title: Optimization of contrast-enhanced spectral mammography depending on clinical indication.
abstract: The objective is to optimize low-energy (LE) and high-energy (HE) exposure parameters of contrast-enhanced spectral mammography (CESM) examinations in four different clinical applications for which different levels of average glandular dose (AGD) and ratios between LE and total doses are required. The optimization was performed on a Senographe DS with a SenoBright® upgrade. Simulations were performed to find the optima by maximizing the contrast-to-noise ratio (CNR) on the recombined CESM image using different targeted doses and LE image quality. The linearity between iodine concentration and CNR as well as the minimal detectable iodine concentration was assessed. The image quality of the LE image was assessed on the CDMAM contrast-detail phantom. Experiments confirmed the optima found on simulation. The CNR was higher for each clinical indication than for SenoBright®, including the screening indication for which the total AGD was 22% lower. Minimal iodine concentrations detectable in the case of a 3-mm-diameter round tumor were 12.5% lower than those obtained for the same dose in the clinical routine. LE image quality satisfied EUREF acceptable limits for threshold contrast. This newly optimized set of acquisition parameters allows increased contrast detectability compared to parameters currently used without a significant loss in LE image quality.
authors.affiliation: Institut de Cancérologie Gustave Roussy , Department of Radiology, 114, Rue Edouard Vaillant 94805 Villejuif Cedex, France.
authors.forename: Clarisse
authors.initials: C
authors.lastname: Dromain
authors.affiliation: Institut de Cancérologie Gustave Roussy , Department of Radiology, 114, Rue Edouard Vaillant 94805 Villejuif Cedex, France.
authors.forename: Sandra
authors.initials: S
authors.lastname: Canale
authors.affiliation: GE Healthcare , 283 rue de la Minière, 78530 Buc, France.
authors.forename: Sylvie
authors.initials: S
authors.lastname: Saab-Puong
authors.affiliation: GE Healthcare , 283 rue de la Minière, 78530 Buc, France.
authors.forename: Ann-Katherine
authors.initials: AK
authors.lastname: Carton
authors.affiliation: GE Healthcare , 283 rue de la Minière, 78530 Buc, France.
authors.forename: Serge
authors.initials: S
authors.lastname: Muller
authors.affiliation: University Hospital Charite , Department of Radiology, Berlin, Germany.
authors.forename: Eva Maria
authors.initials: EM
authors.lastname: Fallenberg
keywords: breast; cancer; contrast media; dual energy; spectral mammography