Phantom-based comparative analysis of contrast-enhanced mammography systems: Image quality and performance evaluation

Area of Science:

• Medical Imaging
• Radiology
• Breast Imaging

Background:

• Contrast-enhanced mammography (CEM) utilizes dual-energy imaging to create energy-subtracted (ES) images, enhancing visualization of iodinated contrast uptake in breast lesions.
• This technique aims to improve the detection and characterization of breast abnormalities.

Purpose of the Study:

• To analyze and compare the performance of different contrast-enhanced mammography (CEM) systems from various vendors.
• To evaluate image quality metrics and radiation dose across different CEM platforms.

Main Methods:

• Four CEM systems (Fujifilm, Hologic, GE, IMS) were assessed using a dedicated phantom with varying iodine concentrations and thicknesses.
• Acquisition parameters, average glandular dose (AGD), contrast-to-noise ratio (CNR), and linearity of iodine concentration response were evaluated.

Main Results:

• Average glandular doses (AGDs) varied across systems, with high-energy dose contributions ranging from 23.8% to 41.5%.
• Contrast-to-noise ratio (CNR) generally increased with iodine concentration and decreased with phantom thickness.
• Hologic, Fujifilm, and GE systems demonstrated good linearity in iodine concentration response with minimal error across different phantom thicknesses.

Conclusions:

• Significant similarities and differences in image quality and radiation dose were observed among the evaluated CEM systems.
• The linearity of iodine concentration response at various thicknesses holds potential for clinical application in distinguishing suspicious breast lesions.