Calcification content quantification by dual-energy x-ray absorptiometry with a 2D digital radiographic detector

In a previous paper (SPIE Medical Imaging 2001), a dual energy method for bone densitometry using a 2D digital radiographic detector has been presented. In this paper, calcium content quantification performance of the approach is precised. The main challenge is to achieve quantification using scatter-corrected dual energy acquisitions. Therefore a scatter estimation approach, based on an expression of scatter as a functional of the primary flux, has been developed. This expression is derived from the Klein and Nishina equation and includes tabulated scatter level values. The calcium quantification performances are validated on two configurations. A first one is issued from criteria developed by the French “Groupe de Recherche et d'Information sur les Osteoporoses.” It is based on the use of a phantom made of five 3mm thick PVC sheets in the form of five steps, representing five different bone mineral density values, included in a lucite container filled with water. Additional lucite plates can be put over the phantom. This phantom has been used for evaluation of quantification robustness versus patient thickness and composition variations, and for accuracy evaluation. The second configuration, composed of small calcified objects (representative of lung nodules), is used for evaluating capacities to differentiate calcified from non calcified nodules and to test calcium content quantification performance.