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Hauke, C.; Bartl, P.; Leghissa, M.; Ritschl, L.; Sutter, S. M.; Weber, T.; Zeidler, J.; Freudenberger, J.; Mertelmeier, T.; Radicke, M.; Michel, T.; Anton, G.; Meinel, F. G.; Bähr, A.; Auweter, S.; Bondesson, D.; Gaass, T.; Dinkel, J.; Reiser, M. and Hellbach, K. (2018): A preclinical Talbot-Lau prototype for x-ray dark-field imaging of human-sized objects. In: Medical Physics, Vol. 45, No. 6: pp. 2565-2571

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Purpose: Talbot-Lau x-ray interferometry provides information about the scattering and refractive properties of an object - in addition to the object's attenuation features. Until recently, this method was ineligible for imaging human-sized objects as it is challenging to adapt Talbot-Lau interferometers (TLIs) to the relevant x-ray energy ranges. In this work, we present a preclinical Talbot-Lau prototype capable of imaging human-sized objects with proper image quality at clinically acceptable dose levels. Methods: The TLI is designed to match a setup of clinical relevance as closely as possible. The system provides a scan range of 120 x 30 cm(2) by using a scanning beam geometry. Its ultimate load is 100 kg. High aspect ratios and fine grid periods of the gratings ensure a reasonable setup length and clinically relevant image quality. The system is installed in a university hospital and is, therefore, exposed to the external influences of a clinical environment. To demonstrate the system's capabilities, a full-body scan of a euthanized pig was performed. In addition, freshly excised porcine lungs with an extrinsically provoked pneumothorax were mounted into a human thorax phantom and examined with the prototype. Results: Both examination sequences resulted in clinically relevant image quality - even in the case of a skin entrance air kerma of only 0.3 mGy which is in the range of human thoracic imaging. The presented case of a pneumothorax and a reader study showed that the prototype's dark-field images provide added value for pulmonary diagnosis. Conclusion: We demonstrated that a dedicated design of a Talbot-Lau interferometer can be applied to medical imaging by constructing a preclinical Talbot-Lau prototype. We experienced that the system is feasible for imaging human-sized objects and the phase-stepping approach is suitable for clinical practice. Hence, we conclude that Talbot-Lau x-ray imaging has potential for clinical use and enhances the diagnostic power of medical x-ray imaging.

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