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.     

A comparison between objective and subjective image quality measurements for a full field digital mammography system

This paper presents pre-sampling modulation transfer function (MTF), normalized noise power spectrum (NNPS) and detective quantum efficiency (DQE) results for an amorphous selenium (a-Se) full field digital mammography system. MTF was calculated from the image of an angled 0.5 mm thick Cu edge, acquired without additional beam filtration. NNPS data were acquired at detector air-kerma levels ranging from 9.1 microGy to 331 microGy, using a standard mammography x-ray spectrum of 28 kV, Mo/Mo target/filter combination and 4 cm of PMMA additional filtration. Prior to NNPS estimation, the image statistics were assessed using a variance image. This method was able to easily identify a detector artefact and should prove useful in routine quality assurance (QA) measurements. Detector DQE, calculated from the NNPS and MTF data, dropped to 0.3 for low detector air-kerma settings but reached an approximately constant value of 0.6 above 50 microGy at the detector. Subjective image quality data were also obtained at these detector air-kerma settings using the CDMAM contrast-detail (c-d) test object. The c-d data reflected the trend seen in DQE, with threshold contrast increasing at low detector air-kerma values. The c-d data were then compared against predictions made using two established models, the Rose model and a standard signal detection theory model. Using DQE(0), the Rose model gave results within approximately 15% on average for all the detector air-kerma values studied and for detail diameters down to 0.2 mm. Similar agreement was also found between the measured c-d data and the signal detection theory results, which were calculated using an ideal human visual response function and a system magnification of unity. The use of full spatial frequency DQE improved the agreement between the calculated and observer results for detail sizes below 0.13 mm.     

Effect of area x-ray beam equalization on image quality and dose in digital mammography

In mammography, thick or dense breast regions persistently suffer from reduced contrast-to-noise ratio (CNR) because of degraded contrast from large scatter intensities and relatively high noise. Area x-ray beam equalization can improve image quality by increasing the x-ray exposure to under-penetrated regions without increasing the exposure to other breast regions. Optimal equalization parameters with respect to image quality and patient dose were determined through computer simulations and validated with experimental observations on a step phantom and an anthropomorphic breast phantom. Three parameters important in equalization digital mammography were considered: attenuator material (Z = 13-92), beam energy (22-34 kVp) and equalization level. A Mo/Mo digital mammography system was used for image acquisition. A prototype 16 x 16 piston driven equalization system was used for preparing patient-specific equalization masks. Simulation studies showed that a molybdenum attenuator and an equalization level of 20 were optimal for improving contrast, CNR and figure of merit (FOM = CNR2/dose). Experimental measurements using these parameters showed significant improvements in contrast, CNR and FOM. Moreover, equalized images of a breast phantom showed improved image quality. These results indicate that area beam equalization can improve image quality in digital mammography.     

Spectral analysis of full field digital mammography data

The spectral content of mammograms acquired from using a full field digital mammography (FFDM) system are analyzed. Fourier methods are used to show that the FFDM image power spectra obey an inverse power law; in an average sense, the images may be considered as 1/f fields. Two data representations are analyzed and compared (1) the raw data, and (2) the logarithm of the raw data. Two methods are employed to analyze the power spectra (1) a technique based on integrating the Fourier plane with octave ring sectioning developed previously, and (2) an approach based on integrating the Fourier plane using rings of constant width developed for this work. Both methods allow theoretical modeling. Numerical analysis indicates that the effects due to the transformation influence the power spectra measurements in a statistically significant manner in the high frequency range. However, this effect has little influence on the inverse power law estimation for a given image regardless of the data representation or the theoretical analysis approach. The analysis is presented from two points of view (1) each image is treated independently with the results presented as distributions, and (2) for a given representation, the entire image collection is treated as an ensemble with the results presented as expected values. In general, the constant ring width analysis forms the foundation for a spectral comparison method for finding spectral differences, from an image distribution sense, after applying a nonlinear transformation to the data. The work also shows that power law estimation may be influenced due to the presence of noise in the higher frequency range, which is consistent with the known attributes of the detector efficiency. The spectral modeling and inverse power law determinations obtained here are in agreement with that obtained from the analysis of digitized film-screen images presented previously. The form of the power spectrum for a given image is approximately l/f2beta with beta approximately 1.4-1.5.     

Optimization of exposure parameters in full field digital mammography

Optimization of exposure parameters (target, filter, and kVp) in digital mammography necessitates maximization of the image signal-to-noise ratio (SNR), while simultaneously minimizing patient dose. The goal of this study is to compare, for each of the major commercially available full field digital mammography (FFDM) systems, the impact of the selection of technique factors on image SNR and radiation dose for a range of breast thickness and tissue types. This phantom study is an update of a previous investigation and includes measurements on recent versions of two of the FFDM systems discussed in that article, as well as on three FFDM systems not available at that time. The five commercial FFDM systems tested, the Senographe 2000D from GE Healthcare, the Mammomat Novation DR from Siemens, the Selenia from Hologic, the Fischer Senoscan, and Fuji's 5000MA used with a Lorad M-IV mammography unit, are located at five different university test sites. Performance was assessed using all available x-ray target and filter combinations and nine different phantom types (three compressed thicknesses and three tissue composition types). Each phantom type was also imaged using the automatic exposure control (AEC) of each system to identify the exposure parameters used under automated image acquisition. The figure of merit (FOM) used to compare technique factors is the ratio of the square of the image SNR to the mean glandular dose. The results show that, for a given target/filter combination, in general FOM is a slowly changing function of kVp, with stronger dependence on the choice of target/filter combination. In all cases the FOM was a decreasing function of kVp at the top of the available range of kVp settings, indicating that higher tube voltages would produce no further performance improvement. For a given phantom type, the exposure parameter set resulting in the highest FOM value was system specific, depending on both the set of available target/filter combinations, and on the receptor type. In most cases, the AECs of the FFDM systems successfully identified exposure parameters resulting in FOM values near the maximum ones, however, there were several examples where AEC performance could be improved.     

Improved image quality in digital mammography with image processing

PURPOSE: The effect of image processing, specifically Bayesian image estimation (BIE), on digital mammographic images is studied. BIE is an iterative, nonlinear statistical estimation technique that has previously been used in chest radiography to reduce image scatter content and improve the contrast-to-noise ratio (CNR). We adapt this technique to digital mammography and examine its effect. METHODS/MATERIALS: Images of the American College of Radiologists (ACR) breast phantom were acquired on a calibrated digital mammography system at a normal mammographic exposure both with and without a grid. An iterative Bayesian estimation algorithm was formulated and used to process the images acquired without a grid. Quantitative scatter fractions were measured and compared for the image acquired with the grid, the image acquired without the grid, and the image acquired without the grid and processed by the Bayesian algorithm. CNR values were also computed for the four visible masses in the ACR phantom before and after processing and compared to a grid. RESULTS: Initial images acquired without an antiscatter grid had scatter fractions of 0.46. Processing this image with BIE reduced the scatter content to under 0.04. In comparison, the image acquired with a grid had scatter of 0.19. BIE processing accounted for CNR improvements from 29% to 219% for the masses seen in the ACR phantom as compared to the unprocessed image. Visibility of the four masses in the phantom was improved. CONCLUSIONS: Bayesian image estimation can be used with digital mammography to reduce scatter fractions. This technique is very useful as it can reduce scatter content effectively without introducing any adverse effects, such as grid line aliasing. Bayesian processing can also increase image CNR, which may potentially increase the visualization of subtle masses. Preliminary work shows an improvement in CNR to values greater than that provided by a standard grid.     

Characterization of the effects of the FineView algorithm for full field digital mammography

The aim of this study was to characterize the effect of an image processing algorithm (FineView) on both quantitative image quality parameters and the threshold contrast detail response of the GE Senographe DS full-field digital mammography system. The system was characterized using signal transfer property, pre-sampling modulation transfer function (MTF), normalized noise power spectrum (NNPS) and detective quantum efficiency (DQE) of the system. An algorithmic modulation transfer function (MTF(a)) was calculated from images acquired at a reduced detector air kerma (DAK) and with the FineView algorithm enabled. Two sets of beam conditions were used: Mo/Mo/28 kV and Rh/Rh/29 kV, both with 2 mm added Al filtration at the x-ray tube. Images were acquired with and without FineView at four DAK levels from 14 to 378 μGy. The threshold contrast detail response was assessed using the CDMAM contrast-detail test object which was imaged under standard clinical conditions with and without FineView at three DAK levels from 24 to 243 μGy. The images were scored by both human observers and by automated scoring software. Results indicated an improvement of up to 125% at 5 mm?1 in MTF(a) when FineView was activated, particularly at high DAK levels. A corresponding increase of up to 425% at 5 mm?1 was also seen in the NNPS, again with the same DAK dependence. FineView did not influence DQE, an indication that the signal to noise ratio transfer of the system remained unchanged. FineView did not affect the threshold contrast detectability of the system, a result that is consistent with the DQE results.     

Quantification of breast arterial calcification using full field digital mammography

Breast arterial calcification is commonly detected on some mammograms. Previous studies indicate that breast arterial calcification is evidence of general atherosclerotic vascular disease and it may be a useful marker of coronary artery disease. It can potentially be a useful tool for assessment of coronary artery disease in women since mammography is widely used as a screening tool for early detection of breast cancer. However, there are currently no available techniques for quantification of calcium mass using mammography. The purpose of this study was to determine whether it is possible to quantify breast arterial calcium mass using standard digital mammography. An anthropomorphic breast phantom along with a vessel calcification phantom was imaged using a full field digital mammography system. Densitometry was used to quantify calcium mass. A calcium calibration measurement was performed at each phantom thickness and beam energy. The known (K) and measured (M) calcium mass on 5 and 9 cm thickness phantoms were related by M=0.964K -0.288 mg (r=0.997 and SEE=0.878 mg) and M=1.004K+0.324 mg (r=0.994 and SEE = 1.32 mg), respectively. The results indicate that accurate calcium mass measurements can be made without correction for scatter glare as long as careful calcium calibration is made for each breast thickness. The results also indicate that composition variations and differences of approximately 1 cm between calibration phantom and breast thickness introduce only minimal error in calcium measurement. The uncertainty in magnification is expected to cause up to 5% and 15% error in calcium mass for 5 and 9 cm breast thicknesses, respectively. In conclusion, a densitometry technique for quantification of breast arterial calcium mass was validated using standard full field digital mammography. The results demonstrated the feasibility and potential utility of the densitometry technique for accurate quantification of breast arterial calcium mass using standard digital mammography.     

Automatic exposure control for a slot scanning full field digital mammography system

Automatic exposure control (AEC) is an important feature in mammography. It enables consistently optimal image exposure despite variations in tissue density and thickness, and user skill level. Full field digital mammography systems cannot employ conventional AEC methods because digital receptors fully absorb the x-ray beam. In this paper we describe an AEC procedure for slot scanning mammography. With slot scanning detectors, our approach uses a fast low-resolution and low-exposure prescan to acquire an image of the breast. Tube potential depends on breast thickness, and the prescan histogram provides the necessary information to calculate the required tube current. We validate our approach with simulated prescan images and phantom measurements. We achieve accurate exposure tracking with thickness and density, and expect this method of AEC to reduce retakes and improve workflow.     

Physical characterization of a prototype selenium-based full field digital mammography detector

The purpose of this study was to measure experimentally the physical performance of a prototype mammographic imager based on a direct detection, flat-panel array design employing an amorphous selenium converter with 70 microm pixels. The system was characterized for two different anode types, a molybdenum target with molybdenum filtration (Mo/Mo) and a tungsten target with rhodium filtration (W/Rh), at two different energies, 28 and 35 kVp, with approximately 2 mm added aluminum filtration. To measure the resolution, the presampled modulation transfer function (MTF) was measured using an edge method. The normalized noise power spectrum (NNPS) was measured by two-dimensional Fourier analysis of uniformly exposed mammograms. The detective quantum efficiencies (DQEs) were computed from the MTFs, the NNPSs, and theoretical ideal signal to noise ratios. The MTF was found to be close to its ideal limit and reached 0.2 at 11.8 mm(-1) and 0.1 at 14.1 mm(-1) for images acquired at an RQA-M2 technique (Mo/Mo anode, 28 kVp, 2 mm Al). Using a tungsten technique (MW2; W/Rh anode, 28 kVp, 2 mm Al), the MTF went to 0.2 at 11.2 mm(-1) and to 0.1 at 13.3 mm(-1). The DQE reached a maximum value of 54% at 1.35 mm(-1) for the RQA-M2 technique at 1.6 microC/kg and achieved a peak value of 64% at 1.75 mm(-1) for the tungsten technique (MW2) at 1.9 microC/kg. Nevertheless, the DQE showed strong exposure and frequency dependencies. The results indicated that the detector offered high MTFs and DQEs, but structured noise effects may require improved calibration before clinical implementation.     

Retrospective analysis of a detector fault for a full field digital mammography system

This paper describes objective and subjective image quality measurements acquired as part of a routine quality assurance (QA) programme for an amorphous selenium (a-Se) full field digital mammography (FFDM) system between August-04 and February-05. During this period, the FFDM detector developed a fault and was replaced. A retrospective analysis of objective image quality parameters (modulation transfer function (MTF), normalized noise power spectrum (NNPS) and detective quantum efficiency (DQE)) is presented to try and gain a deeper understanding of the detector problem that occurred. These measurements are discussed in conjunction with routine contrast-detail (c-d) results acquired with the CDMAM (Artinis, The Netherlands) test object. There was significant reduction in MTF over this period of time indicating an increase in blurring occurring within the a-Se converter layer. This blurring was not isotropic, being greater in the data line direction (left to right across the detector) than in the gate line direction (chest wall to nipple). The initial value of the 50% MTF point was 6 mm(-1); for the faulty detector the 50% MTF points occurred at 3.4 mm(-1) and 1.0 mm(-1) in the gate line and data line directions, respectively. Prior to NNPS estimation, variance images were formed of the detector flat field images. Spatial distribution of variance was not uniform, suggesting that the physical blurring process was not constant across the detector. This change in variance with image position implied that the stationarity of the noise statistics within the image was limited and that care would be needed when performing objective measurements. The NNPS measurements confirmed the results found for the MTF, with a strong reduction in NNPS as a function of spatial frequency. This reduction was far more severe in the data line direction. A somewhat tentative DQE estimate was made; in the gate line direction there was little change in DQE up to 2.5 mm(-1) but at the Nyquist frequency the DQE had fallen to approximately 35% of the original value. There was severe attenuation of DQE in the data line direction, the DQE falling to less than 0.01 above approximately 3.0 mm(-1). C-d results showed an increase in threshold contrast of approximately 25% for details less than 0.2 mm in diameter, while no reduction in c-d performance was found at the largest detail diameters (1.0 mm and above). Despite the detector fault, the c-d curve was found to pass the European protocol acceptable c-d curve.     

The value of scatter removal by a grid in full field digital mammography

Our objective in this study was to investigate the usefulness of an anti-scatter grid in digital mammography using a contrast detail phantom. The mammography system we investigated was a GE Senographe 2000D. We carried out phantom measurements under various conditions with and without using the anti-scatter grid. A new version of the CDMAM phantom (version 3.4) was used. This phantom consists of a matrix of square cells with disks of varying size and contrast. For given exposure conditions detectability of these disks can be determined and used for construction of contrast detail curves. Previously, a computer program was developed at our institute that performs a fully automatic analysis of the phantom recordings using the ideal observer model. Breast thickness was simulated by a homogeneous layer of PMMA in the range of 1 to 7 cm. Series of images were recorded for different KeV and target-filter combinations depending on the simulated thickness. The dose was kept constant for each thickness with and without using a grid. It appeared that image quality improved for simulated breast thickness below 5 cm when the grid was removed. In the range from 5 to 7 cm contrast detail curves obtained with or without a grid were similar. Results suggest that for compressed breast thickness in the range of 1 to 7 cm a grid might not be needed in the digital mammography system we investigated. Below 5 cm, omitting the grid may allow lower dose to the patient without losing image quality.     

Influence of x-ray pulse parameters on the image quality for moving objects in digital cardiac imaging

The image quality of a single frame in a modern cardiac imaging x-ray facility can be improved by adjusting the automatic pulse exposure parameters. The effects of acquisition rate on patient dose and the detectability of moving objects have been fully described in scientific literature. However, the influence of automatic pulse exposure parameters is still to be determined. Images of a moving wheel (with lead wires) were acquired using an H5000 Philips Integris cardiac x-ray system. Poly(methylmethacrylate) plastic samples 20 and 30 cm thick were employed as the build-up phantom to simulate a patient. The images were obtained using preset clinical parameters for cardiac imaging procedures. The signal detectability and motion blur of a contrast bar at a transversal speed in the range of 100-150 mm/s were evaluated with a cine pulse width of 3, 5, 7, and 10 ms under automatic mA kV regulation. Two levels of exposure at the image intensifier entrance were included in this study. Signal detectability was analyzed in terms of the signal-to-noise ratio (SNR) and the value of SNR2/entrance surface dose. The blurring was modeled as a Gaussian-shaped blurring function, and the motion blur was expressed in terms of the peak full width at half maximum and amplitude (apparent contrast) of the resolution functions. A contrast bar simulating a vessel in motion at the maximum velocities of typical cardiac structures was exposed. Severe loss of image quality occurred at pulse widths > or =7 ms. It is also shown that below 5 ms static nonlinearities, likely caused by the need to use a large focus for cine acquisition, dominate the blurring process.     

Experimental investigation of the dose and image quality characteristics of a digital mammography imaging system

Our purpose in this study was to investigate the image quality and absorbed dose characteristics of a digital mammography imaging system with a CsI scintillator, and to identify an optimal x-ray tube voltage for imaging simulated masses in an average size breast with 50% glandularity. Images were taken of an ACR accreditation phantom using a LORAD digital mammography system with a Mo target and a Mo filter. In one experiment, exposures were performed at 80 mAs with x-ray tube voltages varying between 24 and 34 kVp. In a second experiment, the x-ray tube voltage was kept constant at 28 kVp and the technique factor was varied between 5 and 500 mAs. The average glandular dose at each x-ray tube voltage was determined from measurements of entrance skin exposure and x-ray beam half-value layer. Image contrast was measured as the fractional digital signal intensity difference for the image of a 4 mm thick acrylic disk. Image noise was obtained from the standard deviation in a uniformly exposed region of interest expressed as a fraction of the background intensity. The measured digital signal intensity was proportional to the mAs and to the kVp5.8. Image contrast was independent of mAs, and dropped by 21% when the x-ray tube voltage increased from 24 to 34 kVp. At a constant x-ray tube voltage, image noise was shown to be approximately proportional to (mAs)(-05), which permits the image contrast to noise ratio (CNR) to be modified by changing the mAs. At 80 mAs, increasing the x-ray tube voltage from 24 to 34 kVp increased the CNR by 78%, and increased the average glandular dose by 285%. At a constant lesion CNR, the lowest average glandular dose value occurred at 27.3 kVp. Increasing or decreasing the x-ray tube voltage by 2.3 kVp from the optimum kVp increased the average glandular dose values by 5%. These results show that imaging simulated masses in a 4.2 cm compressed breast at approximately 27 kVp with a Mo/Mo target/filter results in the lowest average glandular dose.     

Evaluation of the use of digital images for a national prostate core external quality assurance scheme

Harnden P, Coleman D, Moss S, Kodikara S, Griffin N R & Melia J

(2011) Histopathology 59 , 703–709 Evaluation of the use of digital images for a national prostate core external quality assurance scheme Aims: To evaluate the use of virtual images as an alternative to glass slides to expand the number of participants in the External Quality Assurance Scheme for prostatic biopsies. Methods and results: Benign and neoplastic cases, previously circulated as glass slides, were selected to include cases that had demonstrated a high level of agreement (n = 10) and a lesser degree of agreement (n = 10). Whole slide virtual images were circulated to 68 pathologists; 51 responses were returned. The levels of agreement for the primary diagnosis and for Gleason grading of cancers were analysed using kappa statistics. Responses for glass slides versus images were compared for the 24 pathologists for whom data were available. Levels of agreement for diagnostic categories using virtual slides were moderate to substantial, comparable to those found using glass slides. The level of agreement for Gleason grades 8–10 was substantial, but for lower grades was fair or moderate, poorer than for the glass slide circulation. Conclusions: Circulation of virtual images of biopsy material is a suitable alternative to glass slide‐based schemes for the evaluation of diagnostic consistency. The majority of participants agreed that the ability to evaluate limited diagnostic material outweighed the disadvantages of a virtual system.     

Image quality evaluation of flat panel and image intensifier digital magnification in x-ray fluoroscopy

Interventional devices used in radiology often have dimensions on the order of a pixel, and radiologists resort to image magnification to better visualize such small devices. Traditional image intensifier (II) systems use analog magnification with x-ray exposure inversely proportional to the area of field of view (FOV) so as to maintain light output for the camera. Analog magnification is impossible with flat panel (FP) detectors, and images must be magnified using digital interpolation that does not reduce the pixel partial area effect for small devices. We quantitatively investigated image quality of digital and analog magnification using a clinically relevant task of detecting a partially deployed stent in x-ray fluoroscopy image sequences that were created using realistic detector models. Using the standard exposure strategy for II analog magnification, exposure was increased from a nominal 43.65 nGy (5.0 microR) per frame at 23 cm FOV to 79.9 nGy (9.15 microR) per frame and 117.81 nGy (13.49 microR) per frame at 17 cm and 14 cm FOV, respectively. Contrast sensitivity improved significantly (p<0.1) by 43.5+/-6.5% and 64.1+/-7.3% with the 17 cm and 14 cm FOV, respectively. Exposure for digitally magnified images was varied in an adaptive forced choice experiment so as to match performance with II analog magnification. For digital magnification, bilinear interpolation was used to give magnified stents sizes equivalent to those in the analog magnified images. For equivalent image quality, FP required 34.87+/-2.59, 80.16+/-5.37, and 84.08+/-5.59 nGy per frame at normal, and the two magnification modes, respectively. Hence, FP with digital magnification gives significant (p<0.1) dose savings of 20+/-6% and 27+/-5% at the normal and highest magnification modes, respectively. Digitally magnified II images required exposures of 110.85+/-8.07 and 103.34+/-5.90 nGy per frame for the two magnifications levels, respectively, giving no significant (p>0.1) dose savings. A spatiotemporal human observer model based on signal detection theory successfully predicted the human data and was used to predict other conditions associated with image magnification. Model predictions quantitatively showed that magnification is most useful when signal size is relatively small and that FP digital magnification can improve image quality for the stent deployment task without increasing exposure. In conclusion, the results show that FP digital magnification can be useful and dose efficient as compared to analog magnification.     

Image quality assessment in digital mammography: part I. Technical characterization of the systems

In many European countries, image quality for digital x-ray systems used in screening mammography is currently specified using a threshold-detail detectability method. This is a two-part study that proposes an alternative method based on calculated detectability for a model observer: the first part of the work presents a characterization of the systems. Eleven digital mammography systems were included in the study; four computed radiography (CR) systems, and a group of seven digital radiography (DR) detectors, composed of three amorphous selenium-based detectors, three caesium iodide scintillator systems and a silicon wafer-based photon counting system. The technical parameters assessed included the system response curve, detector uniformity error, pre-sampling modulation transfer function (MTF), normalized noise power spectrum (NNPS) and detective quantum efficiency (DQE). Approximate quantum noise limited exposure range was examined using a separation of noise sources based upon standard deviation. Noise separation showed that electronic noise was the dominant noise at low detector air kerma for three systems; the remaining systems showed quantum noise limited behaviour between 12.5 and 380 μGy. Greater variation in detector MTF was found for the DR group compared to the CR systems; MTF at 5 mm(-1) varied from 0.08 to 0.23 for the CR detectors against a range of 0.16-0.64 for the DR units. The needle CR detector had a higher MTF, lower NNPS and higher DQE at 5 mm(-1) than the powder CR phosphors. DQE at 5 mm(-1) ranged from 0.02 to 0.20 for the CR systems, while DQE at 5 mm(-1) for the DR group ranged from 0.04 to 0.41, indicating higher DQE for the DR detectors and needle CR system than for the powder CR phosphor systems. The technical evaluation section of the study showed that the digital mammography systems were well set up and exhibiting typical performance for the detector technology employed in the respective systems.     

Optimization of x-ray spectra in digital mammography through Monte Carlo simulations

In this work, a Monte Carlo code was used to investigate the performance of different x-ray spectra in digital mammography, through a figure of merit (FOM), defined as FOM = CNR2/(ˉ)D(g), with CNR being the contrast-to-noise ratio in image and [Formula: see text] being the average glandular dose. The FOM was studied for breasts with different thicknesses t (2 cm ≤ t ≤ 8 cm) and glandular contents (25%, 50% and 75% glandularity). The anode/filter combinations evaluated were those traditionally employed in mammography (Mo/Mo, Mo/Rh, Rh/Rh), and a W anode combined with Al or K-edge filters (Zr, Mo, Rh, Pd, Ag, Cd, Sn), for tube potentials between 22 and 34 kVp. Results show that the W anode combined with K-edge filters provides higher values of FOM for all breast thicknesses investigated. Nevertheless, the most suitable filter and tube potential depend on the breast thickness, and for t ≥ 6 cm, they also depend on breast glandularity. Particularly for thick and dense breasts, a W anode combined with K-edge filters can greatly improve the digital technique, with the values of FOM up to 200% greater than that obtained with the anode/filter combinations and tube potentials traditionally employed in mammography. For breasts with t < 4 cm, a general good performance was obtained with the W anode combined with 60 μm of the Mo filter at 24-25 kVp, while 60 μm of the Pd filter provided a general good performance at 24-26 kVp for t = 4 cm, and at 28-30 and 29-31 kVp for t = 6 and 8 cm, respectively.