Optimization of dual energy contrast enhanced breast tomosynthesis for improved mammographic lesion detection and diagnosis

Abstract

Dual-energy contrast-enhanced breast tomosynthesis has been proposed as a technique to improve the detection of early-stage cancer in young, high-risk women. This study focused on optimizing this technique using computer simulations. The computer simulation used analytical calculations to optimize the signal difference to noise ratio (SdNR) of resulting images from such a technique at constant dose. The optimization included the optimal radiographic technique, optimal distribution of dose between the two single-energy projection images, and the optimal weighting factor for the dual energy subtraction. Importantly, the SdNR included both anatomical and quantum noise sources, as dual energy imaging reduces anatomical noise at the expense of increases in quantum noise. Assuming a tungsten anode, the maximum SdNR at constant dose was achieved for a high energy beam at 49 kVp with 92.5 μm copper filtration and a low energy beam at 49 kVp with 95 μm tin filtration. These analytical calculations were followed by Monte Carlo simulations that included the effects of scattered radiation and detector properties. Finally, the feasibility of this technique was tested in a small animal imaging experiment using a novel iodinated liposomal contrast agent. The results illustrated the utility of dual energy imaging and determined the optimal acquisition parameters for this technique. This work was supported in part by grants from the Komen Foundation (PDF55806), the Cancer Research and Prevention Foundation, and the NIH (NCI R21 CA124584-01). CIVM is a NCRR/NCI National Resource under P41-05959/U24-CA092656.