New X-ray 100 billion times brighter than hospital machine used to show damage to lungs by COVID-19

From left to right: Dr. Claire Walsh, Dr. Paul Tafforeau at ESRF on beamline BM05 with two samples prepared for HiP-CT imaging (Handout)

TORONTO -

A new X-ray machine that allows scientists to zoom down to the cellular level has been used to show COVID-19’s damage to human lungs, as reported in an article published in the journal Nature Methods Thursday.

Scientists at the University College London in the U.K. and the European Synchrotron Research Facility in France used the machine called a Hierarchical Phase-Contrast Tomography (HiP-CT), which is the brightest X-ray in the world, to scan donated human organs, including lungs from a donor who had COVID-19.

HiP-CT allows researchers and scientists to utilize 3D mapping of the object scanned at a various range of scales by imaging the whole organ and then zooming down to a cellular level, according to a release.

The technique uses the brightest source of X-rays in the world and is 100 billion times brighter than a hospital X-ray. The brightness allows researchers to view blood vessels five microns in diameter -- about a tenth of the diameter of a strand of hair -- in an intact human lung.

• Newsletter sign-up: Get The COVID-19 Brief sent to your inbox

Regular clinical CT scans only show blood vessels around 100 times larger, around one millimetre in diameter.

“The ability to see organs across scales like this will really be revolutionary for medical imaging,” Dr. Claire Walsh, a mechanical engineer involved with the project, said in the release. “As we start to link our HiP-CT images to clinical images through AI techniques, we will -- for the first time -- be able to highly accurately validate ambiguous findings in clinical images.”

Using the HiP-CT, researchers were able to see how severe COVID-19 infection “shunts” blood between two separate systems: the capillaries which oxygenate the blood and those which feed the lung tissue itself.

The cross-linking stops the patient’s blood from being properly oxygenated, which was previously hypothesized but not proven, the release indicates.

“By combining our molecular methods with the HiP-CT multiscale imaging in lungs affected by COVID-19 pneumonia, we gained a new understanding how shunting between blood vessels in a lung’s two vascular systems occurs in COVID-19 injured lungs, and the impact it has on oxygen levels in our circulatory system," said Danny Jonigk, a professor of thoracic pathology at Hannover Medical School in Germany, in the release.

Researchers are now using the HiP-CT to produce a “Human Organ Atlas” launching Thursday, showing the brain, lung, heart, two kidneys and a spleen and the lung of a patient who died from COVID-19, which includes a lung biopsy and a COVID-19 lung biopsy.

The Atlas will be available online for surgeons, clinicians and the public.

“The Atlas spans a previously poorly explored scale in our understanding of human anatomy, which is the centimetre to micron scale in intact organs,” said project lead Peter Lee in the release. “Clinical CT and MRI scans can resolve down to just below a millimetre, whilst histology (studying cells / biopsy slices under a microscope), electron microscopy (which uses an electron beam to generate images) and other similar techniques resolve structures with sub-micron accuracy, but only on small biopsies of tissue from an organ. HiP-CT bridges these scales in 3D, imaging whole organs to provide new insights into our biological makeup.”

Researchers posit that the new imaging will provide insights into diseases like cancer or Alzheimer’s, and eventually hope to update the Atlas to contain images of a “library of diseases” that affect organs to help doctors diagnose a wide range of ailments.