? This proposal concerns a novel x-ray imaging modality for mammography, called multiple-image radiography (MIR), which may represent a dramatic improvement over conventional radiography. Whereas a conventional radiograph measures only x-ray absorption, MIR simultaneously produces three parametric images, which separately depict: 1) x-ray absorption, 2) x-ray refraction, and 3) ultra-small-angle x-ray scattering (USAXS). In addition, all three images are virtually immune to the scatter that degrades conventional radiographs; therefore, MIR images show fine image detail not seen in today's clinical mammography. The potential benefits of MIR for breast imaging are: 1) very high contrast for the features that are most important to detection and characterization of breast cancer; 2) reductions in absorbed patient dose; and 3) reduction of the need for breast compression during imaging. The enhanced visibility of important image features may have the following implications: 1) MIR may permit cancer to be detected at an earlier stage than is possible with conventional radiography, 2) MIR may improve diagnostic specificity, and 3) clear visualization of the extent of fibril proliferation may aid in surgical planning. A clinical MIR device for breast imaging has not yet been designed or investigated. Thus far, MIR studies have been conducted entirely using synchrotron light sources. Therefore, the next step for this technology is to tackle the technical challenges involved in transferring this synchrotron-based technique to the clinic, and to demonstrate its diagnostic importance. In this project we will study the technical issues of implementing MIR as a clinical device, and develop candidate designs for a compact clinical MIR imager. The overall objective will be: a) to determine the best image quality that can realistically be obtained from a compact clinical MIR imager; and b) to use radiologist reader studies to determine whether practically achievable MIR images will provide significantly more diagnostic information than conventional radiographs. As a byproduct of this research, we will have developed several optimized candidate designs for a compact clinical MIR breast imager, which will form the basis for construction of the first-ever prototype of its kind in a future project. ? ?
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