Dual-energy subtraction for contrast-enhanced digital breast tomosynthesis

Carton, Ann-Katherine; Lindman, Karin; Ullberg, Christer; Francke, T.; Maidment, Andrew D. A.

doi:10.1117/12.713703

Cited by 19 publications

(27 citation statements)

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“…By contrast, dual-energy images show little motion artefact because both the HE and LE images are acquired after injection. This is the practical advantage of dual-energy subtraction contrastenhanced X-ray imaging of the breast [13][14][15][16].…”

Section: Discussionmentioning

confidence: 99%

“…In this subtraction, a weighting factor, w t , of 0.21 was applied. This value was found to cancel breast tissue optimally in a region of the breast with constant thickness [16]. A total variation (TV) noise reduction algorithm was applied to the subtracted images to reduce the noise without blurring the image [22].…”

Section: Image Processingmentioning

confidence: 99%

“…Pre-and post-contrast images are then subtracted logarithmically, yielding iodine-enhanced images. In dual-energy subtraction, post-contrast images are acquired in pairs at energies that closely bracket the Kedge of iodine [13][14][15][16]. At each time point, iodine-enhanced images are calculated by weighted logarithmic subtraction of the low-and high-energy (LE and HE) images.…”

mentioning

confidence: 99%

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Dual-energy contrast-enhanced digital breast tomosynthesis – a feasibility study

Carton

Gavenonis²,

Currivan³

et al. 2010

BJR

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ABSTRACT. Contrast-enhanced digital breast tomosynthesis (CE-DBT) is a novel modality for imaging breast lesion morphology and vascularity. The purpose of this study is to assess the feasibility of dual-energy subtraction as a technique for CE-DBT (a temporal subtraction CE-DBT technique has been described previously). As CE-DBT evolves, exploration of alternative image acquisition techniques will contribute to its optimisation. Evaluation of dual-energy CE-DBT was conducted with Institutional Review Board (IRB) approval from our institution and in compliance with federal Health Insurance Portability and Accountability Act (HIPAA) guidelines. A 55-year old patient with a known malignancy in the right breast underwent imaging with MRI and CE-DBT. CE-DBT was performed in the medial lateral oblique view with a DBT system, which was modified under IRB approval to allow high-energy image acquisition with a 0.25 mm Cu filter. Image acquisition occurred via both temporal and dual-energy subtraction CE-DBT. Between the pre-and post-contrast DBT image sets, a single bolus of iodinated contrast agent (1.0 ml kg -1 ) was administered, followed by a 60 ml saline flush. The contrast agent and saline were administrated manually at a rate of ,2 ml s -1 . Images were reconstructed using filtered-back projection and transmitted to a clinical PACS workstation. Dual-energy CE-DBT was shown to be clinically feasible. In our index case, the dual-energy technique was able to provide morphology and kinetic information about the known malignancy. This information was qualitatively concordant with that of CE-MRI. Compared with the temporal subtraction CE-DBT technique, dual-energy CE-DBT appears less susceptible to motion artefacts. Breast tumour growth and metastasis are accompanied by the development of new blood vessels that have an abnormally increased permeability [1]. As a result, the absorption of vascular contrast agents in malignant breast tissue is often different to that in benign and normal tissues. Today, contrast-enhanced MRI (CE-MRI), which uses a gadolinium chelate as a vascular contrast agent, is the standard for vascular imaging of breast cancers [2][3][4][5][6][7]. Breast lesion characterisation with CE-MRI relies on a combination of the analysis of the morphological features of the lesion and the vascular enhancement kinetics.Preliminary studies have demonstrated that contrastenhanced digital breast tomosynthesis (CE-DBT) using an iodinated vascular contrast agent has the potential to demonstrate morphology and vascular enhancement information concordant with that of CE-MRI [8]. As the clinical uses of CE-MRI continue to expand, investigation into a potential alternative such as CE-DBT (which is projected to be less costly and more widely available than MRI) may also increase in importance.Two CE X-ray imaging techniques have been proposed: temporal and dual-energy subtraction. In temporal subtraction breast X-ray imaging, one pre-contrast and one (or more) post-contrast time-points are acquired using a spectrum pred...

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Section: Discussionmentioning

confidence: 99%

Section: Image Processingmentioning

confidence: 99%

mentioning

confidence: 99%

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Dual-energy contrast-enhanced digital breast tomosynthesis – a feasibility study

Carton

Gavenonis²,

Currivan³

et al. 2010

BJR

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“…(Boone, Shaber et al 1990) analyzed detector parameters, effects of X-ray parameters and filtrations and the effect of scatter on the quality of the dual energy images. Kappadath et al (Kappadath, Shaw et al 2004 greatly improved the visibility of malignant cancerous tissues (Chen, Jing et al 2006;Arvanitis, Royle et al 2007;Puong, Bouchevreau et al 2007), the combination of dual energy CT and Iodine contrast together offers yet more improvements to our ability to separate different tissues from one another in an image (Carton, Lindman et al 2007), (Puong, Patoureaux et al 2007;Saunders, Samei et al 2008). …”

Section: Dual Energy Imaging Applicationsmentioning

confidence: 99%

Contrast Enhancement in Mammography Imaging Including K Edge Filtering

Zentai¹

2012

Imaging of the Breast - Technical Aspects and Clinical Implication

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“…These images are then combined into iodine and soft tissue images. 2,3 Key technical parameters that determine the detectability of the iodine are the x-ray spectra used to produce the LE and HE images, the dose allocation between the LE and HE images, and the total dose to the patient. In a companion paper, 4 we developed a DE acquisition technique for a photon-counting DBT imaging system.…”

Section: Introductionmentioning

confidence: 99%

Optimization of a dual‐energy contrast‐enhanced technique for a photon‐counting digital breast tomosynthesis system: II. An experimental validation

2010

Self Cite

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Purpose: Previously, the authors developed a dual-energy ͑DE͒ acquisition technique for a photoncounting digital breast tomosynthesis ͑DBT͒ imaging system. Low-energy ͑LE͒ and high-energy ͑HE͒ images are acquired in a single scan by covering alternate slits of a multislit prepatient collimator with Sn and Cu, respectively. A theoretical model was used to optimize the technique. In this article, an experimental validation of this technique is presented. Methods: Experiments were performed on a prototype DBT system. LE and HE projection images were acquired sequentially; either a Sn or a Cu filter was positioned in the filter holder at the exit window of the x-ray tube. Sn filters from 0.113 to 0.242 mm thick and Cu filters from 0.103 to 0.267 mm were used. The images were acquired with a W target at 49 kV. Tomographic images, hereafter referred to as DBT images, were reconstructed using a shift-and-add algorithm. DE-DBT images were obtained by weighted logarithmic subtraction of the LE and HE images. Weighting factors w t that optimally cancel breast tissues with two different glandularities were assessed for 20-80 mm thick phantoms with 0%, 50%, and 100% glandularity. The mean and standard deviation in the per-pixel signal intensity ͑SI͒ were calculated in the DBT images. These data were used to calculate signal-difference-to-noise ratios ͑SDNRs͒ between iodine enhanced and nonenhanced polymethyl methacrylate backgrounds. To illustrate the feasibility of the technique, DE-DBT images of a structured phantom containing iodine disks were assessed. The experimental results were compared against the values obtained from a theoretical model of the imaging system. Results: The average difference between theoretical and experimental w t was found to range from 8% to 21%. Experimental w t values increase with phantom thickness and Cu thickness, depend somewhat on Sn thickness, and vary more as a function of breast composition in thick breasts than in thin breasts. Theoretical and experimental mean and standard deviation in the per-pixel SI differ by Ϫ7% to 10% and by Ϫ3% to 4%. Theoretical and experimental SDNR values differ, on average, by 1.5%. Iodine concentrations can be predicted from SDNR; the relationship can be accurately fit to a quadratic. In the images of the structured phantom, iodine concentrations of 1 mg/ cm 2 and larger are discernable. Conclusions:The strong agreement between experimental and theoretical results in this article indicates that the authors' computer model is accurate.

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Dual-energy subtraction for contrast-enhanced digital breast tomosynthesis

Cited by 19 publications

References 0 publications

Dual-energy contrast-enhanced digital breast tomosynthesis – a feasibility study

Dual-energy contrast-enhanced digital breast tomosynthesis – a feasibility study

Contrast Enhancement in Mammography Imaging Including K Edge Filtering

Optimization of a dual‐energy contrast‐enhanced technique for a photon‐counting digital breast tomosynthesis system: II. An experimental validation

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