Dual-energy mammography: Initial experimental results

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Abstract
Dual-energy X-ray techniques may be able to enhance the detectablilty of calcifications in mammographic examinations [for cancer diagnosis] by removing the background clutter caused by contrast between adipose and glandular tissue. This hypothesis is examined experimentally by implementation of dual-energy imaging on a prototype digital scanned projection radiography system. A model of the propagation of signal and noise in dual-energy processing for a given radiation dose is validated by measurements from phantom images. The experimental imaging system has low spatial resolution and cannot be operated at dose-optimum energies; since both the single- and dual-energy images are subject to the same technical limitations, a comparison of such images allows an assessment of the benefits of dual energy. Experimental images of breast tissue specimens, showing improved detectability of calcifications when obscuring background clutter is removed, are presented. The dose required for a given signal-to-noise ratio can be reduced by smoothing the higher energy image prior to dual-energy processing. For practical implementation, it is reasonable to smooth the higher energy image such that its variance is reduced 4-fold.