X-ray phase contrast imaging: From synchrotrons to conventional sources

— Phase-based approaches can revolutionize X-ray imaging and remove its main limitation: poor image contrast arising from low attenuation differences. They exploit the unit decrement of the real part of the refractive index, typically 1000 times larger than the imaginary part driving attenuation. This increases the contrast of all details, and enables the detection of features classically considered “X-ray invisible”. Following pioneering experiments dating back to the mid-sixties, X-ray phase contrast imaging “exploded” in the mid-nineties, when third generation synchrotron sources became more widely available. Applications were proposed in fields as diverse as material science, palaeontology, biology, food science, cultural heritage preservation, and many others. Among these applications, medicine has been constantly considered the most important; among medical applications, mammography is arguably the one that attracted most attention. Applications to mammography were pioneered by the SYRMEP (SYnchrotron Radiation for MEdical Physics) group in Trieste, which was already active in the area through a combination of innovative ways to do imaging at synchrotrons and development of novel X-ray detectors. This pioneering phase led to the only clinical experience of phase contrast mammography on human patients, and spawned a number of ideas as to how these advances could be translated into clinical practice.