Dual-Energy Contrast Enhanced Digital Mammography: theoretical and experimental study of optimal monoenergetic beam parameters using synchrotron radiation

Dual-energy imaging with the injection of an iodinated contrast medium has the potential to depict cancers in the breast, by the demonstration of tumour angiogenesis and the suppression of the breast structure noise. The present study investigates the optimum monoenergetic beam parameters for this application. First, a theoretical study of the beam parameters was performed to find the best compromise between the quality of the dual-energy recombined image and the patient dose. The result of this analysis was then validated by phantom experiments using synchrotron monoenergetic radiation at the European Synchrotron Radiation Facility (ESRF, Grenoble, France). For an average breast of 5cm thickness and 50% glandularity, the theoretical simulations show an optimum at 20 keV for the low energy and 34 keV for the high energy, for a CsI detector of a standard mammography system. The SDNR variations with the low energy, the high energy or the dose repartition are very similar between the measurements on images acquired with synchrotron radiation and the simulated values. This ensures the accuracy of our theoretical optimization and the validity of the optimal beam parameters found in this study. The aim of this work is to demonstrate the potential of Dual-Energy CEDM (Contrast Enhanced Digital Mammography) with ideal monoenergetic sources, in order to provide an indicator of how to shape the polyenergetic spectra produced with classical X-ray sources for this application.