Hybrid Detection of Breast Abnormalities Based on Contrast Agents: Introducing a Proof of Concept from a Physics...

This manuscript attempts to present a proof of concept from a physics perspective of a hybrid detective system based on the utilization of contrast agents with the purpose of indicating breast tissue abnormalities. In the present concept, the photon-counting module of the detector is set up to the K-characteristic radiation emitted by the contrast agent. Τwo X-ray spectra were used: 40 kV- W/Al (1.6 mm) and 50 kV- W/Al (1.6 mm) with additional filtration of 0.3 mm Gd. Iodine (I) contrast agent was studied as a ''fingerprint'' for tissue abnormality indication. A computational Monte Carlo model, based on previously published validated tabulated data and tissue experimental measurements, was developed with the purpose of showing that the present concept has practical potential; however, with a weakness of not being accompanied by experimental validation. The study considered two types of internal tissue layers (fibrous/tumor with thickness values of 0.2-2.5 mm) within an external layer of fat tissue (4 and 8 cm). Quantitative (number of encountered K-photons) and qualitative (tumor-fibrous ratio) advantages of using X-ray spectra of a higher tube voltage (50 kV) and of counting the Κ photons were found. In addition, the quantitative and qualitative benefits were correspondingly more dominant at high (2.5 mm) and low (0.2 mm) tissue thickness values. In conclusion, by utilizing suitable contrast agents as ''fingerprint'' tissue abnormalities, the acquisition of combined morphological and functional imaging features (through the counting of K-X-rays) could enhance breast imaging in its present form and lead to advanced prognostic capabilities of breast abnormalities.