X-ray characterization of breast phantom materials

Tissue-mimicking phantom materials with tunable optical properties suitable for assessment of diffuse reflectance spectroscopy during electrosurgery

Emerging intraoperative tumor margin assessment techniques require the development of more complex and reliable organ phantoms to assess the performance of the technique before its translation into the clinic. In this work, electrically conductive tissue-mimicking materials (TMMs) based on fat, water and agar/gelatin were produced with tunable optical properties. The composition of the phantoms allowed for the assessment of tumor margins using diffuse reflectance spectroscopy, as the fat/water ratio served as a discriminating factor between the healthy and malignant tissue. Moreover, the possibility of using polyvinyl alcohol (PVA) or transglutaminase in combination with fat, water and gelatin for developing TMMs was studied. The diffuse spectral response of the developed phantom materials had a good match with the spectral response of porcine muscle and adipose tissue, as well as in vitro human breast tissue. Using the developed recipe, anatomically relevant heterogeneous breast phantoms representing the optical properties of different layers of the human breast were fabricated using 3D-printed molds. These TMMs can be used for further development of phantoms applicable for simulating the realistic breast conserving surgery workflow in order to evaluate the intraoperative optical-based tumor margin assessment techniques during electrosurgery.

Internal breast dosimetry in mammography: Monte Carlo validation in homogeneous and anthropomorphic breast phantoms with a clinical mammography system

PURPOSE

To validate Monte Carlo (MC)-based breast dosimetry estimations using both a homogeneous and a 3D anthropomorphic breast phantom under polyenergetic irradiation for internal breast dosimetry purposes.

METHODS

Experimental measurements were performed with a clinical digital mammography system (Mammomat Inspiration, Siemens Healthcare), using the x-ray spectrum selected by the automatic exposure control and a tube current-exposure time product of 360 mAs. A homogeneous 50% glandular breast phantom and a 3D anthropomorphic breast phantom were used to investigate the dose at different depths (range 0-4 cm with 1 cm steps) for the homogeneous case and at a depth of 2.25 cm for the anthropomorphic case. Local dose deposition was measured using thermoluminescent dosimeters (TLD), metal oxide semiconductor field-effect transistor dosimeters (MOSFET), and GafChromic™ films. A Geant4-based MC simulation was modified to match the clinical experimental setup. Thirty sensitive volumes (3.2 × 3.2 × 0.38 mm3 ) on the axial-phantom plane were included at each depth in the simulation to characterize the internal dose variation and compare it to the experimental TLD and MOSFET measurements. The experimental 2D dose maps obtained with the GafChromic™ films were compared to the simulated 2D dose distributions.

RESULTS

Due to the energy dependence of the dosimeters and due to x-ray beam hardening, dosimeters based on these three technologies have to be calibrated at each depth of the phantom. As expected, the dose was found to decrease with increasing phantom depth, with the reduction being ~93% after 4 cm for the homogeneous breast phantom. The 2D dose map showed nonuniformities in the dose distribution in the axial plane of the phantom. The mean combined standard uncertainty increased with phantom depth by up to 5.3% for TLD, 6.3% for MOSFET, and 9.6% for GafChromic™ film. In the case of a heterogeneous phantom, the dosimeters are able to detect local dose gradient variations. In particular, GafChromic™ film showed local dose variations of about 46% at the boundaries of two materials.

CONCLUSIONS

Results showed a good agreement between experimental measurements (with TLD and MOSFET) and MC data for both homogeneous and anthropomorphic breast phantoms. Larger discrepancies are found when comparing the GafChromic™ dose values to the MC results due to the inherent less precise nature of the former. MC validations in a heterogeneous background at the level of local dose deposition and in absolute terms play a fundamental role in the development of an accurate method to estimate radiation dose. The potential introduction of a breast dosimetry model involving a nonhomogeneous glandular/adipose tissue composition makes the validation of internal dose distributions estimates crucial.

Comparison study of reconstruction algorithms for prototype digital breast tomosynthesis using various breast phantoms

Digital breast tomosynthesis (DBT) is a recently developed system for three-dimensional imaging that offers the potential to reduce the false positives of mammography by preventing tissue overlap. Many qualitative evaluations of digital breast tomosynthesis were previously performed by using a phantom with an unrealistic model and with heterogeneous background and noise, which is not representative of real breasts. The purpose of the present work was to compare reconstruction algorithms for DBT by using various breast phantoms; validation was also performed by using patient images. DBT was performed by using a prototype unit that was optimized for very low exposures and rapid readout. Three algorithms were compared: a back-projection (BP) algorithm, a filtered BP (FBP) algorithm, and an iterative expectation maximization (EM) algorithm. To compare the algorithms, three types of breast phantoms (homogeneous background phantom, heterogeneous background phantom, and anthropomorphic breast phantom) were evaluated, and clinical images were also reconstructed by using the different reconstruction algorithms. The in-plane image quality was evaluated based on the line profile and the contrast-to-noise ratio (CNR), and out-of-plane artifacts were evaluated by means of the artifact spread function (ASF). Parenchymal texture features of contrast and homogeneity were computed based on reconstructed images of an anthropomorphic breast phantom. The clinical images were studied to validate the effect of reconstruction algorithms. The results showed that the CNRs of masses reconstructed by using the EM algorithm were slightly higher than those obtained by using the BP algorithm, whereas the FBP algorithm yielded much lower CNR due to its high fluctuations of background noise. The FBP algorithm provides the best conspicuity for larger calcifications by enhancing their contrast and sharpness more than the other algorithms; however, in the case of small-size and low-contrast microcalcifications, the FBP reduced detectability due to its increased noise. The EM algorithm yielded high conspicuity for both microcalcifications and masses and yielded better ASFs in terms of the full width at half maximum. The higher contrast and lower homogeneity in terms of texture analysis were shown in FBP algorithm than in other algorithms. The patient images using the EM algorithm resulted in high visibility of low-contrast mass with clear border. In this study, we compared three reconstruction algorithms by using various kinds of breast phantoms and patient cases. Future work using these algorithms and considering the type of the breast and the acquisition techniques used (e.g., angular range, dose distribution) should include the use of actual patients or patient-like phantoms to increase the potential for practical applications.

Comparison of algorithms for out-of-plane artifacts removal in digital tomosynthesis reconstructions

Digital tomosynthesis is a method of limited angle reconstruction of tomographic images produced at variable heights, on the basis of a set of angular projections taken in an arc around human anatomy. Reconstructed tomograms from unprocessed original projection images, however, are invariably affected by tomographic noise such as blurred images of objects lying outside the plane of interest and superimposed on the focused image of the fulcrum plane. The present work investigates the performance of two approaches for generation of tomograms with a reduced noise: a generalised post-processing method, based on constructing a noise mask from all planes in the reconstructed volume, and its subsequent subtraction from the in-focus plane and a filtered Multiple Projection Algorithm. The comparison between the two algorithms shows that the first method provides reconstructions with very good quality in case of high contrast features, especially for those embedded into a heterogeneous background.

Validation of a method for measuring the volumetric breast density from digital mammograms

The purpose of this study was to evaluate the performance of an algorithm used to measure the volumetric breast density (VBD) from digital mammograms. The algorithm is based on the calibration of the detector signal versus the thickness and composition of breast-equivalent phantoms. The baseline error in the density from the algorithm was found to be 1.25 +/- 2.3% VBD units (PVBD) when tested against a set of calibration phantoms, of thicknesses 3-8 cm, with compositions equivalent to fibroglandular content (breast density) between 0% and 100% and under x-ray beams between 26 kVp and 32 kVp with a Rh/Rh anode/filter. The algorithm was also tested against images from a dedicated breast computed tomography (CT) scanner acquired on 26 volunteers. The CT images were segmented into regions representing adipose, fibroglandular and skin tissues, and then deformed using a finite-element algorithm to simulate the effects of compression in mammography. The mean volume, VBD and thickness of the compressed breast for these deformed images were respectively 558 cm(3), 23.6% and 62 mm. The displaced CT images were then used to generate simulated digital mammograms, considering the effects of the polychromatic x-ray spectrum, the primary and scattered energy transmitted through the breast, the anti-scatter grid and the detector efficiency. The simulated mammograms were analyzed with the VBD algorithm and compared with the deformed CT volumes. With the Rh/Rh anode filter, the root mean square difference between the VBD from CT and from the algorithm was 2.6 PVBD, and a linear regression between the two gave a slope of 0.992 with an intercept of -1.4 PVBD and a correlation with R(2) = 0.963. The results with the Mo/Mo and Mo/Rh anode/filter were similar.

The myth of the 50-50 breast

PURPOSE

For dosimetry and for work in optimization of x-ray imaging of the breast, it is commonly assumed that the breast is composed of 50% fibroglandular tissue and 50% fat. The purpose of this study was to assess whether this assumption was realistic.

METHODS

First, data obtained from an experimental breast CT scanner were used to validate an algorithm that measures breast density from digitized film mammograms. Density results obtained from a total of 2831 women, including 191 women receiving CT and from mammograms of 2640 women from three other groups, were then used to estimate breast compositions.

RESULTS

Mean compositions, expressed as percent fibroglandular tissue (including the skin), varied from 13.7% to 25.6% among the groups with an overall mean of 19.3%. The mean compressed breast thickness for the mammograms was 5.9 cm (sigma = 1.6 cm). 80% of the women in our study had volumetric breast density less than 27% and 95% were below 45%.

CONCLUSIONS

Based on the results obtained from the four groups of women in our study, the "50-50" breast is not a representative model of the breast composition.

The impact of calibration phantom errors on dual-energy digital mammography

Microcalcification is one of the earliest and main indicators of breast cancer. Because dual-energy digital mammography could suppress the contrast between the adipose and glandular tissues of the breast, it is considered a promising technique that will improve the detection of microcalcification. In dual-energy digital mammography, the imaged object is a human breast, while in calibration measurements only the phantoms of breast tissue equivalent materials are available. Consequently, the differences between phantoms and breast tissues will lead to calibration phantom errors. Based on the dual-energy imaging model, formulae of calibration phantom errors are derived in this paper. Then, this type of error is quantitatively analyzed using publicly available data and compared with other types of error. The results demonstrate that the calibration phantom error is large and dominant in dual-energy mammography, seriously decreasing calculation precision. Further investigations on the physical meaning of calibration phantom error reveal that the imaged objects with the same glandular ratio have identical calibration phantom error. Finally, an error correction method is proposed based on our findings.

Quantitative micro-computed tomography: a non-invasive method to assess equivalent bone mineral density

One of the many applications of micro computed tomography (microCT) is to accurately visualize and quantify cancellous bone microstructure. However, microCT based assessment of bone mineral density has yet to be thoroughly investigated. Specifically, the effects of varying imaging parameters, such as tube voltage (kVp), current (microA), integration time (ms), object to X-ray source distance (mm), projection number, detector array size and imaging media (surrounding the specimen), on the relationship between equivalent tissue density (rhoEQ) and its linear attenuation coefficient (micro) have received little attention. In this study, in house manufactured, hydrogen dipotassium phosphate liquid calibration phantoms (K2HPO4) were employed in addition to a resin embedded hydroxyapatite solid calibration phantoms supplied by Scanco Medical AG Company. Variations in current, integration time and projection number had no effect on the conversion relationship between micro and rhoEQ for the K2HPO4 and Scanco calibration phantoms [p>0.05 for all cases]. However, as expected, variations in scanning tube voltage, object to X-ray source distance, detector array size and imaging media (referring to the solution that surrounds the specimen in the imaging vial) significantly affected the conversion relationship between mu and rhoEQ for K2HPO4 and Scanco calibration phantoms [p<0.05 for all cases]. A multivariate linear regression approach was used to estimate rhoEQ based on attenuation coefficient, tube voltage, object to X-ray source distance, detector array size and imaging media for K2HPO4 liquid calibration phantoms, explaining 90% of the variation in rhoEQ. Furthermore, equivalent density values of bovine cortical bone (converted from attenuation coefficient to equivalent density using the K2HPO4 liquid calibration phantoms) samples highly correlated [R2=0.92] with the ash densities of the samples. In conclusion, Scanco calibration phantoms can be used to assess equivalent bone mineral density; however, they cannot be scanned with a specimen or submerged in a different imaging media. The K2HPO4 liquid calibration phantoms provide a cost effective, easy to prepare and convenient means to perform quantitative microCT analysis using any microCT system, with the ability to choose different imaging media according to study needs. However, as with any liquid calibration phantom, they are susceptible to degradation over time.

Histogram partition and interval thresholding for volumetric breast tissue segmentation

It is possible to automatically decompose a volume into subvolumes based on histogram partition and interval thresholding. In practice, a histogram may assume unimodal or multimodal distributions. In this paper, we implement an automatic volumetric segmentation scheme by partitioning a histogram into intervals followed by interval thresholding. Based on its distribution shape, the histogram is partitioned by either a valley-seeking algorithm (for multimodal) or a five-subinterval algorithm (for unimodal). Applied to volumetric breast analysis, this technique decomposes a breast volume into five subvolumes corresponding to five intensity subintervals: lower (air bubble), low (fat), middle (normal tissue, or parenchyma), high (glandular duct), higher (calcification), in the order of X-ray attenuation value. With the assumption that each subvolume resulting from interval thresholding corresponds to a tissue type, the spatial structure of each breast tissue type can be individually visualized and analyzed in a subvolume in an ample space (as big as the whole volume) in the absence of other tissue types. We demonstrate this histogram-partitioned interval thresholding segmentation method with one breast phantom and one breast surgical specimen that are volumetrically reconstructed by cone-beam tomography.

Preparation and characterization of calibration standards for bone density determination by micro-computed tomography

Phantoms for the calibration of local bone mineral densities by micro-computed tomography (microCT), consisting of lithium tetraborate (Li(2)B(4)O(7)) with increasing concentrations of hydroxyapatite [HAp, Ca(10)(PO(4))6(OH)2] have been prepared and characterized for homogeneity. Large-scale homogeneity and concentration of HAp in the phantom materials was determined using laser ablation inductively coupled plasma mass spectrometry (LA-ICPMS), while homogeneity on the micrometer scale was assessed through microCT. A series of standards was prepared by fusion of pure HAp with Li(2)B(4)O(7) in a concentration range between 0.12 and 0.74 g cm(-3). Furthermore, pressed and sintered pellets of pure HAp were prepared to extend the calibration range towards densities of up to 3.05 g cm(-3). A linear calibration curve was constructed using all individual standard materials and the slope of the curve was in good agreement with calculated absorption coefficients at the effective energy of the microCT scanner.

Effective x-ray attenuation measurements with full field digital mammography

This work shows that effective x-ray attenuation coefficients may be estimated by applying Beer's Law to phantom image data acquired with the General Electric Senographe 2000D full field digital mammography system. Theoretical developments are provided indicating that an approximate form of the Beer's relation holds for polychromatic x-ray beams. The theoretical values were compared with experimentally determined measured values, which were estimated at various detector locations. The measured effective attenuation coefficients are in agreement with those estimated with theoretical developments and numerical integration. The work shows that the measured quantities show little spatial variation. The main ideas are demonstrated with polymethylmethacrylate and breast tissue equivalent phantom imaging experiments. The work suggests that the effective attenuation coefficients may be used as known values for radiometric standardization applications that compensate for the image acquisition influences. The work indicates that it is possible to make quantitative attenuation coefficient measurements from a system designed for clinical purposes.

Error analysis of calibration materials on dual-energy mammography

Dual-energy mammography can suppress the contrast between adipose and glandular tissues and improve the detectability of microcalcifications (MCs). In clinical dual-energy mammography, imaging object is human breast, while in calibration measurements, only phantoms of breast-tissue-equivalent material can be used. The composition and density differences between calibration materials and human breast bring the differences of linear attenuation coefficient which lead to the calculation errors in dual-energy imaging. In this paper, the magnitude of MC thickness error from calibration materials has been analyzed using a first-order propagation of error analysis. This analysis shows that the thickness error from calibration materials ranges from dozens to thousands of microns which can not be ignored when carrying out dual-energy calculations. The evaluation of several popular phantoms shows that it is of great importance to adopt the phantom materials approaching human breast most.

Volumetric breast density estimation from full-field digital mammograms

A method is presented for estimation of dense breast tissue volume from mammograms obtained with full-field digital mammography (FFDM). The thickness of dense tissue mapping to a pixel is determined by using a physical model of image acquisition. This model is based on the assumption that the breast is composed of two types of tissue, fat and parenchyma. Effective linear attenuation coefficients of these tissues are derived from empirical data as a function of tube voltage (kVp), anode material, filtration, and compressed breast thickness. By employing these, tissue composition at a given pixel is computed after performing breast thickness compensation, using a reference value for fatty tissue determined by the maximum pixel value in the breast tissue projection. Validation has been performed using 22 FFDM cases acquired with a GE Senographe 2000D by comparing the volume estimates with volumes obtained by semi-automatic segmentation of breast magnetic resonance imaging (MRI) data. The correlation between MRI and mammography volumes was 0.94 on a per image basis and 0.97 on a per patient basis. Using the dense tissue volumes from MRI data as the gold standard, the average relative error of the volume estimates was 13.6%.

Applicability of ACR breast dosimetry methodology to a digital mammography system

Determination of mean glandular dose (MGD) to breast tissue is an essential aspect of mammography equipment evaluations and exposure controls. The American College of Radiology (ACR) Quality Control Manual outlines the procedure for MGD determination in screen-film mammography based upon conversions of entrance skin exposures (ESEs) measured with an ionization chamber (IC). The development of digital mammography has increased with the demand for improved object resolution and tissue contrast. This change in image receptor from screen-film to a solid-state detector has led to questions about the applicability of the ACR MGD methodology to digital mammography. This research has validated the applicability of the ACR MGD methodology to digital mammography in the GE digital mammography system Senographe 2000D. MGD was determined using light output measurements from thermoluminescent dosimeters (MGDTL), exposure measurements from an IC (MGD(IC)) and conversion factors from the ACR Mammography Quality Control Manual. MGD(TL) and MGD(IC) data indicate that there is a statistically significant difference between the two measurements with the Senographe 2000D. However, the applicability of the ACR's methodology was validated by calculating MGD at various depths in a 50/50 breast phantom. Additionally, the results of backscatter measurements from the image receptors of both mammography modalities indicate there is a difference (all P values < 0.001) in the radiation backscattered from each image receptor.

Direct analysis of molybdenum target generated x-ray spectra with a portable device

In routine applications, information about the photon flux of x-ray tubes is obtained from exposure measurements and cataloged spectra. This approach relies mainly on the assumption that the real spectrum is correctly approximated by the cataloged one, once the main characteristics of the tube such as voltage, target material, anode angle, and filters are taken account of. In practice, all this information is not always available. Moreover, x-ray tubes with the same characteristics may have different spectra. We describe an apparatus that should be useful for quality control in hospitals and for characterizing new radiographic systems. The apparatus analyzes the spectrum generated by an x-ray mammographic unit. It is based on a commercial CZT produced by AMPTEK Inc. and a set of tungsten collimator disks. The electronics of the CZT are modified so as to obtain a faster response. The signal is digitized using an analog to digital converter with a sampling frequency of up to 20 MHz. The whole signal produced by the x-ray tube is acquired and analyzed off-line in order to accurately recognize pile-up events and reconstruct the emitted spectrum. The energy resolution has been determined using a calibrated x-ray source. Spectra were validated by comparison of the HVL measured using an ionization chamber.

Computerized analysis of mammographic parenchymal patterns for assessing breast cancer risk: Effect of ROI size and location

The long-term goal of our research is to develop computerized radiographic markers for assessing breast density and parenchymal patterns that may be used together with clinical measures for determining the risk of breast cancer and assessing the response to preventive treatment. In our earlier studies, we found that women at high risk tended to have dense breasts with mammographic patterns that were coarse and low in contrast. With our method, computerized texture analysis is performed on a region of interest (ROI) within the mammographic image. In our current study, we investigate the effect of ROI size and ROI location on the computerized texture features obtained from 90 subjects (30 BRCA1/BRCA2 gene-mutation carriers and 60 age-matched women deemed to be at low risk for breast cancer). Mammograms were digitized at 0.1 mm pixel size and various ROI sizes were extracted from different breast regions in the craniocaudal (CC) view. Seventeen features, which characterize the density and texture of the parenchymal patterns, were extracted from the ROIs on these digitized mammograms. Stepwise feature selection and linear discriminant analysis were applied to identify features that differentiate between the low-risk women and the BRCA1/BRCA2 gene-mutation carriers. ROC analysis was used to assess the performance of the features in the task of distinguishing between these two groups. Our results show that there was a statistically significant decrease in the performance of the computerized texture features, as the ROI location was varied from the central region behind the nipple. However, we failed to show a statistically significant decrease in the performance of the computerized texture features with decreasing ROI size for the range studied.

A volumetric method for estimation of breast density on digitized screen-film mammograms

A method is described for the quantitative volumetric analysis of the mammographic density (VBD) from digitized screen-film mammograms. The method is based on initial calibration of the imaging system with a tissue-equivalent plastic device and the subsequent correction for variations in exposure factors and film processing characteristics through images of an aluminum step wedge placed adjacent to the breast during imaging. From information about the compressed breast thickness and technique factors used for taking the mammogram as well as the information from the calibration device, VBD is calculated. First, optical sensitometry is used to convert images to Log relative exposure. Second, the images are corrected for x-ray field inhomogeneity using a spherical section PMMA phantom image. The effectiveness of using the aluminum step wedge in tracking down the variations in exposure factors and film processing was tested by taking test images of the calibration device, aluminum step wedge and known density phantoms at various exposure conditions and also at different times over one year. Results obtained on known density phantoms show that VBD can be estimated to within 5% accuracy from the actual value. A first order thickness correction is employed to correct for inaccuracy in the compression thickness indicator of the mammography units. Clinical studies are ongoing to evaluate whether VBD can be a better indicator for breast cancer risk.

A calibration approach to glandular tissue composition estimation in digital mammography

The healthy breast is almost entirely composed of a mixture of fatty, epithelial, and stromal tissues which can be grouped into two distinctly attenuating tissue types: fatty and glandular. Further, the amount of glandular tissue is linked to breast cancer risk, so an objective quantitative analysis of glandular tissue can aid in risk estimation. Highnam and Brady have measured glandular tissue composition objectively. However, they argue that their work should only be used for "relative" tissue measurements unless a careful calibration has been performed. In this work, we perform such a "careful calibration" on a digital mammography system and use it to estimate breast tissue composition of patient breasts. We imaged 0%, 50%, and 100% glandular-equivalent phantoms of varying thicknesses for a number of clinically relevant x-ray techniques on a digital mammography system. From these images, we extracted mean signal and noise levels and computed calibration curves that can be used for quantitative tissue composition estimation. In this way, we calculate the percent glandular composition of a patient breast on a pixelwise basis. This tissue composition estimation method was applied to 23 digital mammograms. We estimated the quantitative impact of different error sources on the estimates of tissue composition. These error sources include compressed breast height estimation error, residual scattered radiation, quantum noise, and beam hardening. Errors in the compressed breast height estimate contribute the most error in tissue composition--on the order of +/-7% for a 4 cm compressed breast height: The spatially varying scattered radiation will contribute quantitatively less error overall, but may be significant in regions near the skinline. It is calculated that for a 4 cm compressed breast height, a residual scatter signal error is mitigated by approximately sixfold in the composition estimate. The error in composition due to the quantum noise, which is the limiting noise source in the system, is shown to be less than 1% glandular for most breasts.

Cone-beam volume CT breast imaging: feasibility study

X-ray projection mammography, using a film/screen combination, or digital techniques, has proven to be the most effective imaging modality currently available for early detection of breast cancer. However, the inherent superimposition of structures makes a small carcinoma (a few millimeters in size) difficult to detect when it is occult or in dense breasts, leading to a high false-positive biopsy rate. Cone-beam x-ray-projection-based volume imaging using flat panel detectors (FPDs) may allow obtaining three-dimensional breast images, resulting in more accurate diagnosis of structures and patterns of lesions while eliminating the hard compression of breasts. This article presents a novel cone-beam volume computed tomographic breast imaging (CBVCTBI) technique based on the above techniques. Through a variety of computer simulations, the key issues of the system and imaging techniques were addressed, including the x-ray imaging geometry and corresponding reconstruction algorithms, x-ray characteristics of breast tissue and lesions, x-ray setting techniques, the absorbed dose estimation, and the quantitative effect of x-ray scattering on image quality. The preliminary simulation results support the proposed CVBCTBI modality for breast imaging in respect to its feasibility and practicability. The absorbed dose level is comparable to that of current mammography and will not be a prominent problem for this imaging technique. Compared to conventional mammography, the proposed imaging technique with isotropic spatial resolution will potentially provide significantly better low-contrast detectability of breast tumors and more accurate location of breast lesions.

X-ray scattering from human breast tissues and breast-equivalent materials

The angular distributions of photons scattered by human breast tissues (adipose and glandular) and by eight breast-equivalent materials (water, polymethylmethacrylate, nylon, polyethylene and four commercial breast-equivalent materials simulating different glandular-adipose proportions) have been measured at a photon energy of 17.44 keV (Kalpha-radiation of Mo). Transmission target geometry has been used with an acceptance of +/- 0.6 degrees and an uncertainty of approximately 7%. Experimental molecular form factors were extracted from diffraction patterns normalizing the number of scattered photons with theoretical data in regions where no structure is expected. Linear attenuation coefficients have been measured for all samples at this energy. The results for water, polymethylmethacrylate, nylon and adipose tissue agree with former reported data. The results for human breast tissues at low and medium scattering angle (1-25 degrees, corresponding to the momentum transfer region between 0.2 and 3 nm(-1)) differ from the breast-equivalent materials. The results for adipose tissue are similar to the corresponding values from commercial breast-equivalent materials while the results for glandular tissue are similar to those for water.

A comparison of mammography spectral measurements with spectra produced using several different mathematical models

Due to the relatively complex nature of spectral measurements from x-ray machines, many researchers use mathematical models to simulate the spectra they need. However, there is concern over their accuracy, and hence the impact that their accuracy may have, on subsequent calculations that rely upon the spectra modelled. With this in mind spectral measurements have been performed on a mammography machine and a comparison with spectra calculated using several different models is presented. Several different techniques have been investigated in the spectral measurements to allow for pulse pileup and other effects of high count rate. Comparison with half value layer (HVL) measurements shows that the use of a gating signal in conjunction with the air-free path provides accurate results without the need for a pinhole collimator. Comparison of the measured spectra with those calculated using different models proposed in the literature suggests that accurate results can be produced by all models, but only if the user attempts to match the calculated HVL of the modelled spectrum with the physically measured HVL. If this is not done the modelled spectra may be in error. The impact of such an error is demonstrated in calculations of mean glandular dose, which indicate a possible underestimate of the dose by up to 20%.

Field nonuniformity correction for quantitative analysis of digitized mammograms

Several factors, including the heel effect, variation in distance from the x-ray source to points in the image and path obliquity contribute to the signal nonuniformity of mammograms. To best use digitized mammograms for quantitative image analysis, these field non-uniformities must be corrected. An empirically based correction method, which uses a bowl-shaped calibration phantom, has been developed. Due to the annular spherical shape of the phantom, its attenuation is constant over the entire image. Remaining nonuniformities are due only to the heel and inverse square effects as well as the variable path through the beam filter, compression plate and image receptor. In logarithmic space, a normalized image of the phantom can be added to mammograms to correct for these effects. Then, an analytical correction for path obliquity in the breast can be applied to the images. It was found that the correction causes the errors associated with field nonuniformity to be reduced from 14% to 2% for a 4 cm block of material corresponding to a combination of 50% fibroglandular and 50% fatty breast tissue. A repeatability study has been conducted to show that in regions as far as 20 cm away from the chest wall, variations due to imaging conditions and phantom alignment contribute to <2% of overall corrected signal.

Comparison of tomosynthesis methods used with digital mammography

RATIONALE AND OBJECTIVES

The authors performed this study to investigate the potential applicability of tomosynthesis to digital mammography. Four methods of tomosynthesis-tuned aperture computed tomography (TACT)-backprojection, TACT-iterative restoration, iterative reconstruction with expectation maximization, and Bayesian smoothing-were compared to planar mammography and analyzed in terms of their contrast-detail characteristics. Specific comparisons between the tomosynthesis methods were not attempted in this study.

MATERIALS AND METHODS

A full-field, amorphous, silicon-based, flat-panel digital mammographic system was used to obtain planar and tomosynthesis projection images. A composite tomosynthesis phantom with a centrally located contrast-detail insert was used as the object of interest. The total exposure for multiple views with tomosynthesis was always equal to or less than that for the planar technique. Algorithms were used to reconstruct the object from the acquired projections.

RESULTS

Threshold contrast characteristics with all tomosynthesis reconstruction methods were significantly better than those with planar mammography, even when planar mammography was performed at more than twice the exposure level. Reduction of out-of-plane structural components was observed in all the tomosynthesis methods analyzed.

CONCLUSION

The contrast-detail trends of all the tomosynthesis methods analyzed in this study were better than those of planar mammography. Further optimization of the algorithms could lead to better image reconstruction, which would improve visualization of valuable diagnostic information.

Mammographic imaging with a small format CCD-based digital cassette: physical characteristics of a clinical system

The physical characteristics of a clinical charge coupled device (CCD)-based imager (Senovision, GE Medical Systems, Milwaukee, WI) for small-field digital mammography have been investigated. The imager employs a MinR 2000 (Eastman Kodak Company, Rochester, NY) scintillator coupled by a 1:1 optical fiber to a front-illuminated 61 x 61 mm CCD operating at a pixel pitch of 30 microns. Objective criteria such as modulation transfer function (MTF), noise power spectrum (NPS), detective quantum efficiency (DQE), and noise equivalent quanta (NEQ) were employed for this evaluation. The results demonstrated a limiting spatial resolution (10% MTF) of 10 cy/mm. The measured DQE of the current prototype utilizing a 28 kVp, Mo-Mo spectrum beam hardened with 4.5 cm Lucite is approximately 40% at close to zero spatial frequency at an exposure of 8.2 mR, and decreases to approximately 28% at a low exposure of 1.1 mR. Detector element nonuniformity and electronic gain variations were not significant after appropriate calibration and software corrections. The response of the imager was linear and did not exhibit signal saturation under tested exposure conditions.

Full breast digital mammography with an amorphous silicon-based flat panel detector: physical characteristics of a clinical prototype

The physical characteristics of a clinical prototype amorphous silicon-based flat panel imager for full-breast digital mammography have been investigated. The imager employs a thin thallium doped CsI scintillator on an amorphous silicon matrix of detector elements with a pixel pitch of 100 microm. Objective criteria such as modulation transfer function (MTF), noise power spectrum, detective quantum efficiency (DQE), and noise equivalent quanta were employed for this evaluation. The presampling MTF was found to be 0.73, 0.42, and 0.28 at 2, 4, and 5 cycles/mm, respectively. The measured DQE of the current prototype utilizing a 28 kVp, Mo-Mo spectrum beam hardened with 4.5 cm Lucite is approximately 55% at close to zero spatial frequency at an exposure of 32.8 mR, and decreases to approximately 40% at a low exposure of 1.3 mR. Detector element nonuniformity and electronic gain variations were not significant after appropriate calibration and software corrections. The response of the imager was linear and did not exhibit signal saturation under tested exposure conditions.