Possibility of exposure dose reduction in Contrast Enhanced Spectral Mammography using dual energy subtraction technique: A phantom study

Abstract

Contrast Enhanced Spectral Mammography using energy subtraction technique (CESM) with iodinated contrast media is promising technology to improve the contrast of the image and detectability of tumor. One of the issues to be solved on this technique is giving additional radiation exposure to the patient compared with conventional mammography. We investigated phantom study to optimize scan protocol and parameter setting for reducing radiation dose without image degradation. We acquired the images with two different imaging conditions, fully-automated mode and manual mode, and evaluated image quality by image noise, contrast and exposure dose. On image quality evaluation in manual mode, the normalized noise power spectrum (NNPS) at low-energy image was increased and image quality became worse, but the quality of recombined image was not significantly different comparing to fully-automated mode. The contrast at low-energy image in manual mode was slightly deteriorated, but at recombined image was not much different comparing to auto mode. On the other hand, average glandular dose (AGD) was able to be reduced to 1.41 mGy from 1.96 mGy by setting manual mode. These results suggest it may possible to reduce the exposure dose by using manual mode instead of fully-automated mode when CESM has performed in clinical service. © 2014 Springer International Publishing.