European Radiology

, Volume 27, Issue 3, pp 1081–1086 | Cite as

Technical feasibility proof for high-resolution low-dose photon-counting CT of the breast

  • Willi A. Kalender
  • Daniel Kolditz
  • Christian Steiding
  • Veikko Ruth
  • Ferdinand Lück
  • Ann-Christin Rößler
  • Evelyn Wenkel
Breast

Abstract

X-ray computed tomography (CT) has been proposed and evaluated multiple times as a potentially alternative method for breast imaging. All efforts shown so far have been criticized and partly disapproved because of their limited spatial resolution and higher patient dose when compared to mammography. Our concept for a dedicated breast CT (BCT) scanner therefore aimed at novel apparatus and detector design to provide high spatial resolution of about 100 μm and average glandular dose (AGD) levels of 5 mGy or below. Photon-counting technology was considered as a solution to reach these goals. The complete concept was previously evaluated and confirmed by simulations and basic experiments on laboratory setups. We here present measurements of dose, technical image quality parameters and surgical specimen results on such a scanner. For comparison purposes, the specimens were also imaged with digital mammography (DM) and breast tomosynthesis (BT) apparatus. Results show that photon-counting BCT (pcBCT) at 5 mGy AGD offers sufficiently high 3D spatial resolution for reliable detectability of calcifications and soft tissue delineation.

Key points

• Photon-counting detector technology allows for spatial resolution better than 100 μm.

• pcBCT allows for dose levels in the screening mammography range.

• pcBCT provides the highest quality imaging of microcalcifications.

Keywords

Computed tomography Breast Photon-counting detector Image quality Dose 

Notes

Acknowledgements

The authors gratefully acknowledge support by grants from the German Ministry of Research and Education (BMBF) and by the German Research Foundation (DFG).

Special thanks go to the team of the Department of Gynaecology of the University of Erlangen for providing the specimens.

The scientific guarantor of this publication is Willi Kalender. The authors of this manuscript declare relationships with the following companies: CT Imaging GmbH, Erlangen, Germany: Willi Kalender, Daniel Kolditz, Christian Steiding, Ferdinand Lück. One of the authors has significant statistical expertise.No complex statistical methods were necessary for this paper. Institutional Review Board approval was obtained.

No study subjects or cohorts have been previously reported. Methodology: prospective/retrospective.

References

  1. 1.
    Kalender WA, Beister M, Boone JMB, Kolditz D, Vollmar SV, Weigel MCC (2012) High-resolution spiral CT of the breast at very low dose: concept and feasibility considerations. Eur Radiol 22:1–8CrossRefPubMedGoogle Scholar
  2. 2.
    Lindfors KK, Boone JM, Nelson TR, Yang K, Kwan ALC, Miller DF (2008) Dedicated breast CT: Initial clinical experience. Radiology 246(3):725–733CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    O'Connell A, Kawakyu-O'Connor D (2012) Dedicated cone-beam breast computed tomography and diagnostic mammography: Comparison of radiation dose, patient comfort, and qualitative review of imaging findings im BI-RADS 4 and 5 lesions. J Clin Imaging Sci 2:7CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Sarno A, Mettivier G, Russo P (2014) Dedicated breast computed tomography: Basic aspects. Med Phys 42(6):2786–2804CrossRefGoogle Scholar
  5. 5.
    Boone JM, Kwan ALC, Seibert JA, Shah N, Lindfors KK, Nelson TR (2005) Technique factors and their relationship to radiation dose in pendant geometry breast CT. Med Phys 32(12):3767–3776CrossRefPubMedGoogle Scholar
  6. 6.
    IEC (International Electrotechnical Commission) (2004) Evaluation and routine testing in medical imaging departments – 61223-3-5 Part 3-5: Acceptance tests – Imaging performance of computed tomography X-ray equipment. Geneva, SwitzerlandGoogle Scholar
  7. 7.
    Nosratieh A, Yang K, Aminololama-Shakeri S, Boone JM (2012) Comprehensive assessment of the slice sensitivity profiles in breast tomosynthesis and breast CT. Med Phys 39(12):7254–7261CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    Kalender WA (2011) Computed tomography. Fundamentals, System Technology, Image Quality, Applications. 3rd ed. Publicis ErlangenGoogle Scholar
  9. 9.
    Weigel M, Vollmar S, Kalender WA (2011) Spectral optimization for dedicated breast CT. Med Phys 38(1):114–124CrossRefPubMedGoogle Scholar
  10. 10.
    Kuttig JD, Steiding C, Kolditz D, Hupfer M, Karolczak M, Kalender WA (2015) Comparative investigation of the detective quantum efficiency of direct and indirect conversion detector technologies in dedicated breast CT. Phys Med 31:406–413CrossRefPubMedGoogle Scholar

Copyright information

© European Society of Radiology 2016

Authors and Affiliations

  • Willi A. Kalender
    • 1
    • 2
  • Daniel Kolditz
    • 1
    • 2
  • Christian Steiding
    • 1
    • 2
    • 3
  • Veikko Ruth
    • 1
  • Ferdinand Lück
    • 1
    • 2
  • Ann-Christin Rößler
    • 1
  • Evelyn Wenkel
    • 3
  1. 1.Institute of Medical Physics (IMP)University of Erlangen-NürnbergErlangenGermany
  2. 2.CT Imaging GmbHErlangenGermany
  3. 3.Institute of RadiologyUniversity Hospital of ErlangenErlangenGermany

Personalised recommendations