X-ray in-line holography and holotomography at the NanoMAX beamline

Coherent X-ray imaging techniques, such as in-line holography, exploit the high brilliance provided by diffraction-limited storage rings to perform imaging sensitive to the electron density through contrast due to the phase shift, rather than conventional attenuation contrast. Thus, coherent X-ray imaging techniques enable high-sensitivity and low-dose imaging, especially for low-atomic-number (Z) chemical elements and materials with similar attenuation contrast. Here, the first implementation of in-line holography at the NanoMAX beamline is presented, which benefits from the exceptional focusing capabilities and the high brilliance provided by MAX IV, the first operational diffraction-limited storage ring up to approximately 300 eV. It is demonstrated that in-line holography at NanoMAX can provide 2D diffraction-limited images, where the achievable resolution is only limited by the 70 nm focal spot at 13 keV X-ray energy. Also, the 3D capabilities of this instrument are demonstrated by performing holotomography on a chalk sample at a mesoscale resolution of around 155 nm. It is foreseen that in-line holography will broaden the spectra of capabilities of MAX IV by providing fast 2D and 3D electron density images from mesoscale down to nanoscale resolution.

Tomosynthesis in pediatrics: a retrospective of its application in the world practice and own data

Tomosynthesis is a modern effective and informative method of low-dose X-ray diagnostics, which allows obtaining a significant number of layered images with the subsequent volumetric image reconstruction. The use of tomosynthesis provides a one-time examination of a large anatomical area without loss of the image quality and diagnostics of difficult-to-visualize pathological changes that are not detected by digital radiography. The article presents an overview of the problem of improving low-dose imaging options in the radiation diagnostics, as well as the authors own data on the use of tomosynthesis for the diagnosis of community-acquired pneumonia in children.

Redosing of Fluorescein Sodium Improves Image Interpretation During Intraoperative Ex Vivo Confocal Laser Endomicroscopy of Brain Tumors

BackgroundFluorescein sodium (FNa) is a fluorescence agent used with a wide-field operating microscope for intraoperative guidance and with confocal laser endomicroscopy (CLE) to evaluate brain tissue. Susceptibility of FNa to degradation over time may affect CLE image quality during prolonged surgeries. This study describes improved characteristics of CLE images after intraoperative redosing with FNa.MethodsA retrospective analysis was performed using CLE images obtained ex vivo from samples obtained during tumor resections with FNa-based fluorescence guidance with a wide-field operating microscope. The comparison groups included CLE images acquired after FNa redosing (redose imaging group), images from the same patients acquired after the initial FNa dose (initial-dose imaging group), and images from patients in whom redosing was not used (single-dose imaging group). A detailed assessment of image quality and interpretation regarding different FNa dosage and timing of imaging after FNa administration was conducted for all comparison groups.ResultsThe brightest and most contrasting images were observed in the redose group compared to the initial-dose and single-dose groups (P<0.001). The decay of FNa signal negatively correlated with brightness (rho = -0.52, P<0.001) and contrast (rho = -0.57, P<0.001). Different doses of FNa did not significantly affect the brightness (P=0.15) or contrast (P=0.09) in CLE images. As the mean timing of imaging increased, the percentage of accurately diagnosed images decreased (P=0.03).ConclusionsThe decay of the FNa signal is directly associated with image brightness and contrast. The qualitative interpretation scores of images were highest for the FNa redose imaging group. Redosing with FNa to improve the utility of CLE imaging should be considered a safe and beneficial strategy during prolonged surgeries.

Low Dose Chest CT and Lung Ultrasound for the Diagnosis and Management of COVID-19

Background: The COVID-19 pandemic has provided an opportunity to use low- and non-radiating chest imaging techniques on a large scale in the context of an infectious disease, which has never been done before. Previously, low-dose techniques were rarely used for infectious diseases, despite the recognised danger of ionising radiation. Method: To evaluate the role of low-dose computed tomography (LDCT) and lung ultrasound (LUS) in managing COVID-19 pneumonia, we performed a review of the literature including our cases. Results: Chest LDCT is now performed routinely when diagnosing and assessing the severity of COVID-19, allowing patients to be rapidly triaged. The extent of lung involvement assessed by LDCT is accurate in terms of predicting poor clinical outcomes in COVID-19-infected patients. Infectious disease specialists are less familiar with LUS, but this technique is also of great interest for a rapid diagnosis of patients with COVID-19 and is effective at assessing patient prognosis. Conclusions: COVID-19 is currently accelerating the transition to low-dose and “no-dose” imaging techniques to explore infectious pneumonia and their long-term consequences.