K-edge subtraction imaging for angiography at a compact synchrotron source

About one third of all deaths worldwide can be traced back to some form of cardiovascular disease. The gold standard for the diagnosis and interventional treatment of blood vessels is digital subtraction angiography (DSA). An alternative to DSA is K-edge subtraction (KES) imaging, which has been shown to be advantageous for moving organs and to eliminate image artifacts caused by patient movement. As highly brilliant, monochromatic X-rays are required for this method, it has been limited to synchrotron facilities so far, restraining the applicability in clinical routine. Over the past decades, compact synchrotron X-ray sources based on inverse Compton scattering have been evolving, which provide X-rays with sufficient brilliance and that meet spatial and financial requirements affordable in laboratory settings or for university hospitals. In this study, we demonstrate a proofof-principle KES imaging experiment using the Munich Compact Light Source (MuCLS), the first user-dedicated installation of a compact synchrotron X-ray source worldwide. It is shown that the proposed filter-based KES method allows for iodine-contrast agent and calcium to be clearly separated, thereby providing X-ray images only showing one of the two materials. The results show that the quasi-monochromatic spectrum of the MuCLS enables filter-based K-edge subtraction imaging and can become an important tool in pre-clinical research and possible future clinical diagnostics.

[1]  B. Jacobson,et al.  Dichromatic absorption radiography; dichromography. , 1953, Acta radiologica.

[2]  Keiji Umetani,et al.  Iodine K-edge dual-energy imaging for subtraction angiography using synchrotron radiation and a 2-dimensional detector , 1991 .

[3]  Keiji Umetani,et al.  Iodine filter imaging system for subtraction angiography using synchrotron radiation , 1993 .

[4]  Jaime C. Paz,et al.  Acute Care Handbook for Physical Therapists , 1997 .

[5]  J. Parodi,et al.  Gadolinium-Based Contrast: An Alternative Contrast Agent for Endovascular Interventions , 2000, Annals of vascular surgery.

[6]  H. C. Stary,et al.  Natural history and histological classification of atherosclerotic lesions: an update. , 2000, Arteriosclerosis, thrombosis, and vascular biology.

[7]  P Berkvens,et al.  First human transvenous coronary angiography at the European Synchrotron Radiation Facility. , 2000, Physics in medicine and biology.

[8]  D. Leung,et al.  Gadolinium-based contrast agents in angiography and interventional radiology. , 1999, Radiologic clinics of North America.

[9]  Uwe Spetzger,et al.  Comparison of three-dimensional rotational angiography with digital subtraction angiography in the assessment of ruptured cerebral aneurysms. , 2002, AJNR. American journal of neuroradiology.

[10]  Max A. Viergever,et al.  Image Registration for Digital Subtraction Angiography , 1999, International Journal of Computer Vision.

[11]  R. Loewen,et al.  A compact light source: Design and technical feasibility study of a laser-electron storage ring X-ray source , 2004 .

[12]  François Estève,et al.  The potential for neurovascular intravenous angiography using K-edge digital subtraction angiography , 2005 .

[13]  Ömer Akyürek,et al.  Gadolinium:Nonionic Contrast Media (1:1) Coronary Angiography in Patients With Impaired Renal Function , 2007, Angiology.

[14]  Yasuhiko Okura,et al.  Development of Digital Subtraction Angiography for Coronary Artery , 2009, Journal of Digital Imaging.

[15]  Franz Pfeiffer,et al.  Hard X-ray phase-contrast imaging with the Compact Light Source based on inverse Compton X-rays. , 2009, Journal of synchrotron radiation.

[16]  Alessandro Variola,et al.  THE THOMX PROJECT , 2011 .

[17]  P. Alagona,et al.  The worldwide environment of cardiovascular disease: prevalence, diagnosis, therapy, and policy issues: a report from the American College of Cardiology. , 2012, Journal of the American College of Cardiology.

[18]  G. Potdevin,et al.  Monochromatic computed tomography with a compact laser-driven X-ray source , 2013, Scientific Reports.

[19]  R. Virmani,et al.  Mechanisms of Plaque Formation and Rupture , 2014 .

[20]  Inga Kuhlmann,et al.  Prävention kardiovaskulärer Erkrankungen und Atherosklerose , 2014 .

[21]  M. Jacquet,et al.  High intensity compact Compton X-ray sources: Challenges and potential of applications , 2014 .

[22]  C. Vaccarezza,et al.  Status of the STAR Project , 2016 .

[23]  Franz Pfeiffer,et al.  The Munich Compact Light Source: initial performance measures. , 2016, Journal of synchrotron radiation.

[24]  Franz Pfeiffer,et al.  Mono-Energy Coronary Angiography with a Compact Synchrotron Source , 2017, Scientific Reports.

[25]  Franz Pfeiffer,et al.  K-edge subtraction imaging for coronary angiography with a compact synchrotron X-ray source , 2018, PloS one.

[26]  H Elleaume,et al.  K-edge subtraction synchrotron X-ray imaging in bio-medical research. , 2018, Physica medica : PM : an international journal devoted to the applications of physics to medicine and biology : official journal of the Italian Association of Biomedical Physics.