Phase-contrast x-ray imaging (PCI) is an innovative method that is sensitive to the refraction of the x-rays in matter. PCI is particularly adapted to visualize weakly absorbing details like those often encountered in biology and medicine. In past years, PCI has become one of the most used imaging methods in laboratory and preclinical studies: its unique characteristics allow high contrast 3D visualization of thick and complex samples even at high spatial resolution. Applications have covered a wide range of pathologies and organs, and are more and more often performed in vivo. Several techniques are now available to exploit and visualize the phase-contrast: propagation- and analyzer-based, crystal and grating interferometry and non-interferometric methods like the coded aperture. In this review, covering the last five years, we will give an overview of the main theoretical and experimental developments and of the important steps performed towards the clinical implementation of PCI.

Mammography is the primary imaging tool for screening and diagnosis of human breast cancers, but ∼10–20% of palpable tumors are not detectable on mammograms and only about 40% of biopsied lesions are malignant. Here we report a high-resolution, low-dose phase contrast X-ray tomographic method for 3D diagnosis of human breast cancers. By combining phase contrast X-ray imaging with an image reconstruction method known as equally sloped tomography, we imaged a human breast in three dimensions and identified a malignant cancer with a pixel size of 92 μm and a radiation dose less than that of dual-view mammography. According to a blind evaluation by five independent radiologists, our method can reduce the radiation dose and acquisition time by ∼74% relative to conventional phase contrast X-ray tomography, while maintaining high image resolution and image contrast. These results demonstrate that high-resolution 3D diagnostic imaging of human breast cancers can, in principle, be performed at clinical compatible doses.

Analyzer-based imaging is a powerful phase-sensitive technique that generates improved contrast compared to standard absorption radiography. Combining numerically two images taken on either side at $\text{±1/2}$ of the full width at half-maximum (FWHM) of the rocking curve provides images of “pure refraction” and of “apparent absorption.” In this study, a similar approach is made by combining symmetrical images with respect to the peak of the analyzer rocking curve but at general positions, $\mathrm{\pm \alpha \cdot }\mathrm{FWHM}.$ These two approaches do not consider the ultrasmall angle scattering produced by the object independently, which can lead to inconsistent results. An accurate way to separately retrieve the quantitative information intrinsic to the object is proposed. It is based on a statistical analysis of the local rocking curve, and allows one to overcome the problems encountered using the previous approaches.

Various X-ray phase-contrast imaging techniques have been developed and applied over the last twenty years in different domains, such as material sciences, biology and medicine. However, no comprehensive inter-comparison exists in the literature. We present here a theoretical study that compares three among the most used techniques: propagation-based imaging (PBI), analyzer-based imaging (ABI) and grating interferometry (GI). These techniques are evaluated in terms of signal-to-noise ratio, figure of merit and spatial resolution. Both area and edge signals are considered. Dependences upon the object properties (absorption, phase shift) and the experimental acquisition parameters (energy, system point-spread function etc.) are derived and discussed. The results obtained from this analysis can be used as the reference for determining the most suitable technique for a given application.

Two x-ray phase contrast imaging techniques are compared in a quantitative way for future mammographic applications: diffraction enhanced imaging (DEI) and phase propagation imaging (PPI). DEI involves, downstream of the sample, an analyser crystal acting as an angular filter for x-rays refracted by the sample. PPI simply uses the propagation (Fresnel diffraction) of the monochromatic and partially coherent x-ray beam over large distances. The information given by the two techniques is assessed by theoretical simulations and compared at the level of the experimental results for different kinds of samples (phantoms and real tissues). The imaging parameters such as the energy, the angular position of the analyser crystal in the DEI case or the sample to detector distance in the PPI case were varied in order to optimize the image quality in terms of contrast, visibility and figure of merit.

The purpose of this work was to assess the imaging performance of an indirect conversion detector (taper optics CCD; FReLoN' camera) in terms of the modulation transfer function (MTF), normalized noise power spectrum (NNPS) and detective quantum efficiency (DQE). Measurements were made with a synchrotron radiation laminar beam at various monochromatic energies in the 20-51.5 keV range for a gadolinium-based fluorescent screen varying in thickness; data acquisition and analysis were made by adapting to this beam geometry protocols used for conventional cone beams. The pre-sampled MTFs of the systems were measured using an edge method. The NNPS of the systems were determined for a range of exposure levels by two-dimensional Fourier analysis of uniformly exposed radiographs. The DQEs were assessed from the measured MTF, NNPS, exposure and incoming number of photons. The MTF, for a given screen, was found to be almost energy independent and, for a given energy, higher for the thinnest screen. At 33 keV and for the 40 (100) microm screen, at 10% the MTF is 9.2 (8.6) line-pairs mm(-1). The NNPS was found to be different in the two analyzed directions in relation to frequency. Highest DQE values were found for the combination 100 microm and 25 keV (0.5); it was still equal to 0.4 at 51.5 keV (above the gadolinium K-edge). The DQE is limited by the phosphor screen conversion yield and by the CCD efficiency. At the end of the manuscript the results of the FReLoN characterization and those from a selected number of detectors presented in the literature are compared.