Images from MARS spectral CT scanners show that there is much diagnostic value from using small pixels and good energy data. MARS scanners use energy-resolving photon-counting CZT Medipix3RX detectors that measure the energy of photons on a five-point scale and with a spatial resolution of 110 microns. The energy information gives good material discrimination and quantification. The 3D reconstruction gives a voxel size of 70 microns. We present images of pre-clinical specimens, including excised atheroma, bone and joint samples, and nanoparticle contrast agents along with images from living humans. Images of excised human plaque tissue show the location and extent of lipid and calcium deposition within the artery wall. The presence of intraplaque haemorrhage, where the blood leaks into the artery wall following a rupture, has also been visualised through the detection of iron. Several clinically important bone and joint problems have been investigated including: site-specific bone mineral density, bone-metal interfaces (spectral CT reduces metal artefacts), cartilage health using ionic contrast media, gout and pseudogout crystals, and microfracture assessment using nanoparticles. Metallic nanoparticles have been investigated as a cellular marker visible in MARS images. Cell lines of different cancer types (Raji and SK-BR3) were incubated with monoclonal antibody-functionalised AuNPs (Herceptin and Rituximab). We identified and quantified the labelled AuNPs demonstrating that Herceptin-functionalised AuNPs bound to SK-BR3 breast cancer cells but not to the Raji lymphoma cells. In vivo human images show the bone microstructure. Fat, water, and calcium concentrations are quantifiable.
The aim is to perform qualitative and quantitative assessment of metal induced artefacts of small titanium biomaterials using photon counting spectral CT. The energy binning feature of some photon counting detectors enables the measured spectrum to be segmented into low, mid and high energy bins in a single exposure. In this study, solid and porous titanium implants submerged in different concentrations of calcium solution were scanned using the small animal MARS photon counting spectral scanner equipped with a polyenergetic X-ray source operated at 118 kVp. Five narrow energy bins (7-45 keV, 45-55 keV, 55-65 keV, 65-75 keV and 75-118 keV) in charge summing mode were utilised. Images were evaluated in the energy domain (spectroscopic images) as well as material domain (material segmentation and quantification). Results show that calcium solution outside titanium implants can be accurately quantified. However, there was an overestimation of calcium within the pores of the scaffold. This information is critical as it can severely limit the assessment of bone ingrowth within metal structures. The energy binning feature of the spectral scanner was exploited and a correction factor, based on calcium concentrations adjacent to and within metal structures, was used to minimise the variation. Qualitative and quantitative evaluation of bone density and morphology with and without titanium screw shows that photon counting spectral CT can assess bone-metal interface with less pronounced artefacts. Quantification of bone growth in and around the implants would help in orthopaedic applications to determine the effectiveness of implant treatment and assessment of fracture healing.
We assess the performance of a cadmium zinc telluride (CZT)-based Medipix3RX energy-resolving and photon-counting x-ray detector as a candidate for spectral microcomputed tomography (micro-CT) imaging. It features an array of 128 × 128, 110-μm2 pixels, each with four simultaneous threshold counters that utilize real-time charge summing. Each pixel’s response is assessed by imaging with a range of incident x-ray intensities and detector integration times. Energy-related assessments are made by exposing the detector to the emission from an I-125 radioisotope brachytherapy seed. Long-term stability is assessed by repeating identical exposures over the course of 1 h. The high yield of properly functioning pixels (98.8%), long-term stability (linear regression of whole-chip response over 1 h of acquisitions: y = − 0.0038x + 2284; standard deviation: 3.7 counts), and energy resolution [2.5 keV full-width half-maximum (FWHM) (single pixel), 3.7 keV FWHM (across the full image)] make this device suitable for spectral micro-CT.
We assessed the performance of a cadmium zinc telluride (CZT)-based Medipix3RX x-ray detector as a candidate for
micro-computed tomography (micro-CT) imaging. This technology was developed at CERN for the Large Hadron
Collider. It features an array of 128 by 128, 110 micrometer square pixels, each with eight simultaneous threshold
counters, five of which utilize real-time charge summing, significantly reducing the charge sharing between contiguous
pixels. Pixel response curves were created by imaging a range of x-ray intensities by varying x-ray tube current and by
varying the exposure time with fixed x-ray current. Photon energy-related assessments were made by flooding the
detector with the tin foil filtered emission of an I-125 radioisotope brachytherapy seed and sweeping the energy
threshold of each of the four charge-summed counters of each pixel in 1 keV steps. Long term stability assessments were
made by repeating exposures over the course of one hour. The high properly-functioning pixel yield (99%), long term
stability (linear regression of whole-chip response over one hour of acquisitions: y = -0.0038x + 2284; standard
deviation: 3.7 counts) and energy resolution (2.5 keV FWHM (single pixel), 3.7 keV FWHM across the full image)
make this device suitable for spectral micro-CT. The charge summing performance effectively reduced the measurement
corruption caused by charge sharing which, when unaccounted for, shifts the photon energy assignment to lower
energies, degrading both count and energy accuracy. Effective charge summing greatly improves the potential for
calibrated, energy-specific material decomposition and K edge difference imaging approaches.
The Medipix All Resolution Scanner (MARS) spectral CT is intended for small animal, pre-clinical imaging and uses an x-ray detector (Medipix) operating in single photon counting mode. The MARS system provides spectrometric information to facilitate differentiation of tissue types and bio-markers. For longitudinal studies of disease models, it is desirable to characterise the system’s dosimetry. This dosimetry study is performed using three phantoms each consisting of a 30 mm diameter homogeneous PMMA cylinder simulating a mouse. The imaging parameters used for this study are derived from those used for gold nanoparticle identification in mouse kidneys. Dosimetry measurement are obtained with thermo-luminescent Lithium Fluoride (LiF:CuMgP) detectors, calibrated in terms of air kerma and placed at different depths and orientations in the phantoms. Central axis TLD air kerma rates of 17.2 (± 0.71) mGy/min and 18.2 (± 0.75) mGy/min were obtained for different phantoms and TLD orientations. Validation measurements were acquired with a pencil ionization chamber, giving an air-kerma rate of 20.3 (±1) mGy/min and an estimated total air kerma of 81.2 (± 4) mGy for a 720 projection acquisition. It is anticipated that scanner design improvements will significantly decrease future dose requirements. The procedures developed in this work will be used for further dosimetry calculations when optimizing image acquisition for the MARS system as it undergoes development towards human clinical applications.
We report histological changes in port-wine stains treated with illumination times of 3.3 ms (5 W) and 17 - 26 ms (2 W). A copper vapor laser is used and the spot diameter is 0.4 mm. The results show that using an illumination time of 3.3 ms there is more damage to the endothelial cells of the vessel walls and less damage to non vascular tissue. This is in agreement with the predictions of theoretical calculations.