Optimization of clinical protocols for contrast enhanced breast imaging

Abstract

Contrast enhanced (CE) breast imaging has been proposed as a method to increase the sensitivity and specificity of breast cancer detection. Because malignant lesions often exhibit angiogenesis, the uptake of radio-opaque contrast agents (e.g. iodine) results in increased attenuation compared to the background tissue. Both planar CE digital mammography (CE-DM) and digital breast tomosynthesis (CE-DBT) have been proposed, using temporal or dual energy (DE) subtraction to remove tissue backgrounds. In the current study, we apply a cascaded linear systems model approach to analyze CE techniques with DE subtraction for designing a diagnostic imaging study, including the effects of contrast dynamics. We apply the model for both CE-DM and CE-DBT to calculate the ideal observer signal-to-noise ratio (SNR) for the detection of I contrast objects of different sizes and concentrations. The calculation of this figure-of-merit (FOM) was be used to optimize CE clinical imaging protocols. Keywords: