Thomas Knogler1,2, Peter Homolka3, Mathias Hörnig4, Robert Leithner3, Georg Langs5,6, Martin Waitzbauer5,6, Katja Pinker-Domenig5,7, Sabine Leitner5,7, Thomas H Helbich5,7. 1. Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria. thomas.helbich@meduniwien.ac.at. 2. Division of Molecular and Gender Imaging, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria. thomas.helbich@meduniwien.ac.at. 3. Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria. 4. Siemens AG, Healthcare, X-Ray Products, Allee am Röthelheimpark 2, 91052, Erlangen, Germany. 5. Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria. 6. Computational Imaging Research Laboratory, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria. 7. Division of Molecular and Gender Imaging, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.
Abstract
OBJECTIVES: To demonstrate the feasibility of contrast-enhanced dual-energy mammography (CEDEM) using titanium (Ti) filtering at 49 kVp for high-energy images and a novel artefact reducing image-subtraction post-processing algorithm. METHODS: Fifteen patients with suspicious findings (ACR BI-RADS 4 and 5) detected with digital mammography (MG) that required biopsy were included. CEDEM examinations were performed on a modified prototype machine. Acquired HE and low-energy raw data images were registered non-rigidly to compensate for possible subtle tissue motion. Subtracted CEDEM images were generated via weighted subtraction, using a fully automatic, locally adjusted tissue thickness-dependent subtraction factor to avoid over-subtraction at the breast border. Two observers evaluated the MG and CEDEM images according to ACR BI-RADS in two reading sessions. Results were correlated with histopathology. RESULTS: Seven patients with benign and eight with malignant findings were included. All malignant lesions showed a strong contrast enhancement. BI-RADS assessment was altered in 66.6 % through the addition of CEDEM, resulting in increased overall accuracy. With CEDEM, additional lesions were depicted and false-positive rate was reduced compared to MG. CONCLUSIONS: CEDEM using Ti filtering with 49 kVp for HE exposures is feasible in a clinical setting. The proposed image-processing algorithm has the potential to reduce artefacts and improve CEDEM images. KEY POINTS: • CEDEM with a titanium filter is feasible in a clinical setting. • Breast thickness-dependent image subtraction has the potential to improve CEDEM images. • The proposed image-processing algorithm reduces artefacts.
OBJECTIVES: To demonstrate the feasibility of contrast-enhanced dual-energy mammography (CEDEM) using titanium (Ti) filtering at 49 kVp for high-energy images and a novel artefact reducing image-subtraction post-processing algorithm. METHODS: Fifteen patients with suspicious findings (ACR BI-RADS 4 and 5) detected with digital mammography (MG) that required biopsy were included. CEDEM examinations were performed on a modified prototype machine. Acquired HE and low-energy raw data images were registered non-rigidly to compensate for possible subtle tissue motion. Subtracted CEDEM images were generated via weighted subtraction, using a fully automatic, locally adjusted tissue thickness-dependent subtraction factor to avoid over-subtraction at the breast border. Two observers evaluated the MG and CEDEM images according to ACR BI-RADS in two reading sessions. Results were correlated with histopathology. RESULTS: Seven patients with benign and eight with malignant findings were included. All malignant lesions showed a strong contrast enhancement. BI-RADS assessment was altered in 66.6 % through the addition of CEDEM, resulting in increased overall accuracy. With CEDEM, additional lesions were depicted and false-positive rate was reduced compared to MG. CONCLUSIONS: CEDEM using Ti filtering with 49 kVp for HE exposures is feasible in a clinical setting. The proposed image-processing algorithm has the potential to reduce artefacts and improve CEDEM images. KEY POINTS: • CEDEM with a titanium filter is feasible in a clinical setting. • Breast thickness-dependent image subtraction has the potential to improve CEDEM images. • The proposed image-processing algorithm reduces artefacts.
Entities:
Keywords:
Breast cancer; Contrast agent; Contrast-enhanced digital mammography; Digital mammography; Image processing
Authors: Ann-Katherine Carton; Christer Ullberg; Karin Lindman; Raymond Acciavatti; Tom Francke; Andrew D A Maidment Journal: Med Phys Date: 2010-11 Impact factor: 4.071
Authors: Felix Diekmann; Martin Freyer; Susanne Diekmann; Eva M Fallenberg; Thomas Fischer; Ulrich Bick; Alexander Pöllinger Journal: Eur J Radiol Date: 2009-11-19 Impact factor: 3.528
Authors: Roberta A Jong; Martin J Yaffe; Mia Skarpathiotakis; Rene S Shumak; Nathalie M Danjoux; Anoma Gunesekara; Donald B Plewes Journal: Radiology Date: 2003-07-24 Impact factor: 11.105
Authors: Thomas Knogler; Peter Homolka; Mathias Hoernig; Robert Leithner; Georg Langs; Martin Waitzbauer; Katja Pinker; Sabine Leitner; Thomas H Helbich Journal: Breast Care (Basel) Date: 2017-08-17 Impact factor: 2.860
Authors: Francesco Sardanelli; Eva M Fallenberg; Paola Clauser; Rubina M Trimboli; Julia Camps-Herrero; Thomas H Helbich; Gabor Forrai Journal: Insights Imaging Date: 2016-11-16
Authors: Paola Clauser; Pascal A T Baltzer; Panagiotis Kapetas; Mathias Hoernig; Michael Weber; Federica Leone; Maria Bernathova; Thomas H Helbich Journal: J Magn Reson Imaging Date: 2020-02-14 Impact factor: 4.813