Quantitative evaluation of dual-energy digital mammography for calcification imaging

Dual-energy digital mammography (DEDM), where separate low- and high-energy images are acquired and synthesized to cancel the tissue structures, may improve the ability to detect and visualize microcalcifications. Under ideal imaging conditions, when the mammography image data are free of scatter and other biases, DEDM could be used to determine the thicknesses of the imaged calcifications. We present quantitative evaluation of a DEDM technique for calcification imaging. The phantoms used in the evaluation were constructed by placing aluminium strips of known thicknesses (to simulate calcifications) across breast-tissue-equivalent materials of different glandular-tissue compositions. The images were acquired under narrow-beam geometry and high exposures to suppress the detrimental effects of scatter and random noise. The measured aluminium thicknesses were found to be approximately linear with the true aluminium thicknesses and independent of the underlying glandular-tissue composition. However, the dual-energy images underestimated the true aluminium thickness due to the presence of scatter from adjacent regions. Regions in the DEDM image that contained no aluminium yielded very low aluminium thicknesses (<0.07 mm). The aluminium contrast-to-noise ratio in the dual-energy images increased with the aluminium thickness and decreased with the glandular-tissue composition. The changes to the aluminium contrast-to-noise ratio and the contrast of the tissue structures between the low-energy and DEDM images are also presented.