This paper explores the application to mammography of phase contrast produced by variations in x-ray refractive index. As a spatially coherent x-ray beam propagates through an x-ray transparent medium, the phase of the incident wavefront becomes modified in a manner related to the electron density of the medium. The resulting phase gradient across the wavefront is equivalent to a small change in direction of the propagation of the wave. For a general object, the change in propagation direction will vary from point to point depending on the structures within the object. The net effect can be recorded in a radiographic image using an appropriate geometry to produce the visual appearance of edge enhancement at interfaces between materials with differing x-ray refractive indices. Normally these materials will also have differences in attenuation coefficient, so the overall effect is to increase the visibility of interfaces between materials. It is proposed that mammographic images can be subtly enhanced by the use of phase contrast information to overcome some of the known limitations of the imaging process whilst leaving the gross radiological appearance of the images substantially unchanged. The design trade-offs required to utilize phase contrast information were investigated using a conventional mammographic x-ray generator and film-screen system. The Leeds TORMAM mammographic image quality test object was then used to demonstrate a considerable improvement in image quality for the phase contrast enhanced images over those produced in the conventional geometry with no increase in radiation dose to the patient. The results are discussed in terms of their possible practical application.

Abstract. An image restoration approach based on a Bayesian maximum entropy method (MEM) has been applied to a radiological image deconvolution problem, that of reduction of geometric blurring in magnification mammography. The aim of the work is to demonstrate an improvement in image spatial resolution in realistic noisy radiological images with no associated penalty in terms of reduction in the signalto-noise ratio perceived by the observer. Images of the TORMAM mammographic image quality phantom were recorded using the standard magnification settings of 1.8 magnification/fine focus and also at 1.8 magnification/broad focus and 3.0 magnification/fine focus; the latter two arrangements would normally give rise to unacceptable geometric blurring. Measured point-spread functions were used in conjunction with the MEM image processing to de-blur these images. The results are presented as comparative images of phantom test features and as observer scores for the raw and processed images. Visualization of high resolution features and the total image scores for the test phantom were improved by the application of the MEM processing. It is argued that this successful demonstration of image de-blurring in noisy radiological images offers the possibility of weakening the link between focal spot size and geometric blurring in radiology, thus opening up new approaches to system optimization.

The performance of a low dose rate pulsed fluoroscopy option and its successful application to cardiac pacing and electrophysiology is reported. Low dose rate 6.25 frames per second pulsed fluoroscopy was made available in two catheter laboratories at a specialist cardiac centre in February 2003, and was adopted as the standard imaging technique for cardiac pacing procedures. The image quality was found to be considerably poorer than conventional modern units, being very similar to that which would have been accepted as adequate performance 20 years ago, but at less than one-tenth of the dose rate. No problems with the clinical acceptance of this imaging mode for cardiac pacing and electrophysiology have been reported. The already low median patient dose-area product for pacing at this cardiac centre was further reduced by 50% with the introduction of this fluoroscopy option.

Anomalously high image quality scores were noted for images of the Leeds TORMAM phantom obtained using magnification mammography. Comparison of optical density profiles of fibre features in the images with non-magnified images and images previously obtained using an in-line phase contrast geometry showed the presence of phase contrast enhancement in the magnification images. The effect on the phantom score is particularly marked for this design of phantom owing to its use of fibres, which tend to enhance well. A large proportion of the phantom score is associated with fibrous features. It is concluded that direct comparison of TORMAM phantom scores from magnified images with those from non-magnified images is not valid due to the different balance of physical mechanisms forming the two kinds of image.

Advances in microfocus X-ray tube design together with the availability of high resolution charge coupled device (CCD) detectors have led to the introduction of high magnification digital specimen cabinets for the examination of tissue samples. This paper explores the effect that the high magnification geometry permitted by such units has upon image quality in terms of phase contrast edge enhancement, spatial resolution and the appearance of test phantom images. Phase contrast effects and spatial resolution were studied using a previously established method (using edge profiles) and by computing the system spatial frequency response at various geometries. It was demonstrated that the magnitude of the phase contrast enhancement effect reaches a stable maximum at a magnification of x 4. It has also been shown that a continual increase in both the spatial resolution together with an improved signal to noise ratio occurs up to the maximum permissible magnification geometry, with effects of focal spot blur being negligible. In practice, the limited size of the digital detector and the difficulty of object alignment can constrain the use of the very high magnification option.