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Updated: May 14, 2026
Tissue-simulating Phantoms for Assessing Potential Near-infrared Fluorescence Imaging Applications in Breast Cancer Surgery
Published on: September 19, 2014
Phantom evaluation of spectral performance in photon-counting CT for breast cancer imaging
Liqiang Ren1, Yin Xi1, Lakshmi Ananthakrishnan1
1Department of Radiology, UT Southwestern Medical Center, Dallas, Texas, USA.
Background:
Contrast enhancement is the most sensitive indicator for detecting breast malignancies. Computed tomography (CT) has had a limited role for the locoregional staging of breast tumors due to low soft tissue contrast.
Purpose:
To evaluate and optimize the performance of clinical photon-counting computed tomography (PCCT) for breast cancer imaging using a contrast-enhanced mammography (CEM) phantom and to compare its imaging performance with dual-source dual-energy CT (DS-DECT).
Methods:
A CEM phantom containing simulated breast lesions was positioned on an anthropomorphic thoracic phantom and scanned using a clinical PCCT system at 120 kV in multi-energy mode and a DS-DECT system with two kV pairs of 70/Sn150 kV and 90/Sn150 kV. PCCT scanner variables included scan mode [standard resolution (SR) and ultra-high resolution (UHR)], field of view (FOV) size (large and small), matrix size (512 and 1024), and type of image used for analysis [low-energy threshold images, virtual monoenergetic images (VMIs) at 50, 60, and 70 keV, and iodine maps]. Quantitative analysis was performed using circular regions of interest (ROIs) placed on iodine-containing lesions and background within the phantom. For each ROI, mean CT numbers or iodine concentrations and standard deviations were measured across the central five slices and three independent scans. Contrast-to-noise ratio (CNR) and circularity were evaluated across all PCCT configurations and image types and compared with those obtained from DS-DECT.
Results:
Among all PCCT configurations, the UHR mode with a small FOV and either a 512 or 1024 matrix at 50 keV VMI achieved the highest combined CNR across all iodine concentrations. Additionally, the UHR mode with a 512 matrix and either small or large FOV yielded the highest combined circularity values. The optimal PCCT configuration achieved higher CNR, and higher or comparable circularity compared with 50 keV VMIs derived from DECT scans.
Conclusions:
This phantom study demonstrated that optimal spectral performance for potential breast cancer imaging with PCCT is achieved using UHR mode, low-keV VMIs, a regular matrix size, and dedicated reconstruction FOVs, outperforming DECT.
