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Respiratory Disease Screening with Dark-Field Computed Tomography

Periodic Reporting for period 3 - RespeCT (Respiratory Disease Screening with Dark-Field Computed Tomography)

Reporting period: 2019-08-01 to 2021-01-31

The grand goal of this proposal is to translate a recently explored and fundamentally different x-ray contrast mechanism, namely x-ray dark-field imaging, from present in-vivo small-animal proof-of-principle studies to a first clinical dark-field computed tomography (CT) prototype for future human diagnostics.

Complementing this main technological development goal, we will explore the potential future clinical diagnostic application range of this technology by systematically screening multiple small-animal disease models.

As one of the potentially most beneficial applications, we will particularly focus on one rapidly growing challenge in the healthcare sector, namely the early detection and screening of chronic obstructive pulmonary disease (COPD). For Europe, COPD has been estimated to affect 5-10% of adults over 40 years of age. This translates to 12-25 million individuals affected by COPD in the European Union. If dark-field CT imaging can substantially improve early diagnosis and thus prompt appropriate therapeutic treatment in these patients, this project has the potential to prolong and improve the lives of millions of Europeans. Further, the cost of COPD to society in Europe could be decreased by billions each year, if COPD – with emphysema as one of its main components – could be accurately detected, effectively treated, and stabilised at early stages of the disease.

Besides COPD, we will explore the potential clinical benefit of dark-field CT for better diagnosis of pulmonary fibrosis, lung cancer, asthma, pneumothorax, acute lung injury, bronchopulmonary dysplasia, inflammation, and radiation-induced lung injury as a consequence of radiation therapy after lung cancer.
To achieve the project goals, the efforts of this proposal comprise two research strands, including (A) a systematic preclinical exploratory biomedical research program to screen for the highest diagnostic benefits of this new technology by using several classes of small-animal disease models (including emphysema, fibrosis, and asthma), and (B) the technical development of this innovative new in vivo medical imaging technology for a next generation human dark-field CT scanner.

Up until now, we have achieved the following main results:
- successful continuation of screening the diagnostic range using small-animal lung disease models,
- technical optimisation of an updated low-dose small-animal dark-field CT scanner,
- installation and commissioning of a human CT gantry plattform for the project,
- fabrication, characterisation and testing of suitable x-ray gratings,
- development of iterative model-based CT reconstruction algorithms for continuously rotating gantries,
- extensive testing of algorithms in small-animal and bench-top systems.
- added clinical value assessments for lung diseases.