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PubMed2005

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.

Absorptiometry, Photon↗
PubMed2005

Dual-energy digital mammography for calcification imaging: scatter and nonuniformity corrections.

Mammographic images of small calcifications, which are often the earliest signs of breast cancer, can be obscured by overlapping fibroglandular tissue. We have developed and implemented a dual-energy digital mammography (DEDM) technique for calcification imaging under full-field imaging conditions using a commercially available aSi:H/CsI:Tl flat-panel based digital mammography system. The low- and high-energy images were combined using a nonlinear mapping function to cancel the tissue structures and generate the dual-energy (DE) calcification images. The total entrance-skin exposure and mean-glandular dose from the low- and high-energy images were constrained so that they were similar to screening-examination levels. To evaluate the DE calcification image, we designed a phantom using calcium carbonate crystals to simulate calcifications of various sizes (212-425 microm) overlaid with breast-tissue-equivalent material 5 cm thick with a continuously varying glandular-tissue ratio from 0% to 100%. We report on the effects of scatter radiation and nonuniformity in x-ray intensity and detector response on the DE calcification images. The nonuniformity was corrected by normalizing the low- and high-energy images with full-field reference images. Correction of scatter in the low- and high-energy images significantly reduced the background signal in the DE calcification image. Under the current implementation of DEDM, utilizing the mammography system and dose level tested, calcifications in the 300-355 microm size range were clearly visible in DE calcification images. Calcification threshold sizes decreased to the 250-280 microm size range when the visibility criteria were lowered to barely visible. Calcifications smaller than approximately 250 microm were usually not visible in most cases. The visibility of calcifications with our DEDM imaging technique was limited by quantum noise, not system noise.

Algorithms↗
PubMed2006

Quality control for digital mammography in the ACRIN DMIST trial: part I.

The Digital Mammography Imaging Screening Trial, conducted by the American College of Radiology Imaging Network, is a clinical trial designed to compare the accuracy of full-field digital mammography (FFDM) versus screen-film mammography in a screening population. Five FFDM systems from four manufacturers (Fischer, Fuji, General Electric, and Lorad) were employed in the study at 35 clinical sites. A core physics team devised and implemented tests to evaluate these systems. A detailed description of physics and quality control tests is presented, including estimates of: mean glandular dose, modulation transfer function (MTF), 2D noise power spectra, and signal-to-noise ratio (SNR). The mean glandular doses for the standard breast ranged from 0.79 to 2.98 mGy, with 1.62 mGy being the average across all units and machine types. For the five systems evaluated, the MTF dropped to 50% at markedly different percentages (22% to 87%) of the Nyquist limit, indicating that factors other than detector element (del) size have an important effect on spatial resolution. Noise power spectra and SNR were measured; however, we found that it was difficult to standardize and compare these between units. For each machine type, the performance as measured by the tests was very consistent, and no predictive benefit was seen for many of the tests during the 2-year period of the trial. It was found that, after verification of proper operation during acceptance testing, if systems failed they generally did so suddenly rather than through gradual deterioration of performance. Because of the relatively short duration of this study further, investigation of the long-term failure characteristics of these systems is advisable.

Algorithms↗
PubMed2006

Effect of scatter and an antiscatter grid on the performance of a slot-scanning digital mammography system.

The use of a grid increases perceptibility of low contrast objects in mammography. Slot-scan mammography provides a more dose efficient reduction of the scattered radiation reaching the detector than obtained with an antiscatter grid in screen-film or flat-panel digital mammography. In this paper, the potential of using a grid in a slot-scan system to provide a further reduction of scattered radiation is investigated. The components of the digital signal: primary radiation, off-focus radiation, scattered radiation, and optical fluorescence glare in a CsI(Tl) detector were quantified. Based on these measurements, the primary and scatter transmission factors (Tp, Ts), scatter-to-primary ratio (SPR), signal-difference-to-noise ratio (SDNR), and the SDNR improvement factor (K(SDNR)) were obtained. Our results showed that the SPR ranged from 0.05 to 0.19 for breast thicknesses between 2 and 8 cm, respectively. The values of K(SDNR) ranged from 0.85 to 0.94. Because the slot-scanning system has an inherently low SPR, the increase in dose required when the grid is used outweighs the benefit of the small increase in SDNR. It is possible that greater benefit could be achieved by using a grid with a higher Tp, such as obtained using air-core technology.

Artifacts↗
PubMed2006

Suitability of new anode materials in mammography: dose and subject contrast considerations using Monte Carlo simulation.

Mammography is the technique with the highest sensitivity and specificity, for the early detection of nonpalpable lesions associated with breast cancer. As screening mammography refers to asymptomatic women, the task of optimization between the image quality and the radiation dose is critical. A way toward optimization could be the introduction of new anode materials. A method for producing the x-ray spectra of different anode/filter combinations is proposed. The performance of several mammographic spectra, produced by both existing and theoretical anode materials, is evaluated, with respect to their dose and subject contrast characteristics, using a Monte Carlo simulation. The mammographic performance is evaluated utilizing a properly designed mathematical phantom with embedded inhomogeneities, irradiated with different spectra, based on combinations of conventional and new (Ru, Ag) anode materials, with several filters (Mo, Rh, Ru, Ag, Nb, Al). An earlier developed and validated Monte Carlo model, for deriving both image and dose characteristics in mammography, was utilized and overall performance results were derived in terms of subject contrast to dose ratio and squared subject contrast to dose ratio. Results demonstrate that soft spectra, mainly produced from Mo, Rh, and Ru anodes and filtered with k-edge filters, provide increased subject contrast for inhomogeneities of both small size, simulating microcalcifications and low density, simulating masses. The harder spectra (W and Ag anode) come short in the discrimination task but demonstrate improved performance when considering the dose delivered to the breast tissue. As far as the overall performance is concerned, new theoretical spectra demonstrate a noticeable good performance that is similar, and in some cases better compared to commonly used systems, stressing the possibility of introducing new materials in mammographic practice as a possible contribution to its optimization task. In the overall optimization task in terms of subject contrast to dose ratio, tube voltage was found to have a minor effect, while with respect to the filter material, a lesion specific performance was noticed, with Al filtered spectra showing improved characteristics in case of the inhomogeneities simulating microcalcifications, while softer k-edge filtered spectra are more suitable for the discrimination of inhomogeneities simulating masses.

Computer Simulation↗
PubMedDate not supplied

Analysis of the significance of scattered radiation in reduced dose mammography, including magnification effects, scatter suppression, and focal spot and detector blurring.

A systems analysis of reduced dose mammography with scatter removal has quantitatively specified the relationships between the several parameters in mammography systems. While the results are only preliminary in the sense that they need to be proven experimentally, they do seem to provide a good feel for the nature of the important trade-offs. The major uncertainties in the analysis probably have to do with the formal equivalence, that is implicit in the aperture theory, between large area and detail contrast, as well as the output versus focal spot relationship that was adopted. Also, there are important questions about specifying motion unsharpness as a function of exposure time in mammography examinations.

Mammography↗
PubMedDate not supplied

Optimal x-ray spectra for screen-film mammography.

Theoretical and experimental techniques have been used to study optimal x-ray for screen-film mammography. A simple model of mammographic imaging predicts optimum x-ray energies which are significantly higher than the K-characteristic energies of Mo. A subjective comparison of x-ray spectra from Mo-anode and W-anode tubes indicates that spectra produced by a W-anode tube filtered with materials of atomic number just above that of Mo are more suitable for screen-film mammography than spectra produced by the Mo-anode/Mo-filter system. The imaging performance of K-edge filtered, W-anode tube spectra was compared to the performance of Mo-anode spectra using phantom measurements and mastectomy specimen radiography. It was shown that optimal W-anode spectra can produce equal contrast with an exposure reduction of a factor of two to three, a dose reduction of a factor of two, and equal or reducing tube loading, compared to Mo-anode spectra. A computer simulation was carried out to extend the initial, monoenergetic theory to the case of real, polychromatic sources. The effects of varying filter material and thickness, tube operating potential, and breast thickness were all studied. Since W-anode x-ray tubes are considered to be better for Xerox mammography than Mo-anode tubes, this study has shown that both Xerox and screen-film techniques can be performed optimally with a single, properly designed, W-anode x-ray tube.

Breast Neoplasms↗
PubMedDate not supplied

Radiation probe for indirect evaluation of the high-voltage waveform of a Mo anode mammography unit.

A radiation probe was designed for indirectly determining the high voltage of a Mo anode mammography unit. The real time processing of the probe outputs yields exposure time, voltage waveform, kVp, and ripple in the range 24-40 kVp useful for screen-film mammography. The probe, connected to a portable computer, will be employed in a survey of radiation dose and image quality in mammography as part of an ongoing program in Italy.

Electrodes↗
PubMedDate not supplied

Film-screen mammography x-ray tube anodes: molybdenum versus tungsten.

Gridless screen-film mammography at 23 kVp with a W anode (inherent filtration: 0.1 mm A1, added filtration: 0.025 mm Mo) can achieve contrast identical to that achieved with gridless film-screen mammography at 27 kVp with a Mo anode (inherent filtration: 1.0 mm Be, added filtration: 0.025-mm Mo). However, W-anode film-screen mammograms obtained at 23 kVp require more radiation than Mo-anode film-screen mammograms obtained at 27 kVp. The lack of contrast of W-anode film-screen images produced at the same kVp as Mo-anode images was verified clinically and with a low contrast test object imaged over a range of densities. A step wedge test object was then used to match contrast between Mo- and W-anode gridless film-screen images at various kVp. The low contrast test object images verified the contrast equivalence of images obtained at 23 kVp for a W anode and 27 kVp for a Mo anode. A comparison of the two kVp for different anode materials was tested clinically on ten patients. The clinical and low contrast test object experiments were reviewed by three radiologists specializing in mammography.

Electrodes↗
PubMed1994

Feasibility study for positron emission mammography.

A feasibility study is presented for a small, low-cost, dedicated device for positron emission mammography. Two detector arrays above and below the breast would be placed in a conventional mammography unit. These detectors are sensitive to positron annihilation radiation, and are connected to a coincidence circuit and a multiplane image memory. Images of the distribution of positron-emitting isotope are obtained in real time by incrementing the memory location at the intersection of each line of response. Monte Carlo simulations of a breast phantom are compared with actual scans of this phantom in a conventional PET scanner. The simulations and experimental data are used to predict the performance of the proposed system. Spatial resolution experiments using very narrow bismuth germanate BGO crystals suggest that spatial resolutions of about 2 mm should be possible. The efficiency of the proposed device is about ten times that of a conventional brain scanner. The scatter fraction is greater, but the scattered radiation has a very flat distribution. By designing the device to fit in an existing mammography unit, conventional mammograms can be taken after the injection of the radio-pharmaceutical allowing exact registration of the emission and conventional mammographic images.

Biophysical Phenomena↗
PubMed1994

Rotary scanning equalization radiography: an efficient geometry for equalization mammography.

The detection of cancer in the radiographically dense breast is problematic, since the breast will produce a range of exposure that exceeds the useful dynamic range of high contrast film-screen combinations. It has been shown previously that mammographic scanning equalization radiography (MSER) can be used to overcome the latitude limitations of film-screen mammography. However, the tube loading of MSER is orders of magnitude greater than conventional mammography. A new rotary geometry for equalization radiography is proposed, in which the image receptor is exposed by repeated scans of a modulated slot beam, oriented at a variety of scanning angles with respect to the object. The superposition of the exposure from appropriately modulated, rotated slot beams produces an entrance exposure that will effectively equalize the film exposure. The principle advantages of this geometry is its simplicity and reduced tube loading. To determine the effectiveness and feasibility of RSER the effect of conventional, MSER, and RSER have been numerically simulated on the appearance of clinical mammograms, the relative heat loading, and the fraction of the breast imaged with high contrast are calculated. It is found that RSER produces images that are free of artefacts, and exhibit a similar degree of equalization, as found in MSER images. RSER accomplishes this with only four scanning angles, and a beam that is approximately 4 cm wide. The resulting tube loading is only three times greater than that found in conventional imaging. Numerical simulations indicate that RSER is a simple, feasible means of overcoming the latitude limitations of film-screen mammography.

Computer Simulation↗
PubMed1994

A model for optimization of spectral shape in digital mammography.

X-ray mammography is the most sensitive imaging modality available for the detection of breast cancer. The highest performance can only be achieved, however, if the complete imaging system is optimized. The development of digital mammography offers an opportunity to obtain improved sensitivity in mammography. In such systems, the decoupling of the recording and display processes allows each component of the imaging system to be optimized separately. In this paper we describe a method for optimizing the recording process for digital mammographic techniques. Our method uses an energy transport model of the propagation of signal and noise through the imaging system. The computations make use of experimentally determined data wherever possible so that the number of assumptions in the model can be minimized. The model predicts the signal-to-noise ratio for a constant dose to the breast, and therefore allows comparison and optimization both for different x-ray spectra and for different imaging tasks. The major energy-dependent components of the model have been verified, and good agreement is demonstrated between predictions by the model of both contrast and SNR and experimentally measured values. Calculations for a particular imaging task, detection of a 200-microns cubic calcification in a 6-cm, 50% adipose-50% glandular breast, illustrate application of the model for optimization of spectral shape.

Breast Neoplasms↗
PubMed1995

Quantitative mammography contrast threshold test tool.

Mammographic contrast is commonly evaluated by visualizing small objects of varying size or mass divided by projected area. These qualitative contrast determinations are commonly performed by imaging a phantom like the American College of Radiology accreditation phantom at clinical mammographic settings. However, this contrast assessment does not take into account the kVp of the machine. This work describes a quantitative mammography contrast threshold test tool which examines light object contrast on a uniform background for a contrast range of 0.32% to 1.38% at 25 kVp. For this mammography contrast threshold test tool, contrast is defined by delta I/I = loge (psi O/ psi b), where psi O is the target energy flux, and psi b is the background energy flux. Contrast threshold is defined as the lowest contrast value for which the objects are visible. Unlike traditional assessments of mammographic contrast, this measurement of contrast threshold is kVp corrected. The mammography contrast threshold test tool is constructed out of common plastics and provides a quantitative means of assessing contrast threshold for individual mammographic units and total mammographic systems.

Accreditation↗
PubMed1995

Slit camera focal spot measurement errors in mammography.

Mammography x-ray tube focal spot sizes are routinely measured during acceptance testing and annual performance audits. The National Electrical Manufactures Association (NEMA) recommends the slit camera for this purpose. Investigated were the effect of slit rotational misalignment, tilt misalignment, image film density, film and screen-film image receptors, microscope magnification and reticule accuracy, and observer variation on slit camera focal spot measurements. Our results indicate that small rotational misalignment (< 5 degrees) and tilt misalignment (< 3 degrees) introduce insignificant error. Measured focal spot size increased slightly with image optical density, indicating that for consistent results the image optical density variations should be minimized. Also desirable for accurate field measurements is a high power microscope (25-50x) and a reticule with divisions of < or = 0.02 mm. Screen-film imaging consistently resulted in a slightly smaller measured focal spot size than direct film. The greatest source of error was due to observer variation. Of interest is that reader variability showed a consistent pattern and variation between two measurements by the same observer was much smaller than between observer variation, suggesting that standardized criteria should be established and a method of reader training developed. The length of the focal spot is defined at a reference axis angle specified by the mammography unit manufacturer. Presented is a tabulation of the focal spot geometry and reference axis angles for the majority of mammography units currently and recently marketed in North America.

Biophysical Phenomena↗
PubMed1997

System considerations in CCD-based x-ray imaging for digital chest radiography and digital mammography.

System modeling is used to investigate the effect of various system parameters on the image quality in CCD-based x-ray imaging systems. The systems considered consist of a typical phosphor-based scintillating screen coupled to a CCD through lens or fiberoptic taper. Two applications, chest radiography and mammography, are analyzed. For each application typical system characteristics and operating conditions are used to determine the detective quantum efficiency (DQE) as a function of spatial frequency, optical collection efficiency, optical demagnification factor, and electronic noise. The DQE is modeled by extending the analysis for storage phosphor systems. The calculations are done for typical exposure conditions (0.25 mR for chest and 10.0 mR for mammography); however, the exposure effects are also discussed. It was found that a reasonable DQE can be obtained for both applications through each coupling approach; however, the demagnification requirements and electronic noise limitations are more stringent for the digital mammography application.

Biophysical Phenomena↗
PubMed1998

Scattered radiation in scanning slot mammography.

Monte Carlo simulations were used to quantify the amount of scattered radiation a scanning slot detector geometry designed for use in digital mammography. Ratios of the scatter to primary (S/P) x-ray photon energy absorbed in the detector were obtained for a Lucite phantom, and were investigated as a function of photon energy, phantom thickness, and slot detector width. Over a Lucite phantom thickness range of 2-6 cm, the S/P ratios range from about 0.10 to 0.17 for a 4 mm wide slot detector at the x-ray photon energies used in mammography. These ratios increased by a factor of approximately 1.8 when the slot width was increased to 10 mm. In general, 20 keV photons gave S/P ratios similar to those of a 30 kVp x-ray spectrum (Mo target + 30 microns Mo filtration). The use of a 3 cm air gap reduced the S/P ratios by a factor of between 2.5 and 3.4, depending on the phantom thickness. For a constant primary energy fluence, coherent scatter was reduced as photon energy increased, whereas Compton scatter increased with increasing photon energy. With no air gap, the contributions of coherent and Compton scatter were found to be equal at 25 keV, whereas the introduction of a 3 cm air gap resulted in equal contributions for the two scatter processes at 36 keV. A 10 mm wide slot detector consisting of a 36.7 mg/cm2 thick Gd2O2S:Tb phosphor screen was compared to an ideal detector absorbing all incident primary/scatter photons. Average differences in the S/P ratios for these two detectors were 7% with no air gap and approximately 4% with a 3 cm air gap. The results obtained in this study will assist in the design of an optimal slot detector for use in digital mammography.

Breast↗
PubMed2000

Using light sensitometry to evaluate mammography film performance.

The performance of commercially available light sensitometers was compared with two other methods of x-ray sensitometry to determine whether commercially available sensitometers are viable for evaluating clinical performance of mammography film. X-ray sensitometry was performed using mammography screens that were modified to accommodate a graded optical step tablet (screen sensitometry). Finally, a means for performing intensity-scale x-ray sensitometry was configured (inverse-square sensitometry). Clinical mammography x-ray exposure conditions were used and film processing quality was closely monitored during the study. Statistical results for chi-square probabilities on the resulting contrast curves yielded good agreement for most of the configurations investigated. Comparison of film gradient versus optical density curves showed good agreement for maximum contrast values and the corresponding optical density for maximum contrast for three of the four screen-film combinations used when comparing light sensitometry to screen sensitometry. A similar comparison of light sensitometers to inverse-square sensitometry showed good agreement for maximum contrast, but less agreement for the corresponding optical density of maximum contrast. Based on these results, the authors concluded that commercially available sensitometers could be used to estimate clinical film performance for the screen-film systems tested. In particular they can be used to determine the range of optical densities that provide optimal film contrast.

Biophysical Phenomena↗
PubMed2000

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.

Algorithms↗