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Burkhardt, R. ; Gora, T.* ; Fingerle, A.A.* ; Sauter, A.P.* ; Meurer, F.* ; Gassert, F.T.* ; Dobiasch, S. ; Schilling, D. ; Feuchtinger, A. ; Walch, A.K. ; Multhoff, G. ; Herzen, J.* ; Noel, P.B.* ; Rummeny, E.J.* ; Combs, S.E. ; Schmid, T.E. ; Pfeiffer, F.* ; Wilkens, J.J.*

In-vivo X-ray dark-field computed tomography for the detection of radiation-induced lung damage in mice.

Phys. Imag. Radiat. Oncology 20, 11-16 (2021)

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Background and Purpose: Radiotherapy of thoracic tumours can lead to side effects in the lung, which may benefit from early diagnosis. We investigated the potential of X-ray dark-field computed tomography by a proof-of-principle murine study in a clinically relevant radiotherapeutic setting aiming at the detection of radiation-induced lung damage. Material and Methods: Six mice were irradiated with 20 Gy to the entire right lung. Together with five unirradiated control mice, they were imaged using computed tomography with absorption and dark-field contrast before and 16 weeks post irradiation. Mean pixel values for the right and left lung were calculated for both contrasts, and the right-to-left-ratio R of these means was compared. Radiologists also assessed the tomograms acquired 16 weeks post irradiation. Sensitivity, specificity, inter- and intra-reader accuracy were evaluated. Results: In absorption contrast the group-average of R showed no increase in the control group and increased by 7% (p = 0.005) in the irradiated group. In dark-field contrast, it increased by 2% in the control group and by 14% (p = 0.005) in the irradiated group. Specificity was 100% for both contrasts but sensitivity was almost four times higher using dark-field tomography. Two cases were missed by absorption tomography but were detected by dark-field tomography. Conclusions: The applicability of X-ray dark-field computed tomography for the detection of radiation-induced lung damage was demonstrated in a pre-clinical mouse model. The presented results illustrate the differences between dark-field and absorption contrast and show that dark-field tomography could be advantageous in future clinical settings.

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