Mats Danielsson

Two-View and Single-View Tomosynthesis versus Full-Field Digital Mammography: High-Resolution X-Ray Imaging Observer Study

PURPOSE To compare the diagnostic accuracy of two-dimensional (2D) full-field digital mammography with that of two-view (mediolateral and craniocaudal) and single-view (mediolateral oblique) tomosynthesis in an observer study involving two institutions. MATERIALS AND METHODS Ethical committee approval was obtained. All participating women gave informed consent. Two hundred twenty women (mean age, 56.3; range, 40-80 years) with breast density of 2-4 according to American College of Radiology criteria were recruited between November 2008 and September 2009 and underwent standard treatment plus tomosynthesis with a prototype photon-counting machine. After exclusion criteria were met, this resulted in a final test set of 130 women. Ten accredited readers classified the 130 cases (40 cancers, 24 benign lesions, and 66 normal images) using 2D mammography and two-view tomosynthesis. Another 10 readers reviewed the same cases using 2D mammography but single-view tomosynthesis. The multireader, multicase receiver operating characteristic (ROC) method was applied. The significance of the observed difference in accuracy between 2D mammography and tomosynthesis was calculated. RESULTS For diagnostic accuracy, 2D mammography performed significantly worse than two-view tomosynthesis (average area under ROC curve [AUC] = 0.772 for 2D, AUC = 0.851 for tomosynthesis, P = .021). Significant differences were found for both masses and microcalcification (P = .037 and .049). The difference in AUC between the two modalities of -0.110 was significant (P = .03) only for the five readers with the least experience (<10 years of reading); with AUC of -0.047 for the five readers with 10 years or more experience (P = .25). No significant difference (P = .79) in reader performance was seen when 2D mammography (average AUC = 0.774) was compared with single-view tomosynthesis (average AUC = 0.775). CONCLUSION Two-view tomosynthesis outperforms 2D mammography but only for readers with the least experience. The benefits were seen for both masses and microcalcification. No differences in classification accuracy was seen between and 2D mammography and single-view tomosynthesis.

Detective quantum efficiency dependence on x‐ray energy weighting in mammography

An evaluation of the dependence of detective quantum efficiency (DQE) on the incident energy spectrum has been made for mammography. The DQE dependence on the energy spectrum has been evaluated for energy-integrating detectors, photon-counting detectors, and detectors that measure the energy of each photon. To isolate the effect of the x-ray energy spectrum the detector has been assumed to be ideal, i.e., all noise sources are assumed to be zero except for quantum fluctuations. The result shows that the improvement in DQE, if the energy-integrating detector is compared to a single-photon counting detector, is of the order of 10%. Comparing the energy-integrating detector and the detector measuring the energy for each photon the improvement is around 30% using a molybdenum anode spectrum typical in mammography. It is shown that the optimal weight factors to combine the data in the case the energy is measured are very well approximated if the weight factors are proportional to E(-3). Another conclusion is that in calculating the DQE, a detector should be compared to one that uses ideal energy weighting for each photon since this provides the best signal-to-noise ratio. This has generally been neglected in the literature.

Photon-counting spectral computed tomography using silicon strip detectors: a feasibility study

We show how the spectral imaging framework should be modified to account for a high fraction of Compton interactions in low Z detector materials such as silicon. Using this framework, where deposited energies differ from actual photon energies, we compare the performance of a silicon strip detector, including the influence of scatter inside the detector and charge sharing but disregarding signal pileup, with an ideal energy integrating detector. We show that although the detection efficiency for silicon rapidly drops for the acceleration voltages encountered in clinical computed tomography practice, silicon detectors could perform on a par with ideal energy integrating detectors for routine imaging tasks. The use of spectrally sensitive detectors opens up the possibility for decomposition techniques such as k-edge imaging, and we show that the proposed modification of the spectral imaging framework is beneficial for such imaging tasks.

Energy resolution of a photon-counting silicon strip detector

A photon-counting silicon strip detector with two energy thresholds was investigated for spectral X-ray imaging in a mammography system. Preliminary studies already indicate clinical benefit of the ...

Physical characterization of a scanning photon counting digital mammography system based on Si-strip detectors

The physical performance of a scanning multislit full field digital mammography system was determined using basic image quality parameters. The system employs a direct detection detector comprised of linear silicon strip sensors in an edge-on geometry connected to photon counting electronics. The pixel size is 50 microm and the field of view 24 x 26 cm2. The performance was quantified using the presampled modulation transfer function, the normalized noise power spectrum and the detective quantum efficiency (DQE). Compared to conventional DQE methods, the scanning geometry with its intrinsic scatter rejection poses additional requirements on the measurement setup, which are investigated in this work. The DQE of the photon counting system was found to be independent of the dose level to the detector in the 7.6-206 microGy range. The peak DQE was 72% and 73% in the scan and slit direction, respectively, measured with a 28 kV W-0.5 mm Al anode-filter combination with an added 2 mm Al filtration.

Scatter rejection in multislit digital mammography

The scatter to primary ratio (SPR) was measured on a scanning multislit full-field digital mammography system for different thickness of breast equivalent material and different tube voltages. Scatter within the detector was measured separately and was found to be the major source of scatter in the assembly. Measured total SPRs below 6% are reported for breast range 3-7 cm. The performance of the multislit assembly is compared to other imaging geometries with different scatter rejection schemes by using the scatter detective quantum efficiency.

Evaluation of a photon counting X-ray imaging system

A digital imaging system has been developed for mammography using silicon strip detectors operated in a pulse-counting mode and configured in a scanned slit geometry. Almost 100% of the photons are absorbed in the sensor, the scatter rejection is very efficient and the image formation is nearly optimal since each X-ray is processed individually. The result is a very dose-efficient system. In this paper we present measurements that verify that the performance of the read-out electronics is sufficient to count photons at high rates with high quantum efficiency (QE) and a charge collection efficiency (CCE) that does not limit the dose efficiency. The spatial resolution of the system was measured to provide a modulation transfer function (MTF) of approximately 0.5 at a spatial frequency 10 1p/mm. Images of a mammography phantom were recorded experimentally to test overall system performance.

Contrast-enhanced spectral mammography with a photon-counting detector

PURPOSE Spectral imaging is a method in medical x-ray imaging to extract information about the object constituents by the material-specific energy dependence of x-ray attenuation. The authors have investigated a photon-counting spectral imaging system with two energy bins for contrast-enhanced mammography. System optimization and the potential benefit compared to conventional non-energy-resolved absorption imaging was studied. METHODS A framework for system characterization was set up that included quantum and anatomical noise and a theoretical model of the system was benchmarked to phantom measurements. RESULTS Optimal combination of the energy-resolved images corresponded approximately to minimization of the anatomical noise, which is commonly referred to as energy subtraction. In that case, an ideal-observer detectability index could be improved close to 50% compared to absorption imaging in the phantom study. Optimization with respect to the signal-to-quantum-noise ratio, commonly referred to as energy weighting, yielded only a minute improvement. In a simulation of a clinically more realistic case, spectral imaging was predicted to perform approximately 30% better than absorption imaging for an average glandularity breast with an average level of anatomical noise. For dense breast tissue and a high level of anatomical noise, however, a rise in detectability by a factor of 6 was predicted. Another approximately 70%-90% improvement was found to be within reach for an optimized system. CONCLUSIONS Contrast-enhanced spectral mammography is feasible and beneficial with the current system, and there is room for additional improvements. Inclusion of anatomical noise is essential for optimizing spectral imaging systems.

Study of hole-type gas multiplication structures for portal imaging and other high counting rate applications

We performed studies in the operation of various hole-type gaseous multiplication structures (GEM, capillary plates, and others) at very high fluxes of X-rays (<60 keV-bremsstrahlung) and pulsed gamma radiation (<50 MeV-bremsstrahlung). In the case of X-rays, the counting rate was 10/sup 5/-10/sup 6/ Hz/mm/sup 2/; in the case of gammas it reached levels of up to 10/sup 9/ Hz/mm/sup 2/ during the pulses. In most measurements, the entire area of the detector was exposed to these extremely high fluxes. Results obtained so far indicate that the GEM and the hydrogen-treated capillary plates could be successfully used in medical imaging applications.

Focusing hard X-rays with old LPs

We have found that two sections cut from a vinyl long-playing record can form a spherical aberration-free refractive lens for hard X-rays. Our manufactured saw-tooth refractive lens has a focal length of 22 cm for 23-keV X-rays. The low cost and short focal length of this lens make it feasible for use in small-scale experiments with conventional X-ray tubes.