Evaluation of x-ray scatter properties in a dedicated cone-beam breast CT scanner.

The magnitude of scatter contamination on a first-generation prototype breast computed tomography (CT) scanner was evaluated using the scatter-to-primary ratio (SPR) metric. The SPR was measured and characterized over a wide range of parameters relevant to breast CT imaging, including x-ray beam energy, breast diameter, breast composition, isocenter-to-detector distance, collimated slot thickness, and grid ratio. The results demonstrated that in the absence of scatter reduction techniques, the SPR levels for the average breast (e.g., 14 cm diameter 50/50 composition cylindrical phantom) are quite high (approximately 0.5 at the center of the phantom for 80 kVp in true cone-beam CT geometry), and increases as the diameter of the phantom is increased (to approximately 1.0 at the center of a 18 cm diameter 50/50 phantom). The x-ray beam energy and the phantom compositions had only minimal impact on the measured SPR. When an ideal bowtie filter was used, the SPRs at the central axis of the 14 and 18 cm cylindrical phantoms were reduced while the SPRs at the edge of the phantoms were increased. Lastly, collimation in the vertical direction had a significant impact on the SPRs at the central axis of the phantoms. These high SPR levels might lead to cupping artifacts and increased noise in the reconstructed CT images, and this suggests that efficient scatter rejection and/or correction techniques may be required to improve the quality and accuracy of cone beam CT images.

Technique factors and their relationship to radiation dose in pendant geometry breast CT.

The use of breast computed tomography (CT) as an alternative to mammography in some patients is being studied at several institutions. However, the radiation dosimetry issues associated with breast CT are markedly different than in the case of mammography. In this study, the spectral properties of an operational breast CT scanner were characterized both by physical measurement and computer modeling of the kVp-dependent spectra, from 40 to 110 kVp (Be window W anode with 0.30 mm added Cu filtration). Previously reported conversion factors, normalized glandular dose for CT-DgN(ct), derived from Monte Carlo methods, were used in concert with the output spectra of the breast scanner to compute the mean glandular dose to the breast based upon different combinations of x-ray technique factors (kVp and mAs). The mean glandular dose (MGD) was measured as a function of the compressed breast thickness (2-8 cm) and three different breast compositions (0%, 50%, and 100% glandular fractions) in four clinical mammography systems in our institution. The average MGD from these four systems was used to compute the technique factors for breast CT systems that would match the two-view mammographic dose levels. For a 14 cm diameter breast (equivalent to a 5 cm thick compressed breast in mammography), air kerma levels at the breast CT scanner's isocenter (468 mm from the source) of 4.4, 6.4, and 9.0 mGy were found to deliver equivalent mammography doses for 0%, 50%, and 100% glandular breasts (respectively) at 80 kVp. At 80 kVp (where air kerma was 11.3 mGy/100 mAs at the isocenter), 57 mAs (integrated over the entire scan) was required to match the mammography dose for a 14 cm 50% glandular breast. At 50 kVp, 360 mAs is required to match mammographic dose levels. Tables are provided for both air kerma at the isocenter and mAs for 0%, 50%, and 100% glandular breasts. Other issues that impact breast CT technique factors are also discussed.