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Contrast-enhanced spectral mammography (CESM) is being implemented to overcome the limitations of conventional mammography where tumor visualization is obstructed by overlapping glandular tissue. CESM exploits the spectral properties of a contrast agent by subtracting two images one obtained above and other below the K-edge energy. The most common approach requires dual-exposure where two images are obtained with differ- ent incident spectra. However, this comes at the expense of increased patient dose and susceptibility to motion artifacts. We propose the use of photon counting spectral detectors to simultaneously obtain multiple images with single-exposure. This is demonstrated using a wide area CdTe Medipix3RX detector to acquire images of iodine contrast agent in an anthropomorphic breast imaging phantom. The electronic thresholds in the detector replace the traditional physical filters. Our results show single-exposure CESM for the detection of iodine with concentrations as low as 2.5 mg/mL of a 10 mm diameter target in a 5 cm thick heterogeneous background. These results demonstrate the viability of photon counting detectors for low dose contrast-enhanced mammography.
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Raul Torrico, Amar Kavuri, Cale Lewis, Mini Das, "Single-exposure contrast enhanced spectral mammography," Proc. SPIE 10948, Medical Imaging 2019: Physics of Medical Imaging, 1094802 (3 April 2019); https://doi.org/10.1117/12.2513515