Comparison of contrast-enhanced digital mammography and contrast-enhanced digital breast tomosynthesis for lesion assessment.

Contrast-enhanced digital mammography (CEDM) reveals neovasculature of breast lesions in a two-dimensional contrast enhancement map. Contrast-enhanced digital breast tomosynthesis (CEDBT) provides contrast enhancement in three dimensions, which may improve lesion characterization and localization. We aim to compare CEDM and CEDBT for lesion assessment. Women with breast imaging-reporting and data system 4 or 5 suspicious breast lesion(s) were recruited in our study and were imaged with CEDM and CEDBT in succession under one breast compression. Two radiologists assessed CEDM and CEDBT with both images displayed side-by-side and compared (1) contrast enhancement of lesions and (2) lesion margin using a five-point scale ranging from - 2 (CEDM much better) to + 2 (CEDBT much better). Biopsy identified 19 malignant lesions with contrast enhancement. Our results show that CEDBT provides better lesion margins than CEDM with limited reduction in contrast enhancement. CEDBT delivers less radiation dose compared to CEDM + DBT. Synthetic CEDM can be generated from CEDBT data and provides lesion contrast enhancement comparable to CEDM. CEDBT has potential for clinical applications, such as treatment response monitoring and guidance for biopsy.

Experimental characterization of a direct conversion amorphous selenium detector with thicker conversion layer for dual-energy contrast-enhanced breast imaging.

PURPOSE: Dual-energy contrast-enhanced imaging is being investigated as a tool to identify and localize angiogenesis in the breast, a possible indicator of malignant tumors. This imaging technique requires that x-ray images are acquired at energies above the k-shell binding energy of an appropriate radiocontrast agent. Iodinated contrast agents are commonly used for vascular imaging, and require x-ray energies greater than 33 keV. Conventional direct conversion amorphous selenium (a-Se) flat-panel imagers for digital mammography show suboptimal absorption efficiencies at these higher energies. METHODS: We use spatial-frequency domain image quality metrics to evaluate the performance of a prototype direct conversion flat-panel imager with a thicker a-Se layer, specifically fabricated for dual-energy contrast-enhanced breast imaging. Imaging performance was evaluated in a prototype digital breast tomosynthesis (DBT) system. The spatial resolution, noise characteristics, detective quantum efficiency, and temporal performance of the detector were evaluated for dual-energy imaging for both conventional full-field digital mammography (FFDM) and DBT. RESULTS: The zero-frequency detective quantum efficiency of the prototype detector is improved by approximately 20% over the conventional detector for higher energy beams required for imaging with iodinated contrast agents. The effect of oblique entry of x-rays on spatial resolution does increase with increasing photoconductor thickness, specifically for the most oblique views of a DBT scan. Degradation of spatial resolution due to focal spot motion was also observed. Temporal performance was found to be comparable to conventional mammographic detectors. CONCLUSIONS: Increasing the a-Se thickness in direct conversion flat-panel imagers results in better performance for dual-energy contrast-enhanced breast imaging. The reduction in spatial resolution due to oblique entry of x-rays is appreciable in the most extreme clinically relevant cases, but may not profoundly affect reconstructed images due to the algorithms and filters employed. Degradation to projection domain spatial resolution is thus outweighed by the improvement in detective quantum efficiency for high-energy x-rays.

Optimization of contrast-enhanced breast imaging: Analysis using a cascaded linear system model.

PURPOSE: Contrast-enhanced (CE) breast imaging involves the injection contrast agents (i.e., iodine) to increase conspicuity of malignant lesions. CE imaging may be used in conjunction with digital mammography (DM) or digital breast tomosynthesis (DBT) and has shown promise in improving diagnostic specificity. Both CE-DM and CE-DBT techniques require optimization as clinical diagnostic tools. Physical factors including x-ray spectra, subtraction technique, and the signal from iodine contrast, must be considered to provide the greatest object detectability and image quality. We developed a cascaded linear system model (CLSM) for the optimization of CE-DM and CE-DBT employing dual energy (DE) subtraction or temporal (TE) subtraction. METHODS: We have previously developed a CLSM for DBT implemented with an a-Se flat panel imager (FPI) and filtered backprojection (FBP) reconstruction algorithm. The model is used to track image quality metrics - modulation transfer function (MTF) and noise power spectrum (NPS) - at each stage of the imaging chain. In this study, the CLSM is extended for CE breast imaging. The effect of x-ray spectrum (varied by changing tube potential and the filter) and DE and TE subtraction techniques on breast structural noise was measured was studied and included as a deterministic source of noise in the CLSM. From the two-dimensional (2D) and three-dimensional (3D) MTF and NPS, the ideal observer signal-to-noise ratio (SNR), also known as the detectability index (d'), may be calculated. Using d' as a FOM, we discuss the optimization of CE imaging for the task of iodinated contrast object detection within structured backgrounds. RESULTS: Increasing x-ray energy was determined to decrease the magnitude of structural noise and not its correlation. By performing DE subtraction, the magnitude of the structural noise was further reduced at the expense of increased stochastic (quantum and electronic) noise. TE subtraction exhibited essentially no residual structural noise at the expense of increased quantum noise, even over that of the DE case. For DE subtraction, optimization of dose weighting to the HE view (fh ) results in the minimization of quantum noise. Both subtraction weighting factor (wSub ) and the iodine contrast signal were dependent on the LE and HE x-ray spectra. To best detect a 5 mm Gaussian lesion with 5 mg/ml of iodine within a 4 cm thick breast, it was found that the high energy (HE) view should be acquired with a tube potential of 47 kVp (W/Ti spectrum) and the low energy (LE) view with a potential of 23 kVp (W/Rh spectrum). Due to the complete removal of structural noise, TE subtraction produced much higher d' than DE subtraction both as a function of mean glandular dose and iodine concentration. CONCLUSIONS: We have shown the effect of increasing x-ray energy as well as projection domain subtraction on breast structural noise. Further, we have exhibited the utility of the CLSM for DE and TE subtraction CE imaging in the optimization of imaging parameters such as x-ray energy, fh , and wSub as well as guiding the understanding of their effects on image contrast and noise.

A scatter correction method for contrast-enhanced dual-energy digital breast tomosynthesis.

Contrast-enhanced dual energy digital breast tomosynthesis (CE-DE-DBT) is designed to image iodinated masses while suppressing breast anatomical background. Scatter is a problem, especially for high energy acquisition, in that it causes severe cupping artifact and iodine quantitation errors. We propose a patient specific scatter correction (SC) algorithm for CE-DE-DBT. The empirical algorithm works by interpolating scatter data outside the breast shadow into an estimate within the breast shadow. The interpolated estimate is further improved by operations that use an easily obtainable (from phantoms) table of scatter-to-primary-ratios (SPR)--a single SPR value for each breast thickness and acquisition angle. We validated our SC algorithm for two breast emulating phantoms by comparing SPR from our SC algorithm to that measured using a beam-passing pinhole array plate. The error in our SC computed SPR, averaged over acquisition angle and image location, was about 5%, with slightly worse errors for thicker phantoms. The SC projection data, reconstructed using OS-SART, showed a large degree of decupping. We also observed that SC removed the dependence of iodine quantitation on phantom thickness. We applied the SC algorithm to a CE-DE-mammographic patient image with a biopsy confirmed tumor at the breast periphery. In the image without SC, the contrast enhanced tumor was masked by the cupping artifact. With our SC, the tumor was easily visible. An interpolation-based SC was proposed by (Siewerdsen et al 2006 Med. Phys. 33 187-97) for cone-beam CT (CBCT), but our algorithm and application differ in several respects. Other relevant SC techniques include Monte-Carlo and convolution-based methods for CBCT, storage of a precomputed library of scatter maps for DBT, and patient acquisition with a beam-passing pinhole array for breast CT. Our SC algorithm can be accomplished in clinically acceptable times, requires no additional imaging hardware or extra patient dose and is easily transportable between sites.

Genetic evidence for multiple invasions of the eastern subterranean termite into Canada.

Social insects are among the world's most successful species at invading new environments. Their characteristic division of labor can influence their capacity to colonize new habitats, often with negative ecological or economic impact. The social Hymenoptera (i.e., ants, bees, and wasps), are well studied in this regard, but much less is known about the invasive biology of termites (Isoptera). In this study we use province-wide sampling and a population genetic analysis to infer the minimum number of eastern subterranean termite [Reticulitermes flavipes (Kollar)] introductions into Ontario (Canada). Structure analysis of multilocus microsatellite genotypes grouped the 30 collection points into K = 3 genetic clusters, suggesting as many three independent introductions into southern Ontario. Levels of genetic diversity were higher in termites from the Pelee region than in termites from Toronto and other Ontario cities, suggesting that these Pelee termite populations are potentially older and native to Ontario. A single origin scenario, in which all populations stem from a single source, therefore is not supported by the genetic data. Instead, our analysis suggests multiple independent introductions of this highly social, subterranean termite into Ontario, where the species is now well established as a structural pest of urban habitats.