Emerging cancer therapies—such as photothermal ablation therapy and metal-mediated radiation therapy—utilize low concentrations of Gold Nanoparticles (GNPs). For safe and effective treatment, the spatial distribution and concentration of GNPs must be known. However, current clinical imaging modalities cannot simultaneously image both the concentration and spatial distribution of GNPs relevant to these therapies. This study presents a novel metal-mapping imaging modality, X-ray Fluorescence Emission Tomography (XFET), that addresses this need by directly detecting x-ray fluorescence emitted from GNPs after interaction with an x-ray pencil beam. This study compares XFET to Computed Tomography (CT) for trace metal mapping by comparing a realistic XFET Monte Carlo simulation to idealized, approximately dose-matched CT acquisitions. The Monte Carlo XFET simulation was performed on a digital MOBY mouse phantom containing gold concentrations ranging from 0.12% to 4% by weight in the kidneys, hind-leg tumor, and other organs. Contrast-to-Noise Ratios (CNRs) of the gold-containing kidneys and tumor were compared between XFET and CT images. XFET produced superior CNR values (CNRs = 24.5, 21.6, 3.4) compared to CT images obtained with both energy-integrating (CNR = 4.4, 4.6, 1.5) and photon-counting (CNR = 6.5, 7.7, 2.0) detection systems. The CNR improvements of XFET averaged 315% and 175%, respectively. Because the gold concentrations imaged here are modeled after a previous preclinical study, this work shows XFET’s feasibility for metal mapping in future preclinical applications and warrants further study to demonstrate proof of benefit and quantification of XFET’s detection limit.
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