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Multi‐energy computed tomography (MECT) offers the opportunity for advanced visualization, detection, and quantification of select elements (e.g., iodine) or materials (e.g., fat) beyond the capability of standard single‐energy computed tomography (CT). However, the use of MECT requires careful consideration as substantially different hardware and software approaches have been used by manufacturers, including different sets of user‐selected or hidden parameters that affect the performance and radiation dose of MECT. Another important consideration when designing MECT protocols is appreciation of the specific tasks being performed; for instance, differentiating between two different materials or quantifying a specific element. For a given task, it is imperative to consider both the radiation dose and task‐specific image quality requirements. Development of a quality control (QC) program is essential to ensure the accuracy and reproducibility of these MECT applications. Although standard QC procedures have been well established for conventional single‐energy CT, the substantial differences between single‐energy CT and MECT in terms of system implementations, imaging protocols, and clinical tasks warrant QC tests specific to MECT. This task group was therefore charged with developing a systematic QC program designed to meet the needs of MECT applications. In this report, we review the various MECT approaches that are commercially available, including information about hardware implementation, MECT image types, image reconstruction, and postprocessing techniques that are unique to MECT. We address the requirements for MECT phantoms, review representative commercial MECT phantoms, and offer guidance regarding homemade MECT phantoms. We discuss the development of MECT protocols, which must be designed carefully with proper consideration of MECT technology, imaging task, and radiation dose. We then outline specific recommended QC tests in terms of general image quality, radiation dose, differentiation and quantification tasks, and diagnostic and therapeutic applications. [ABSTRACT FROM AUTHOR]

Background: Dedicated cone-beam breast computed tomography (CBBCT) using short-scan acquisition is being actively investigated to potentially reduce the radiation dose to the breast.This would require determining the optimal x-ray source trajectory for such short-scan acquisition. Purpose: To quantify the projection angle-dependent normalized glandular dose coefficient (DgNCT) in CBBCT, referred to as angular DgNCT, so that the x-ray ray source trajectory that minimizes the radiation dose to the breast for short-scan acquisition can be determined. Materials and Methods: A cohort of 75 CBBCT clinical datasets was segmented and used to generate three breast models – (I) patient-specific breast with heterogeneous fibroglandular tissue distribution and real breast shape, (II) patient-specific breast shape with homogeneous tissue distribution and matched fibroglandular weight fraction, and (III) homogeneous semi-ellipsoidal breast with patient-specific breast dimensions and matched fibroglandular weight fraction, which corresponds to the breast model used in current radiation dosimetry protocols.For each clinical dataset, the angular DgNCT was obtained at 10 discrete angles, spaced 36° apart, for full-scan, circular, x-ray source trajectory from Monte Carlo simulations. Model III is used for validating the Monte Carlo simulation results.Models II and III are used to determine if breast shape contributes to the observed trends in angular DgNCT. A geometry-based theory in conjunction with center-of-mass (COM) based distribution analysis is used to explain the projection angle-dependent variation in angular DgNCT. Results: The theoretical model predicted that the angular DgNCT will follow a sinusoidal pattern and the amplitude of the sinusoid increases when the centerof- mass of fibroglandular tissue (COMf ) is farther from the center-of-mass of the breast (COMb). It also predicted that the angular DgNCT will be minimized at x-ray source positions complementary to the COMf. The COMf was superior to the COMb in 80% (60/75) of the breasts. From Monte Carlo simulations and for homogeneous breasts (models II and III), the deviation in breast shape from a semi-ellipsoid had minimal effect on angular DgNCT and showed less than 4% variation. From Monte Carlo simulations and for model I, as predicted by our theory, the angular DgNCT followed a sinusoidal pattern with maxima and minima at x-ray source positions superior and inferior to the breast, respectively. For model I, the projection angle-dependent variation in angular DgNCT was 16.4%. Conclusion: The heterogeneous tissue distribution affected the angular DgNCT more than the breast shape. For model I, the angular DgNCT was lowest when the x-ray source was inferior to the breast. Hence, for short-scan CBBCT acquisition with COMb aligned with axis-of -rotation, an x-ray source trajectory inferior to the breast is preferable and such an acquisition spanning 205° can potentially reduce the mean glandular dose by up to 52%. [ABSTRACT FROM AUTHOR]

Tomosynthesis of the breast is currently a topic of intense interest as a logical next step in the evolution of digital mammography. This study reports on the computation of glandular radiation dose in digital tomosynthesis of the breast. Previously, glandular dose estimations in tomosynthesis have been performed using data from studies of radiation dose in conventional planar mammography. This study evaluates, using Monte Carlo methods, the normalized glandular dose (DgN) to the breast during a tomosynthesis study, and characterizes its dependence on breast size, tissue composition, and x-ray spectrum. The conditions during digital tomosynthesis imaging of the breast were simulated using a computer program based on the Geant4 toolkit. With the use of simulated breasts of varying size, thickness and tissue composition, the DgN to the breast tissue was computed for varying x-ray spectra and tomosynthesis projection angle. Tomosynthesis projections centered about both the cranio-caudal (CC) and medio-lateral oblique (MLO) views were simulated. For each projection angle, the ratio of the glandular dose for that projection to the glandular dose for the zero degree projection was computed. This ratio was denoted the relative glandular dose (RGD) coefficient, and its variation under different imaging parameters was analyzed. Within mammographic energies, the RGD was found to have a weak dependence on glandular fraction and x-ray spectrum for both views. A substantial dependence on breast size and thickness was found for the MLO view, and to a lesser extent for the CC view. Although RGD values deviate substantially from unity as a function of projection angle, the RGD averaged over all projections in a complete tomosynthesis study varies from 0.91 to 1.01. The RGD results were fit to mathematical functions and the resulting equations are provided. [ABSTRACT FROM AUTHOR]

Purpose: To determine the x-ray photon energy dependence of the anatomic power spectrum of the breast when imaged with dedicated breast computed tomography (CT). Methods: A theoretical framework for scaling the empirically determined anatomic power spectrum at one x-ray photon energy to that at any given x-ray photon energy when imaged with dedicated breast CT was developed. Theory predicted that when the anatomic power spectrum is fitted with a power curve of the form k f-β, where k and β are fit coefficients and f is spatial frequency, the exponent β would be independent of x-ray photon energy (E), and the amplitude k scales with the square of the difference in energy-dependent linear attenuation coefficients of fibroglandular and adipose tissues. Twenty mastectomy specimens based numerical phantoms that were previously imaged with a benchtop flat-panel cone-beam CT system were converted to 3D distribution of glandular weight fraction (fg) and were used to verify the theoretical findings. The 3D power spectrum was computed in terms of fg and after converting to linear attenuation coefficients at monoenergetic x-ray photon energies of 20-80 keV in 5 keV intervals. The 1D power spectra along the axes were extracted and fitted with a power curve of the form k f-β. The energy dependence of k and β were analyzed. Results: For the 20 mastectomy specimen based numerical phantoms used in the study, the exponent β was found to be in the range of 2.34-2.42, depending on the axis of measurement. Numerical simulations agreed with the theoretical predictions that for a power-law anatomic spectrum of the form k f-β, β was independent of E and k(E) = k1[μg(E) - μa(E)]2, where k1 is a constant, and μg(E) and μa(E) represent the energy-dependent linear attenuation coefficients of fibroglandular and adipose tissues, respectively. Conclusions: Numerical simulations confirmed the theoretical predictions that in dedicated breast CT, the spatial frequency dependence of the anatomic power spectrum will be independent of x-ray photon energy, and the amplitude of the anatomic power spectrum scales by the square of difference in linear attenuation coefficients of fibroglandular and adipose tissues. [ABSTRACT FROM AUTHOR]

A correction to the article "Scatter radiation in digital tomosynthesis of the breast" that was published in the August 27, 2007 issue is presented.

In this paper, the performance of an 8 cm x 8 cm three-side buttable charge-coupled device (CCD)-based imager specially designed for high-resolution fluoroscopy and operating in fluoroscopic (30 frames/second) mode is presented in terms of the presampling modulation transfer function (MTF), noise power spectrum (NPS), and detective quantum efficiency (DQE). The 8 cm x 8 cm CCD imager is coupled to a 450 microm thick CsI:Tl scintillator by nondemagnifying (straight, 1:1) fiberoptics. The CCD imager has a fundamental pixel pitch of 39 microm and incorporates an optically opaque interline (data) channel. The CCD imager was operated at 156 microm pixel pitch by binning 4 x 4 adjacent pixels prior to readout. The fluoroscopic image lag was measured and accounted for in the DQE estimate to provide lag-corrected DQE. The measured limiting spatial resolution at 10% presampling MTF with the imager operated at 156 microm pixel pitch (Nyquist sampling limit: 3.21 cy/mm) was 3.6 cy/mm. In the pulsed fluoroscopic mode, the first-frame image lag was less than 0.9%. The lag-corrected DQE(0) of approximately 0.62 was achieved even at a low fluoroscopic exposure rate of 1 microR/frame. Grid phantom measurements indicate no appreciable distortion. Results from DQE and image lag measurements at fluoroscopic exposure rates combined with the high spatial resolution observed from the MTF suggest that this type of imager or its variants may be a potential candidate for high-resolution neuro-interventional imaging, cardiovascular imaging, pediatric angiography, and small animal imaging. Since the CCD is three-side buttable, four such CCD modules can be joined to form a 2 x 2 matrix providing a field of view of 16 cm x 16 cm.