Contrast-Enhanced Digital Mammography and Angiogenesis

Rosado-Méndez, Iván M.; Palma, B. A.; Villaseñor, Yolanda; Benı́tez-Bribiesca, Luis; Brandan, M. E.

doi:10.1063/1.2825815

Cited by 2 publications

(3 citation statements)

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“…9,13 The combination of dual-energy and temporal subtraction, the dual-energy temporal modality ͑DET͒ has also been suggested. 14 For radiological images, the subtraction technique is based on the nonlinear dependence on energy of the different materials attenuation coefficients. [15][16][17][18] Iodine has been largely used as a contrast medium in radiology due to its strong energy-dependent attenuation properties when compared to breast tissues.…”

Section: Introductionmentioning

confidence: 99%

“…[15][16][17][18] Iodine has been largely used as a contrast medium in radiology due to its strong energy-dependent attenuation properties when compared to breast tissues. 6,[9][10][11][12]14 In this work, we extend and further exploit an existing analytical formalism 19 in order to model image quality and dose descriptors using a common experimental definition of CEDM subtraction techniques. Using mathematical expressions obtained from the formalism, we perform an analytical optimization of radiological parameters for the application of different subtraction modalities ͑SET, DET, and DE͒, assuming a GE Senographe 2000D unit in default setup ͑only adding external filtration͒, aiming at maximizing the contrast over its associated noise in subtracted images with consideration of the total dose delivered to the patient.…”

Section: Introductionmentioning

confidence: 99%

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Analytical optimization of digital subtraction mammography with contrast medium using a commercial unit

2008

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Contrast-medium-enhanced digital mammography (CEDM) is an image subtraction technique which might help unmasking lesions embedded in very dense breasts. Previous works have stated the feasibility of CEDM and the imperative need of radiological optimization. This work presents an extension of a former analytical formalism to predict contrast-to-noise ratio (CNR) in subtracted mammograms. The goal is to optimize radiological parameters available in a clinical mammographic unit (x-ray tube anode/filter combination, voltage, and loading) by maximizing CNR and minimizing total mean glandular dose (D(gT)), simulating the experimental application of an iodine-based contrast medium and the image subtraction under dual-energy nontemporal, and single- or dual-energy temporal modalities. Total breast-entrance air kerma is limited to a fixed 8.76 mGy (1 R, similar to screening studies). Mathematical expressions obtained from the formalism are evaluated using computed mammographic x-ray spectra attenuated by an adipose/glandular breast containing an elongated structure filled with an iodinated solution in various concentrations. A systematic study of contrast, its associated variance, and CNR for different spectral combinations is performed, concluding in the proposal of optimum x-ray spectra. The linearity between contrast in subtracted images and iodine mass thickness is proven, including the determination of iodine visualization limits based on Rose's detection criterion. Finally, total breast-entrance air kerma is distributed between both images in various proportions in order to maximize the figure of merit CNR2/D(gT). Predicted results indicate the advantage of temporal subtraction (either single- or dual-energy modalities) with optimum parameters corresponding to high-voltage, strongly hardened Rh/Rh spectra. For temporal techniques, CNR was found to depend mostly on the energy of the iodinated image, and thus reduction in D(gT) could be achieved if the spectral energy of the noniodinated image is decreased and the breast-entrance air kerma is evenly distributed between both acquisitions. Predicted limits, in terms of iodine concentration, are found to guarantee the visualization of common clinical angiogenic concentrations in the breast.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Analytical optimization of digital subtraction mammography with contrast medium using a commercial unit

2008

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“…1-5 Dual-energy temporal subtraction ͑DET͒ is a combination of the previous two modalities, taking advantage of both a spectral change and temporality in the CM presence: A "mask" ͑without CM͒ image is first obtained, contrast medium is applied under the same weak breast compression, and the second image ͑postinjection͒ is taken with radiological parameters different from those used for the mask. 10 The common use of iodine in radiology daily practice has facilitated its application in CEDM due to proven low toxicity levels and high attenuating properties in the mammographic x-ray energy range ͑iodine K edge at 33.2 keV͒. 2,11 Previous CEDM phantom studies and clinical trials have used relatively energetic x-ray spectra aiming at increasing the average photon energy, so a great spectral proportion could overpass the K edge of iodine.…”

Section: Introductionmentioning

confidence: 99%

Phantom study to evaluate contrast‐medium‐enhanced digital subtraction mammography with a full‐field indirect‐detection system

et al. 2010

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This phantom study simulates contrast-medium-enhanced digital subtraction mammography (CEDM) and compares subtracted image quality and total mean glandular dose for two alternative spectral combinations available in a GE Senographe DS mammography unit. The first choice takes advantage of large iodine attenuation at low photon energies and uses traditionally available spectra (anode/filter combinations Mo/Mo at 25 kV and Rh/Rh at 40 kV, "Mo25-Rh40"). The second choice, selected from a previous analytical optimization, includes harder spectra obtained by adding external filtration to traditional beams (Rh/Rh at 34 kV and Rh/Rh+5 mm of Al at 45 kV, "Rh34-Rh45H"). Individual images of a custom-made phantom containing tubes of various diameters filled with water- or iodine-based contrast agent were acquired with both spectral combinations. The total breast entrance air kerma, considering subtraction of two images, was limited to 8.76 mGy (1 R). The results were compared to predictions obtained through an analytical formalism that assumes noise of stochastic origin. Individual images were evaluated and subtracted under five combinations of temporal and dual-energy modalities. Signal variance analysis in individual raw images showed important contributions of nonstochastic origin, associated with the software applied to raw images, the curved geometry, and strong attenuation of the phantom cylindrical iodine-filled tubes, causing experimental SNR to vary from 2.2 to 0.8 times the predictions from low to high values of SNR. Iodine contrast in the subtracted images was found to be mainly defined by the spectra, independent of exposure, and linearly dependent on the iodine mass thickness. The highest contrast was obtained with the combined dual-energy temporal subtraction with Rh34-Rh45H, its value was 7% larger than the highest value measured with Mo25-Rh40. As expected, temporal modalities (single and dual energy, any spectral choice) led to higher contrast-over-noise ratio (CNR) than nontemporal dual-energy subtraction, the latter being negligibly small with Mo25-Rh40. CNR for 4 mg iodine/cm2 imaged temporally in a dual-energy fashion with Rh34-Rh45H (iodine imaged at high energy) is about 1.7 times the optimum for Mo25-Rh40 (iodine imaged at low energy). Iodine thicknesses needed to fulfill Rose's criterion were 0.78 +/- 0.02 mg iodine/cm2 for Mo25-Rh40 and 0.54 +/- 0.17 mg iodine/cm2 for Rh34-Rh45H, both lower than the proposed biological concentration of iodine in breast tumors after contrast medium administration. Although similar dose levels were obtained with both spectral choices under dual-energy (temporal and nontemporal) subtraction, the dose obtained in single-energy temporal subtraction with the Mo25 spectrum was 1.2 mGy lower than the dose from the modality offering the highest CNR. In all results considered, the spectral choice Mo25-Rh40 was found to represent an interesting alternative to the use of high-energy hardened spectra for CEDM, particularly when performing dynamic studies of the contrast-agent u...

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Contrast-Enhanced Digital Mammography and Angiogenesis

Cited by 2 publications

References 1 publication

Analytical optimization of digital subtraction mammography with contrast medium using a commercial unit

Analytical optimization of digital subtraction mammography with contrast medium using a commercial unit

Phantom study to evaluate contrast‐medium‐enhanced digital subtraction mammography with a full‐field indirect‐detection system

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