relationship between three-dimensional histomorphometric parameters derived from microCT and MRI images of distal radius trabecular bone samples is studied. microFE analysis of the trabecular samples is performed and Young's modulus for cranio-caudal direction is calculated. Most of the MRI and microCT parameters correlate significantly with, respectively, MRI and microCT estimates of bone volume fraction. For some of the parameters strong correlation between microCT and MRI results is also observed. However, in these cases there simultaneously exists correlation between: microCT parameter and microCT bone volume fraction; microCT and MRI bone volume fraction; MRI bone volume fraction and MRI parameter. It is found that, comparing to bone volume fraction, histomorphometric information derived from binarized MRI images does not improve estimation of the Young's modulus of trabecular bone samples (calculated for "gold standard" microCT data). Thus a novel method of "optimal paths" analysis of gray-level MRI images is introduced. "Optimal paths" parameters improve estimation of the Young's modulus of trabecular bone samples. They also provide surrogate, gray-level image-based measure of trabecular thickness.     

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.     

A comparison of reconstruction algorithms for C-arm mammography tomosynthesis

Digital tomosynthesis is an imaging technique to produce a tomographic image from a series of angular digital images in a manner similar to conventional focal plane tomography. Unlike film focal plane tomography, the acquisition of the data in a C-arm geometry causes the image receptor to be positioned at various angles to the reconstruction tomogram. The digital nature of the data allows for input images to be combined into the desired plane with the flexibility of generating tomograms of many separate planes from a single set of input data. Angular datasets were obtained of a low contrast detectability (LCD) phantom and cadaver breast utilizing a Lorad stereotactic biopsy unit with a coupled source and digital detector in a C-arm configuration. Datasets of 9 and 41 low-dose projections were collected over a 30 degrees angular range. Tomographic images were reconstructed using a Backprojection (BP) algorithm, an Iterative Subtraction (IS) algorithm that allows the partial subtraction of out-of-focus planes, and an Algebraic Reconstruction (AR) algorithm. These were compared with single view digital radiographs. The methods' effectiveness at enhancing visibility of an obscured LCD phantom was quantified in terms of the Signal to Noise Ratio (SNR), and Signal to Background Ratio (SBR), all normalized to the metric value for the single projection image. The methods' effectiveness at removing ghosting artifacts in a cadaver breast was quantified in terms of the Artifact Spread Function (ASF). The technology proved effective at partially removing out of focus structures and enhancing SNR and SBR. The normalized SNR was highest at 4.85 for the obscured LCD phantom, using nine projections and IS algorithm. The normalized SBR was highest at 23.2 for the obscured LCD phantom, using 41 projections and an AR algorithm. The highest normalized metric values occurred with the obscured phantom. This supports the assertion that the greatest value of tomosynthesis is in imaging fibroglandular breasts. The ASF performance was best with the AR technique and nine projections.     

Early findings of small-animal MRI and small-animal computed tomography correlate with histological changes in a rat model of rheumatoid arthritis

With the use of a commonly utilized animal model of rheumatoid arthritis, the central goal of this work was to determine how well the small-animal imaging tools, small-animal MRI (microMRI) and small-animal X-ray computed tomography (microCT), can detect very early histological changes that occur immediately after induction of the disease. Arthritis was induced in rats by injecting complete Freund's adjuvant into the tail. Right hind paws of living rats were evaluated with 4.7 T microMRI with T1-weighted spin echo and inversion recovery sequences. Paw specimens were also evaluated with microCT and by histological examination (n = 29). MicroMR images were scored for the presence of joint effusion, soft tissue swelling, bone marrow changes, and bone erosions. MicroCT measured bone mineral density (BMD). Histology scores were obtained from representative slides from the same rats. The correlation between BMD, MRI and histology was analyzed using linear regression analysis and analysis of covariance. MRI abnormalities were detected on day 5 after induction as joint effusion and soft tissue swelling, followed by bone marrow changes on day 6 and bone erosion on day 8. BMD measured by microCT decreased, the decrease becoming significant on day 7 (P < 0.019). Soft tissue swelling, joint effusion, and bone erosion scores on microMRI correlated with histology (r2 approximately 0.7). Bone marrow changes were seen more clearly with microMRI than by histological examination. Bone loss could be detected earlier by microCT than on histological sections. In conclusion, microMRI and microCT can be used to evaluate early disease changes within 1 week of induction in the adjuvant-induced arthritis model, and have the ability to detect certain manifestations of disease earlier than histological analysis. The use of small-animal imaging techniques potentially allows earlier diagnosis, improved subject stratification, earlier drug implementation, and therefore improved drug trials in animal models of rheumatoid arthritis.