Dose and detectability improvements with high energy phase sensitive x-ray imaging in comparison to low energy conventional imaging.

The objective of this study was to demonstrate the potential benefits of using high energy x-rays for phase sensitive breast imaging through a comparison with conventional mammography imaging. We compared images of a contrast-detail phantom acquired on a prototype phase sensitive x-ray imaging system with images acquired on a commercial flat panel digital mammography unit. The phase contrast images were acquired using a micro-focus x-ray source with a 50 µm focal spot at 120 kVp and 4.5 mAs, with a magnification factor of 2.46 and a 50 µm pixel pitch. A phase attenuation duality-based phase retrieval algorithm that requires only a single phase contrast image was applied. Conventional digital mammography images were acquired at 27 kVp, 131 mAs and 28 kVp, 54 mAs. For the same radiation dose, both the observer study and signal-to-noise ratio (SNR)/figure of merit comparisons indicated a large improvement by the phase retrieved image as compared to the clinical system for the larger disc sizes, but the improvement was not enough to detect the smallest discs. Compared to the double dose image acquired with the clinical system, the observer study also indicated that the phase retrieved image provided improved detection capabilities for all disc sizes except the smallest discs. Thus the SNR improvement provided by phase contrast imaging is not yet enough to offset the noise reduction provided by the clinical system at the doubled dose level. However, the potential demonstrated by this study for high energy phase sensitive x-ray imaging to improve lesion detection and reduce radiation dose in mammography warrants further investigation of this technique.