Simulated scatter performance of an inverse-geometry dedicated breast CT system

The purpose of this work was to quantify the effects of scatter for inverse-geometry dedicated breast CT compared to cone-beam breast CT through simulations. The inverse geometry was previously proposed as an alternative to cone-beam acquisition for volumetric CT. The inverse geometry consists of a large-area scanned-source opposite a detector array that is smaller in the transverse direction. While the gantry rotates, the x-ray beam is rapidly sequenced through an array of positions, acquiring a truncated projection image at each position. Inverse-geometry CT (IGCT) is expected to detect less scatter than cone-beam methods because only a fraction of the object is irradiated at any time and the fast detector isolates the measurements from sequential x-ray beams. An additional scatter benefit is the increased air gap due to the inverted geometry. In this study, we modeled inverse-geometry and cone-beam dedicated breast CT systems of equivalent resolution, field of view, and photon fluence. Monte Carlo simulations generated scatter and primary projections of three cylindrical phantoms of diameters 10, 14, and 18 cm composed of 50% adipose/50% glandular tissue. The scatter-to-primary ratio (SPR) was calculated for each breast diameter. Monte Carlo simulations were combined with analytical simulations to generate inverse-geometry and cone-beam images of breast phantoms embedded with tumors. Noise reprehenting the photon fluence of a realistic breast CT scan was added to the simulated projections. Cone-beam data were reconstructed with and without an ideal scatter correction. The CNR between breast tumor and background was compared for the inverse and cone-beam geometries for the three phantom diameters. Results demonstrated an order of magnitude reduction in SPR for the IGCT system compared to the cone-beam system. For example, the peak IGCT SPRs were 0.05 and 0.09 for the 14 and 18 cm phantoms, respectively, compared to 0.42 and 1 for the cone-beam system. For both geometries, the effects of scatter on contrast-to-noise ratio (CNR) were small for the 10 cm diameter phantom. The inverse-geometry improved the CNR by factors of 1.16 for the 14 cm phantom and 1.48 for the 18 cm phantom compared to a cone-beam acquisition without scatter correction. When an ideal scatter correction was applied to the cone-beam acquisition, the IGCT CNR improvements were 1.03 and 1.25 for the 14 and 18 cm phantoms. Overall, the results suggest that the inverse geometry may be advantageous for dedicated breast CT, an application that requires high-contrast resolution, spatial resolution, and dose efficiency.