Veneto Institute of Oncology (IOV), IRCCS, Padua, Italy.
Department of Biomedical Sciences, Humanitas University, Milan, Italy.
Eur Radiol Exp. 2024 Oct 14;8(1):113. doi: 10.1186/s41747-024-00516-3.
Dual-energy subtraction (DES) imaging is critical in contrast-enhanced mammography (CEM), as the recombination of low-energy (LE) and high-energy (HE) images produces contrast enhancement while reducing anatomical noise. The study's purpose was to compare the performance of the DES algorithm among three different CEM systems using a commercial phantom.
A CIRS Model 022 phantom, designed for CEM, was acquired using all available automatic exposure modes (AECs) with three CEM systems from three different manufacturers (CEM1, CEM2, and CEM3). Three studies were acquired for each system/AEC mode to measure both radiation dose and image quality metrics, including estimation of measurement error. The mean glandular dose (MGD) calculated over the three acquisitions was used as the dosimetry index, while contrast-to-noise ratio (CNR) was obtained from LE and HE images and DES images and used as an image quality metric.
On average, the CNR of LE images of CEM1 was 2.3 times higher than that of CEM2 and 2.7 times higher than that of CEM3. For HE images, the CNR of CEM1 was 2.7 and 3.5 times higher than that of CEM2 and CEM3, respectively. The CNR remained predominantly higher for CEM1 even when measured from DES images, followed by CEM2 and then CEM3. CEM1 delivered the lowest MGD (2.34 ± 0.03 mGy), followed by CEM3 (2.53 ± 0.02 mGy) in default AEC mode, and CEM2 (3.50 ± 0.05 mGy). The doses of CEM2 and CEM3 increased by 49.6% and 8.0% compared with CEM1, respectively.
One system outperformed others in DES algorithms, providing higher CNR at lower doses.
This phantom study highlighted the variability in performance among the DES algorithms used by different CEM systems, showing that these differences can be translated in terms of variations in contrast enhancement and radiation dose.
DES images, obtained by recombining LE and HE images, have a major role in CEM. Differences in radiation dose among CEM systems were between 8.0% and 49.6%. One DES algorithm achieved superior technical performance, providing higher CNR values at a lower radiation dose.
在对比增强乳腺摄影（CEM）中，双能减影（DES）成像至关重要，因为低能（LE）和高能（HE）图像的重组在产生对比增强的同时降低了解剖噪声。本研究的目的是使用商业体模比较三种不同 CEM 系统的 DES 算法性能。
使用三个不同制造商（CEM1、CEM2 和 CEM3）的三种 CEM 系统获取专为 CEM 设计的 CIRS Model 022 体模，获取时使用所有可用的自动曝光模式（AEC）。对每个系统/AEC 模式进行三次采集，以测量辐射剂量和图像质量指标，包括测量误差的估计。三次采集的平均腺体剂量（MGD）被用作剂量学指标，而对比噪声比（CNR）则从 LE 和 HE 图像以及 DES 图像中获得，并用作图像质量指标。
平均而言，CEM1 的 LE 图像的 CNR 比 CEM2 高 2.3 倍，比 CEM3 高 2.7 倍。对于 HE 图像，CEM1 的 CNR 分别比 CEM2 和 CEM3 高 2.7 倍和 3.5 倍。即使从 DES 图像中进行测量，CEM1 的 CNR 仍然主要更高，其次是 CEM2，然后是 CEM3。默认 AEC 模式下，CEM1 提供的 MGD 最低（2.34±0.03 mGy），其次是 CEM3（2.53±0.02 mGy），CEM2 最高（3.50±0.05 mGy）。与 CEM1 相比，CEM2 和 CEM3 的剂量分别增加了 49.6%和 8.0%。
一个系统在 DES 算法方面优于其他系统，提供了更高的 CNR 和更低的剂量。
这项体模研究强调了不同 CEM 系统使用的 DES 算法之间的性能差异，表明这些差异可以通过对比度增强和辐射剂量的变化来体现。
通过组合 LE 和 HE 图像获得的 DES 图像在 CEM 中起着重要作用。CEM 系统之间的辐射剂量差异在 8.0%至 49.6%之间。一种 DES 算法实现了卓越的技术性能，在较低的辐射剂量下提供了更高的 CNR 值。
