Cone beam CT (CBCT) technique provides true three-dimensional (3D) images of a breast; however, metal clips and
needles used for surgical planning can cause artifacts, which may extend to many adjacent slices, in the reconstructed
images obtained by the Feldkamp-Davis-Kress (FDK) filtered backprojection method,. In this paper, a sinogram
based method to remove the metal clips in the projection image data is described and discussed for improving the
quality of reconstructed breast images. First, the original projection data was reconstructed using the FDK algorithm
to obtain a volumetric image with metal clips and artifacts. Second, the volumetric image was segmented by using
the threshold method to obtain a 3D map of metal objects. Third, a forward projection algorithm is applied to the
metal object map to obtain projection map of metal objects. Finally, the original projection images and projection
map of metal objects are reorganized into sinograms for correction in the angular space on a pixel-by-pixel basis.
Cone beam CT images of a mastectomy breast specimen are used to demonstrate the feasibility of using this
technique for removal of metal object artifacts. Preliminary results have demonstrated that metal objects artifacts in
3D images were reduced and the image quality were improved.
KEYWORDS: Breast, Image quality, X-rays, Sensors, Composites, 3D image reconstruction, Collimation, Monte Carlo methods, X-ray computed tomography, 3D image processing
In this study, we demonstrated the contrast-to-noise ratio (CNR) improvement in breast cone beam CT (CBCT) using the
volume-of-interest (VOI) scanning technique. In VOI breast CBCT, the breast is first scanned at a low exposure level. A
pre-selected VOI is then scanned at a higher exposure level with collimated x-rays. The two image sets are combined
together to reconstruct high quality 3-D images of the VOI. A flat panel detector based system was built to demonstrate
and investigate the CNR improvement in VOI breast CBCT. The CNRs of the 8 plastic cones (Teflon, Delrin,
polycarbonate, Lucite, solid water, high density polystyrene, nylon and polystyrene) in a breast phantom were measured
in images obtained with the VOI CBCT technique and compared to those measured in standard full field CBCT images.
CNRs in VOI CBCT images were found to be higher than those in regular CBCT images in all plastic cones. The mean
glandular doses (MGDs) from the combination of a high exposure VOI scan and a low exposure full-field scan was
estimated to be similar to that from regular full-field scan at standard exposure level. The VOI CBCT technique allows a
VOI to be imaged with enhanced image quality with an MGD similar to that from regular CBCT technique.
To study the effects of overlapping anatomy on microcalcification detection at various incident exposure levels. Images
of an anthropomorphic breast phantom (RMI 169) overlapping with simulated microcalcifications ranging from 150 to
212 μm in size placed in two breast density regions, fatty and heterogeneously dense, were acquired with an a-Si/a-Se
flat panel based digital mammography system (Selenia) operated with Mo-Mo target/filter combination at 28 kVp. The
mammograms were exposed with 20, 30, 40, 60, 80, 120, 160, 240 and 325 mAs for varying the exposure level. A 4-AFC study was performed for evaluation of the detection performance. Four 400×400-pixel images were displayed as 2×2 array on a LCD flat panel based review workstation. One of the four images contained a cluster of five microcalcifications and was randomly placed in one of the four quadrants. A physicist was asked to select the image
containing the microcalcifications and to report the number of visible microcalcifications. The fraction of correct
responses was computed with two different criteria: (1) the selected images contained one or more microcalcifications,
and (2) the selected images contained 4 or 5 visible microcalcifications. The statistical significance of the differences in fractions for different exposure levels and regions was evaluated. The results showed that, if visibility of one or more
microcalcifications is required, the fractions of correct responses were 1 for all size groups and most exposure levels in
both fatty and heterogeneously dense regions. If a visibility of 80% or more of the microcalcifications was required, the
fractions of correct responses significantly decreased in both regions. The results indicated that microcalcification
detection in the fatty region appeared to be mainly limited by the quantum noise, and that in the heterogeneously dense region may be limited by both the anatomic noise and the quantum noise.
In this study, we demonstrated volume of interest (VOI) scanning technique in dual resolution cone beam CT (CBCT)
breast imaging. A paraffin cylinder with a diameter of 130 mm was used to simulate breast. A wire phantom with a
diameter of 15 mm was constructed as VOI. The phantom contains 8 vertically aluminum wires of various diameters
surrounded by paraffin. The wire phantom was inserted into the breast phantom 45 mm away from the center. The
phantoms were first scanned with a bench top experimental CBCT system at a low exposure level with the detector
operated in a binning mode. Then a VOI mask was placed between the x-ray source and the phantoms. The phantoms
were scanned again with high exposure level and the detector operated in the non-binning mode. The VOI mask was
moved to follow the wire phantom during the whole CT scan to limit the exposures to cover the VOI only. The low
resolution and high resolution images were then combined together for reconstruction with FDK algorithm. Visual
review of the regular and dual resolution CBCT images shows that thinnest resolvable wire in the dual resolution CBCT
images has a diameter of 152 μm. The thinnest resolvable wire in regular CBCT images has a diameter of 254 μm. The
estimated dose to the phantom for dual resolution CBCT is 123% of that with regular CBCT at low exposure level. The dual resolution CBCT technique greatly enhances the CT image quality while still remains a low exposure level to the phantom.
Registration and superimposition of images acquired from two different detectors is essential to dual-resolution cone
beam CT. In this study we implemented and tested a method of integration, which is to register and superimpose the high
resolution volume of interest (VOI) only images to the low resolution full field images. First, we acquired two images
sets: One is low exposure low resolution full field images acquired with a low resolution detector; the other is high
exposure high resolution volume of interest (VOI) images acquired with a high resolution detector and VOI mask. To
locate the VOI positions in full field images, the third images set with VOI mask but without phantom was acquired with the low resolution detector. In the third images set, high contrast VOI boundaries were located and used to determine positions of the VOI in full field images. Then high resolution VOI images were superimposed with the full field images to generate integrated images set. Integrated images set was tested by subtraction from full field images set and then used to reconstruct images using regular FDK algorithm. In the reconstructed images, five Al wires (as small as 152 μm) can be clearly seen in the VOI.
Cone beam breast CT technique provides true three dimensional (3D) images of breast anatomy; however the
detectability of calcification is limited due to low exposure levels on each projection. In this study, we investigated the
possibility of using anisotropic exposure distributions to improve the visibility of calcifications in the breast CT images.
Our approach was to measure the CBCT projections with isotropic high and low exposures separately. Reconstruction
was performed upon different combinations of these two sets of projection sequences to investigate the visibility change
due to the limited-angle high exposure projections. Our preliminary results show that the visibility is improved with the
number of high exposure projections in the combinations. In the future we will measure the CBCT projections with
anisotropic exposures while keeping the total exposure constant.
In this work, we investigated the visibility of microcalcifications in CCD-based cone beam CT (CBCT) breast imaging.
A paraffin cylinder with a diameter of 135 mm and a thickness of 40 mm was used to simulate a 100% adipose breast.
Calcium carbonate grains, ranging from 140-150 to 200-212 μm in size, were used to simulate the microcalcifications.
Groups of 25 same size microcalcifications were arranged into 5 × 5 clusters. Each cluster was embedded at the center of
a smaller (15 mm diameter) cylindrical paraffin phantom, which were inserted into a hole at the center of the breast
phantom. The breast phantom with the simulated microcalcifications was scanned on a bench top experimental CCDbased
cone beam CT system at various exposure levels with two CCD cameras: Hamamatsu's C4742-56-12ER and
Dalsa 99-66-0000-00. 300 projection images were acquired over 360° and reconstructed with Feldkamp's backprojection
algorithm using a ramp filter. The images were reviewed by 6 readers independently. The ratios of visible
microcalcifications were recorded and averaged over all readers. These ratios were plotted as the function of measured
image signal-to-noise ratio (SNR) for various scans. It was found that 94% visibility was achieved for 200-212 μm
calcifications at an SNR of 48.2 while 50% visibility was achieved for 200-212, 180-200, 160-180, 150-160 and 140-150
μm calcifications at an SNR of 25.0, 35.3, 38.2, 42.2 and 64.4, respectively.
Images of mastectomy breast specimens have been acquired with a bench top experimental Cone beam CT
(CBCT) system. The resulting images have been segmented to model an uncompressed breast for
simulation of various CBCT techniques. To further simulate conventional or tomosynthesis mammographic
imaging for comparison with the CBCT technique, a deformation technique was developed to convert the
CT data for an uncompressed breast to a compressed breast without altering the breast volume or regional
breast density. With this technique, 3D breast deformation is separated into two 2D deformations in coronal
and axial views. To preserve the total breast volume and regional tissue composition, each 2D deformation
step was achieved by altering the square pixels into rectangular ones with the pixel areas unchanged and resampling
with the original square pixels using bilinear interpolation. The compression was modeled by first
stretching the breast in the superior-inferior direction in the coronal view. The image data were first
deformed by distorting the voxels with a uniform distortion ratio. These deformed data were then deformed
again using distortion ratios varying with the breast thickness and re-sampled. The deformation procedures
were applied in the axial view to stretch the breast in the chest wall to nipple direction while shrinking it in
the mediolateral to lateral direction re-sampled and converted into data for uniform cubic voxels. Threshold
segmentation was applied to the final deformed image data to obtain the 3D compressed breast model. Our
results show that the original segmented CBCT image data were successfully converted into those for a
compressed breast with the same volume and regional density preserved. Using this compressed breast
model, conventional and tomosynthesis mammograms were simulated for comparison with CBCT.
Breast density has been recognized as one of the major risk factors for breast cancer. However, breast
density is currently estimated using mammograms which are intrinsically 2D in nature and cannot
accurately represent the real breast anatomy. In this study, a novel technique for measuring breast density
based on the segmentation of 3D cone beam CT (CBCT) images was developed and the results were
compared to those obtained from 2D digital mammograms. 16 mastectomy breast specimens were imaged
with a bench top flat-panel based CBCT system. The reconstructed 3D CT images were corrected for the
cupping artifacts and then filtered to reduce the noise level, followed by using threshold-based
segmentation to separate the dense tissue from the adipose tissue. For each breast specimen, volumes of the
dense tissue structures and the entire breast were computed and used to calculate the volumetric breast
density. BI-RADS categories were derived from the measured breast densities and compared with those
estimated from conventional digital mammograms. The results show that in 10 of 16 cases the BI-RADS
categories derived from the CBCT images were lower than those derived from the mammograms by one
category. Thus, breasts considered as dense in mammographic examinations may not be considered as
dense with the CBCT images. This result indicates that the relation between breast cancer risk and true
(volumetric) breast density needs to be further investigated.
To investigate and compare the nodule detection in digital chest imaging between anti-scatter grid and slot scanning
methods. Anthropomorphic chest phantom was imaged with a flat-panel based digital radiography system. The system
was operated in both the slot scanning and full-field modes with and without anti-scatter grid. Imaging technique was
120 kVp and 1 to 16 mAs for both modes. 10-mm in diameter computer-simulated nodules with a nominal peak contrast
ratio of 5% were inserted at hilum and mediastinum locations by applying SPR values. 4-AFC experiment was
conducted to measure the ratio of correct observations as a function of the exposure level for various imaging conditions
and locations. These images were displayed randomly on a review workstation and reviewed by three observers. The
average ratios of correct observations were computed across over the readers. The statistical significance of the
differences in fractions between imaging techniques was computed by the Student t-test. Nodule detection was not
significantly improved by raising the exposure level in the hilum and mediastinum regions. Slot scan without grid and
with grid received the highest and next highest fractions of correct response, followed in order by full-field without and
with grid for the hilum region, and full-field with and without grid for the mediastinum region. Statistical significant
difference was found for most comparisons between slot scan with or without grid and full-field with or without grid.
In this study, we investigated the magnitude of scattered radiation and beam quality on the low contrast performance in
cone beam breast CT imaging with applying volume-of-interest (VOI) imaging technique. For experiments, we used our
bench-top cone beam CT (CBCT) system with a flat-panel digital detector. A cylindrical polycarbonate phantom of 11
cm in diameter was used to simulate breasts to measure radiation dose, scatter-to-primary-ratio (SPR), and contrast-to-noise
ratio. To implement the VOI scanning technique, a lead filter with a rectangular opening was placed between the
x-ray source and the breast phantom. The x-ray tube voltage setting was 80 kVp. The breast phantom was imaged
without and with the VOI filter for open filed and VOI field, respectively. Dose measurement was performed using
TLD dosimeters. Slot scanning technique with varying slot width was used to measure SPR values. The image quality
assessment was performed based on figure of merit (FOM). The results showed that dose can be reduced by a factor of
3 or more outside the VOI and by a factor of 1.6 at the center of the phantom. The SPR value could be reduced by a
factor of 9 inside the VOI, and the FOM was improved by a factor of 1.8 at the center of the phantom.
The use of mammography techniques for the screening and diagnosis of breast cancers has been limited by
the overlapping of cancer symptoms with normal tissue structures. To overcome this problem, two methods
have been developed and actively investigated recently: digital tomosynthesis mammography and cone
beam breast CT. Comparison study with these three techniques will be helpful to understand their
difference and further might be supervise the direction of breast imaging. This paper describes and
discusses about a technique using a general-purpose PC cluster to develop a parallel computer simulation
model to simulate mammograms and tomosynthesis imaging with cone beam CT images of a mastectomy
breast specimen. The breast model used in simulating mammography and tomosynthesis was developed by
re-scaling the CT numbers of cone beam CT images from 80kVp to 20 kev. The compression of breast was
simulated by deformation of the breast model. Re-projection software with parallel computation was
developed and used to compute projection images of this simulated compressed breast for a stationary
detector and a linearly shifted x-ray source. The resulting images were then used to reconstruct
tomosynthesis mammograms using shift-and-add algorithms. It was found that MCs in cone beam CT
images were not visible in regular mammograms but faintly visible in tomosynthesis images. The scatter
signal and noise property needs to be simulated and incorporated in the future.
The feasibility of using the dual-resolution cone beam breast CT technique to obtain high-resolution images inside
a selected volume-of-interest (VOI). The spatial resolution improvement, dose saving and scatter reduction with this
technique are studied and demonstrated with simulations. With the dual-resolution cone beam CT technique, the breast is
first scanned with a low resolution detector at a lower exposure level. A selected volume-of-interest (VOI) in the breast
is then scanned with a small field, high-resolution detector at a higher exposure level. The two image sets are then
combined together to reconstruct high-resolution 3-D images for the VOI. The spatial resolution that can be achieved
was estimated by obtaining 3-D images of point objects and use them to compute the MTFs for evaluation as a function
of the geometric magnification, detector blurring function and focal spot size. Monte Carlo simulation based on the
Geant4 package was used to estimate the degree of dose saving and scatter reduction for a cylinder shaped breast
phantom. The VOI images generated with the dual-resolution cone beam CT technique demonstrated the same visibility
of micro-calcifications as those generated with the full-breast, high resolution image acquisition. It has been shown that
the spatial resolution can be increased by factor of 1.2 with smaller focal spot size and larger magnification. With the
exposure level outside the VOI reduced by a factor of 15, scatter components can be reduced by a factor of 5.5 or greater
in and outside the VOI. Dose can be reduced by a factor of 5.5 inside the VOI and up to 20 outside the VOI. We have
demonstrated that high spatial resolution inside the VOI may be achieved with a high-resolution detector (e.g. CCD/CsI),
reduced focal spot size (0.3 mm), and optimized geometrical magnification (e.g.1.63). Exposure reduction outside the
VOI has been shown to reduce the scatter components in the high-resolution projection image data for the VOI. This has
also led to significantly lowered doses inside and outside the VOI.
The half-scan cone beam technique, requiring a scan for 180° plus detector width only, can help achieve both shorter scan time as well as higher exposure in each individual projection image. This purpose of this paper is to investigate whether half-scan cone beam CT technique can provide acceptable images for clinical application. The half-scan cone beam reconstruction algorithm uses modified Parker's weighting function and reconstructs from slightly more than half of the projection views for full-scan, giving out promising results. A rotation phantom, stationary gantry bench top system was built to conduct experiments to evaluate half-scan cone beam breast CT technique. A post-mastectomy breast specimen, a stack of lunch meat slices embedded with various sizes of calcifications and a polycarbonate phantom inserted with glandular and adipose tissue equivalents are imaged and reconstructed for comparison study. A subset of full-scan projection images of a mastectomy specimen were extracted and used as the half-scan projection data for reconstruction. The results show half-scan reconstruction algorithm for cone beam breast CT images does not significantly degrade image quality when compared with the images of same or even half the radiation dose level. Our results are encouraging, emphasizing the potential advantages in the use of half-scan technique for cone beam breast imaging.
Purpose: To compare two detector systems - one based on the charge-coupled device (CCD) and image amplifier, the
other based on a-Si/CsI flat panel, for cone beam computed-tomography (CT) imaging of small animals.
A high resolution, high framing rate detector system for the cone beam CT imaging of small animals was developed. The
system consists of a 2048×3072×12 bit CCD optically coupled to an image amplifier and an x-ray phosphor screen. The
CCD has an intrinsic pixel size of 12 μm but the effective pixel size can be adjusted through the magnification
adjustment of the optical coupling systems. The system is used in conjunction with an x-ray source and a rotating stage
for holding and rotating the scanned object in the cone beam CT imaging experiments. The advantages of the system
include but are not limited to the ability to adjust the effective pixel size and to achieve extremely high spatial resolution
and temporal resolution. However, the need to use optical coupling compromises the detective quanta efficiency (DQE)
of the system. In this paper, the imaging characteristics of the system were presented and compared with those of an a-
Si/CsI flat-panel detector system.
To investigate how the radiation dose level affects the detection of microcalcifications (MCs) in cone beam breast CT (CBCT), simulated MCs were embedded in simulated breast tissue and imaged with an experimental CBCT system. The system employs a 30 x 40 cm2 a-Si/CsI based flat panel detector with a pixel size of 194 microns. Three 5 x 5 clusters of simulated calcifications (212-224, 250-280, and 300-355 μm) were embedded in a stack of 11 cm diameter lunch meat and positioned at the center of each slice of lunch meat. 300 projection images over 360 degrees were acquired in the non-binning mode at various dose levels (4.2, 6, 12, 18, and 24 mGy) three times, and were reconstructed with the Feldkamp algorithm. After that, 767 x 767 x 9 volume data were extracted from the fifteen reconstructed images for each size group, resulting in 45 CBCT MC phantom images. An observer experiment was performed by counting the number of visible MCs for each MC phantom image. The phantom images were displayed on a review workstation with a 1600 x 1200 CRT monitor and reviewed by six readers independently. The order of the images was randomized for each reader. The ratios of the visible MCs were averaged over all readers and plotted as a function of the dose level. The CNR was calculated for each MC size and each doe level as well. The results showed that the performance of the reconstructed images acquired with 4.2 mGy was similar to the images acquired with 6 mGy, and the images acquired with 18 mGy performed similarly to those acquired with 24 mGy.
The purpose of this study is to compare the detection performance of three different mammography systems: screen/film (SF) combination, a-Si/CsI flat-panel (FP-), and charge-coupled device (CCD-) based systems. A 5-cm thick 50% adipose/50% glandular breast tissue equivalent slab phantom was used to provide an uniform background. Calcium carbonate grains of three different size groups were used to simulate microcalcifications (MCs): 112-125, 125-140, and 140-150 μm overlapping with the uniform background. Calcification images were acquired with the three mammography systems. Digital images were printed on hardcopy films. All film images were displayed on a mammographic viewer and reviewed by 5 mammographers. The visibility of the MC was rated with a 5-point confidence rating scale for each detection task, including the negative controls. Scores were averaged over all readers for various detectors and size groups. Receiver operating characteristic (ROC) analysis was performed and the areas under the ROC curves (Az’s) were computed for various imaging conditions. The results shows that (1) the FP-based system performed significantly better than the SF and CCD-based systems for individual size groups using ROC analysis (2) the FP-based system also performed significantly better than the SF and CCD-based systems for individual size groups using averaged confidence scale, and (3) the results obtained from the Az’s were largely correlated with these from confidence level scores. However, the correlation varied slightly among different imaging conditions.
This paper investigates the feasibility of using a flat panel based cone-beam computer tomography (CT) system for 3-D breast imaging with computer simulation and imaging experiments. In our simulation study, 3-D phantoms were analytically modeled to simulate a breast loosely compressed into cylindrical shape with embedded soft tissue masses and calcifications. Attenuation coefficients were estimated to represent various types of breast tissue, soft tissue masses and calcifications to generate realistic image signal and contrast. Projection images were computed to incorporate x-ray attenuation, geometric magnification, x-ray detection, detector blurring, image pixelization and digitization. Based on the two-views mammography comparable dose level on the central axis of the phantom (also the rotation axis), x-ray kVp/filtration, transmittance through the phantom, detected quantum efficiency (DQE), exposure level, and imaging geometry, the photon fluence was estimated and used to estimate the phantom noise level on a pixel-by-pixel basis. This estimated noise level was then used with the random number generator to produce and add a fluctuation component to the noiseless transmitted image signal. The noise carrying projection images were then convolved with a Gaussian-like kernel, computed from measured 1-D line spread function (LSF) to simulated detector blurring. Additional 2-D Gaussian-like kernel is designed to suppress the noise fluctuation that inherently originates from projection images so that the reconstructed image detectability of low contrast masses phantom can be improved. Image reconstruction was performed using the Feldkamp algorithm. All simulations were performed on a 24 PC (2.4 GHz Dual-Xeon CPU) cluster with MPI parallel programming. With 600 mrads mean glandular dose (MGD) at the phantom center, soft tissue masses as small as 1 mm in diameter can be detected in a 10 cm diameter 50% glandular 50% adipose or fatter breast tissue, and 2 mm or larger masses are visible in a 100% glandular 0% adipose breast tissue. We also found that the 0.15 mm calcification can be detected for 100μm detector while only 0.2 μm or above are visible for 200 μm detector. Our simulation study has shown that the cone-beam CT breast imaging can provide reasonable good quality and
detectability at a dose level similar to that of two views\mammography. For imaging experiments, a stationary x-ray source and detector, a step motor driven rotating phantom system was constructed to demonstrate cone beam breast CT image. A breast specimen from mastectomy and animal tissue embedded with calcifications were imaged. The resulting images show that 355-425 μm calcifications were visible in images obtained at 77 kVp with a voxel size of 316 μm and a center dose of 600 mrads. 300-315 μm calcifications were visible in images obtained at 60 kVp with a voxel size of 158 μm and a center dose of 3.6 rads.
Overlapping fibroglandular tissue structures may obscure small calcifications, essential to the early detection of breast cancer. Dual-energy digital mammography (DEDM), where separate low- and high-energy images are acquired and synthesized to cancel the tissue structures, may improve the ability to detect and visualize calcifications amidst fibroglandular structures. We have developed and implemented a DEDM technique under full-field imaging conditions using a commercially available flat-panel based digital mammography system. We have developed techniques to suppress residual structures due to scatter contamination and non-uniformity in the x-ray field and detector response in our DEDM implementation. The total mean-glandular dose from the low- and high-energy images was constrained to be similar to screening examination levels. The low- and high-energy images were combined using a calibrated nonlinear (cubic) mapping function to generate the calcification images. To evaluate the dual-energy calcification images, we have designed a special phantom with calcium carbonate crystals to simulate calcifications of different sizes superimposed with a 5 cm thick breast-tissue-equivalent material with a continuously varying glandular-tissue ratio from 0.0 to 1.0. The suppression of tissue-structure background by dual-energy imaging comes with the cost of increased noise in the dual-energy images. We report on the effects of different image processing techniques on the dual-energy image signal and noise levels. The effects of image processing on the calcification contrast-to-noise ratios are also presented.
Slot scanning imaging techniques allow for effective scatter rejection without attenuating primary x-rays. The use of these techniques should generate better image quality for the same mean glandular dose (MGD) or a similar image quality for a lower MGD as compared to imaging techniques using an anti-scatter grid. In this study, we compared a slot scanning digital mammography system (SenoScan, Fisher Imaging Systems, Denver, CO) to a full-field digital mammography (FFDM) system used in conjunction with a 5:1 anti-scatter grid (SenoGraphe 2000D, General Electric Medical Systems, Milwaukee, WI). Images of a contrast-detail phantom (University Hospital Nijmegen, The Netherlands) were reviewed to measure the contrast-detail curves for both systems. These curves were measured at 100%, 71%, 49% and 33% of the reference mean glandular dose (MGD), as determined by photo-timing, for the Fisher system and 100% for the GE system. Soft-copy reading was performed on review workstations provided by the manufacturers. The correct observation ratios (CORs) were also computed and used to compare the performance of the two systems. The results showed that, based on the contrast-detail curves, the performance of the Fisher images, acquired at 100% and 71% of the reference MGD, was comparable to the GE images at 100% of the reference MGD. The CORs for Fisher images were 0.463 and 0.444 at 100% and 71% of the reference MGD, respectively, compared to 0.453 for the GE images at 100% of the reference MGD.
Small microcalcifications essential to the early detection of breast cancer may be obscured by overlapping tissue structures. Dual-energy digital mammography (DEDM), where separate low- and high-energy images are acquired and synthesized to cancel the tissue structures, may improve the ability to detect and visualize microcalcifications. The investigation of DEDM began with a signal-to noise ratio analysis to estimate and relate the noise level in the dual-energy calcification signals to the x-ray spectra, microcalcification size, tissue composition and breast thickness. We investigated various inverse-mapping functions, both linear and non-linear, to estimate the calcification thickness from low- and high-energy measurements. Transmission (calibration) measurements made at two different kVp values for variable aluminum thickness (to simulate calcifications) and variable glandular-tissue ratio for a fixed total tissue thickness were used to determine the coefficients of the inverse-mapping functions by a least-squares analysis. We implemented and evaluated the DEDM technique under narrow-beam geometry. Phantoms, used in the evaluation, were constructed by placing different aluminum strips over breast-tissue-equivalent materials of different compositions. The resulting phantom images consisted of four distinct regions, each with a different combination of aluminum thickness and tissue composition. DEDM with non-linear inverse-mapping functions could successfully cancel the contrast of the tissue-structure background to better visualize the overlapping aluminum strip. We are currently in the process of translating our DEDM techniques into full-field imaging. We have designed special phantoms with variable glandular ratios and variable calcification thicknesses for evaluation of the full-field dual-energy calcification images.
The amorphous silicon (a-Si:H) flat panel imaging systems have recently become commercially available and gained acceptance as promising candidates for implementing digital radiography. In this work, SNRs, CNRs and figure-of-merit, defined as CNR2/SEEs, were measured for a commercial a-Si:H/CsI(Tl) flat-panel digital chest radiography system as a function of the kVp for three different regions in the images of a chest phantom: lung, heart and subphrenic. Using these measurements, issues of image quality and optimal selection of the kVp are discussed.
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