Contrast-enhanced dual energy mammography with a novel anode/filter combination and artifact reduction: a feasibility study.

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 a...

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Published in:European Radiology Vol. 26; no. 6; pp. 1575 - 1582
Main Authors: Knogler, Thomas, Homolka, Peter, Hörnig, Mathias, Leithner, Robert, Langs, Georg, Waitzbauer, Martin, Pinker-Domenig, Katja, Leitner, Sabine, Helbich, Thomas, Helbich, Thomas H
Format: diagnostic images research tables/charts Journal Article
Published: Springer Nature Jun2016
Online Access:View this record in EBSCOhost
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      dt: Jun2016
      vid: 26
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      pub: Springer Nature
      place: New York, New York
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        10.1007/s00330-015-4007-6
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        atl: Contrast-enhanced dual energy mammography with a novel anode/filter combination and artifact reduction: a feasibility study.
      aug:
        au:
          Knogler, Thomas
          Homolka, Peter
          Hörnig, Mathias
          Leithner, Robert
          Langs, Georg
          Waitzbauer, Martin
          Pinker-Domenig, Katja
          Leitner, Sabine
          Helbich, Thomas
          Hörnig, Mathias
          Helbich, Thomas H
        affil: Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Waehringer Guertel 18-20 1090 Vienna Austria
      sug:
        subj:
          Neoplasms, Ductal, Lobular, and Medullary
          Breast Neoplasms
          Granuloma
          Fibrocystic Disease of Breast
          Radiographic Image Enhancement Methods
          Carcinoma, Ductal, Breast
          Artifacts
          Contrast Media
          Image Processing, Computer Assisted Methods
          Female
          Aged
          Algorithms
          Pilot Studies
          Breast
          Middle Age
          Neoplasms, Fibrous Tissue
          Adult
          Sensitivity and Specificity
          Mammography Methods
          Electrodes
          Image Enhancement
          Human
          Aged: 65+ years
          Middle Aged: 45-64 years
          Adult: 19-44 years
          Female
      ab: 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.
      pubtype: Academic Journal
      doctype:
        diagnostic images
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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