Phase-contrast virtual chest radiography.
Phase-contrast virtual chest radiography.
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DOI：
10.1073/pnas.2210214120
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发表时间：
2023-01-03
影响因子：
11.1
通讯作者：
中科院分区：
文献类型：
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胸部X线摄影在呼吸系统疾病检测中起着重要作用，但目前的使用方式从根本上受到基本对比机制的限制：X射线衰减。这使得肺部的细微病理变化在常规胸部X线摄影中不可见，因为这些变化不足以改变通过胸部的总体衰减。在过去的几十年中，在利用X射线辐射的相移来提高成像灵敏度方面已经取得了巨大的进展。然而，具有相位对比的人类胸部成像仍然在很大程度上未被探索。在我们的工作中，我们生成逼真的虚拟胸片，以表明相位对比胸片可以可视化最小的气道及其疾病相关的阻塞，这是今天使用传统技术无法观察到的。通过相位对比增强的呼吸X射线成像已经在动物模型中显示出改善的气道可视化。然而，当前X射线技术的局限性阻碍了临床转化，使潜在的临床影响成为一个悬而未决的问题。在这里，我们探讨相衬胸部摄影在一个现实的硅框架。具体来说，我们使用预处理的虚拟患者生成计算机胸部X射线照片的菲涅耳衍射模拟的X射线波传播。在与临床放射科医师进行的阅片者研究之后，我们预测相衬边缘增强对改善孤立性肺结节检测（6至20 mm）的影响可以忽略不计。然而，支气管壁的边缘增强使小气道（< 2 mm）可视化，这在常规X线摄影中不可见。我们的研究结果表明，相位对比胸部X线摄影在观察小气道阻塞（例如，与哮喘或早期慢性阻塞性肺疾病相关），其不能使用当前的临床方法直接可视化，从而激发临床转化所需的实验开发。最后，我们讨论了定量要求的距离和X射线源/探测器规格的临床实施相衬胸部摄影。
Chest radiography plays an important role in respiratory disease detection, yet the way it is used today is fundamentally limited by the underlying contrast mechanism: X-ray attenuation. This renders subtle pathological changes in the lungs invisible in conventional chest radiography as these do not sufficiently change the overall attenuation through the thorax. The last decades have seen tremendous progress in utilizing the phase shift of X-ray radiation to improve imaging sensitivity. However, human chest imaging with phase contrast remains largely unexplored. In our work, we generate realistic virtual chest radiographs to show that phase-contrast chest radiography can visualize the smallest airways and their disease-related obstruction, which cannot be observed today using the conventional technique. Respiratory X-ray imaging enhanced by phase contrast has shown improved airway visualization in animal models. Limitations in current X-ray technology have nevertheless hindered clinical translation, leaving the potential clinical impact an open question. Here, we explore phase-contrast chest radiography in a realistic in silico framework. Specifically, we use preprocessed virtual patients to generate in silico chest radiographs by Fresnel-diffraction simulations of X-ray wave propagation. Following a reader study conducted with clinical radiologists, we predict that phase-contrast edge enhancement will have a negligible impact on improving solitary pulmonary nodule detection (6 to 20 mm). However, edge enhancement of bronchial walls visualizes small airways (< 2 mm), which are invisible in conventional radiography. Our results show that phase-contrast chest radiography could play a future role in observing small-airway obstruction (e.g., relevant for asthma or early-stage chronic obstructive pulmonary disease), which cannot be directly visualized using current clinical methods, thereby motivating the experimental development needed for clinical translation. Finally, we discuss quantitative requirements on distances and X-ray source/detector specifications for clinical implementation of phase-contrast chest radiography.
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DOI：
10.1056/nejmoa1312547
发表时间：
2014-11-06
期刊：
The New England journal of medicine
影响因子：
--
作者：
Black WC;Gareen IF;Soneji SS;Sicks JD;Keeler EB;Aberle DR;Naeim A;Church TR;Silvestri GA;Gorelick J;Gatsonis C;National Lung Screening Trial Research Team
通讯作者：
National Lung Screening Trial Research Team
影响因子：
10.6
作者：
Abadi E;Segars WP;Sturgeon GM;Roos JE;Ravin CE;Samei E
通讯作者：
Samei E
影响因子：
158.5
作者：
HOGG, JC;MACKLEM, PT;THURLBECK, WM
通讯作者：
THURLBECK, WM
影响因子：
2.5
作者：
Donnelley, Martin;Morgan, Kaye S.;Parsons, David W.
通讯作者：
Parsons, David W.
影响因子：
4.6
作者：
Lovric, Goran;Mokso, Rajmund;Stampanoni, Marco
通讯作者：
Stampanoni, Marco