Contrast-enhanced digital mammography image quality evaluation in the clinic

Abstract

Some limitations of mammography that particularly affect diagnosis of women with dense breasts, such as tissue superposition and marginal cancer image contrast, can be overcome with the use of contrast-enhanced digital mammography (CEDM). CEDM uses iodinated contrast agents to increase attenuation in areas exhibiting hyper-vascularization, potentially due to tumour angiogenesis, and image subtraction to cancel normal tissue signal. Here, we propose a method for objective task-based image quality evaluation of CEDM that can be routinely carried out in the clinic. A phantom was designed with features that allow for practical measurements of MTF, NPS, and iodine contrast that were used to estimate a CEDM detectability index for a given imaging task. We present results from several months of weekly testing of a commercial dual-energy CEDM system. From these data, we demonstrate measurement sensitivity to variations from standard acquisition conditions, suggesting the potential to identify system failure modes using this approach. © 2014 Springer International Publishing.