Breast-density measurement using photon-counting spectral mammography.

Area of Science:

• Medical Imaging
• Radiology
• Biophysics

Background:

• Breast density is a key factor in breast cancer risk assessment and mammographic diagnostic accuracy.
• Accurate breast density measurement is crucial for personalized screening, treatment monitoring, and radiation dose estimation.

Purpose of the Study:

• To evaluate a novel measurement method for breast density utilizing photon-counting spectral mammography.
• To assess the precision and reliability of this spectral method compared to existing nonspectral techniques.

Main Methods:

• The spectral method leverages differences in X-ray attenuation between adipose and fibro-glandular tissues without requiring prior information.
• Evaluation involved phantom studies with tissue-equivalent materials and analysis of clinical data from 1329 screening participants.
• Benchmarking was performed against a state-of-the-art nonspectral breast density assessment method.

Main Results:

• The spectral method demonstrated a precision of 1.5-1.8 percentage points (pp) for breast density measurements.
• Observed correlations between breast thickness, density, and volume were consistent with expectations in the screening population.
• The spectral method's precision was approximately twice that of the nonspectral method (2.7-2.8 pp), which struggled with thin/dense breasts.

Conclusions:

• Photon-counting spectral mammography provides a highly precise method for breast density assessment.
• The improved precision facilitates individual-based applications, including enhanced cancer screening and treatment monitoring.