It has previously been shown that 2D spectral mammography can be used to discriminate between (likely benign) cystic and (potentially malignant) solid lesions in order to reduce unnecessary recalls in mammography. One limitation of the technique is, however, that the composition of overlapping tissue needs to be interpolated from a region surrounding the lesion. The purpose of this investigation was to demonstrate that lesion characterization can be done with spectral tomosynthesis, and to investigate whether the 3D information available in tomosynthesis can reduce the uncertainty from the interpolation of surrounding tissue. A phantom experiment was designed to simulate a cyst and a tumor, where the tumor was overlaid with a structure that made it mimic a cyst. In 2D, the two targets appeared similar in composition, whereas spectral tomosynthesis revealed the exact compositional difference. However, the loss of discrimination signal due to spread from the plane of interest was of the same strength as the reduction of anatomical noise. Results from a preliminary investigation on clinical tomosynthesis images of solid lesions yielded results that were consistent with the phantom experiments, but were still to some extent inconclusive. We conclude that lesion characterization is feasible in spectral tomosynthesis, but more data, as well as refinement of the calibration and discrimination algorithms, are needed to draw final conclusions about the benefit compared to 2D.
Spectral imaging is the acquisition of multiple images of an object at different energy spectra. In mammography,
dual-energy imaging (spectral imaging with two energy levels) has been investigated for several applications, in
particular material decomposition, which allows for quantitative analysis of breast composition and quantitative
contrast-enhanced imaging. Material decomposition with dual-energy imaging is based on the assumption that
there are two dominant photon interaction effects that determine linear attenuation: the photoelectric effect and
Compton scattering. This assumption limits the number of basis materials, i.e. the number of materials that
are possible to differentiate between, to two. However, Rayleigh scattering may account for more than 10% of
the linear attenuation in the mammography energy range. In this work, we show that a modified version of a
scanning multi-slit spectral photon-counting mammography system is able to acquire three images at different
spectra and can be used for triple-energy imaging. We further show that triple-energy imaging in combination
with the efficient scatter rejection of the system enables measurement of Rayleigh scattering, which adds an
additional energy dependency to the linear attenuation and enables material decomposition with three basis
materials. Three available basis materials have the potential to improve virtually all applications of spectral
imaging.
KEYWORDS: Modulation transfer functions, Sensors, Point spread functions, Photodetectors, X-rays, Image quality, 3D modeling, 3D image processing, Mammography, X-ray imaging
Tomosynthesis is emerging as a next generation technology in mammography. Combined with photon-counting detectors with the ability for energy discrimination, a novel modality is enabled — spectral tomosynthesis. Further advantages of photon-counting detectors in the context of tomosynthesis include elimination of electronic noise, efficient scatter rejection (in some geometries) and no lag. Fourier-based linear-systems analysis is a well-established method for optimizing image quality in two-dimensional x-ray systems. The method has been successfully adapted to threedimensional imaging, including tomosynthesis, but several areas need further investigation. This study focuses on two such areas: 1) Adaption of the methodology to photon-counting detectors, and 2) violation of the shift-invariance and stationarity assumptions in non-cylindrical geometries. We have developed a Fourier-based framework to study the image quality in a photon-counting tomosynthesis system, assuming locally linear, stationary, and shift-invariant system response. The framework includes a cascaded-systems model to propagate the modulation-transfer function (MTF) and noise-power spectrum (NPS) through the system. The model was validated by measurements of the MTF and NPS. High degrees of non-shift invariance and non-stationarity were observed, in particular for the depth resolution as the angle of incidence relative the reconstruction plane varied throughout the imaging volume. The largest effects on image quality in a given point in space were caused by interpolation from the inherent coordinate system of the x-rays to the coordinate system that was used for reconstruction. This study is part of our efforts to fully characterize the spectral tomosynthesis system, we intend to extend the model further to include the detective-quantum efficiency, observer modelling, and spectral effects.
The development of new x-ray imaging techniques often requires prior knowledge of tissue attenuation, but the sources of such information are sparse. We have measured the attenuation of adipose breast tissue using spectral imaging, in vitro and in vivo. For the in-vitro measurement, fixed samples of adipose breast tissue were imaged on a spectral mammography system, and the energy-dependent x-ray attenuation was measured in terms of equivalent thicknesses of aluminum and poly-methyl methacrylate (PMMA). For the in-vivo measurement, a similar procedure was applied on a number of spectral screening mammograms. The results of the two measurements agreed well and were consistent with published attenuation data and with measurements on tissue-equivalent material.
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