Quantitative flow phantom for contrast-enhanced breast tomosynthesis

The use of contrast agents can help to overcome a lack of intrinsic radiographic contrast between malignant and benign breast tissue by taking advantage of the properties of tumour angiogenesis. Studies of contrast-enhanced mammography have demonstrated increased lesion conspicuity and have shown that this technique provides information on contrast uptake kinetics. It has been suggested that malignant and benign lesions can be differentiated in part by their uptake kinetics, so this additional data may lead to more accurate diagnoses. Tomosynthesis is a 3D x-ray imaging technique that permits lesion depth localization and increased conspicuity in comparison with 2D x-ray projection techniques. This modality, used in combination with contrast agents, promises to be a sensitive method of breast cancer detection. To develop the technique of contrast-enhanced breast tomosynthesis, a dynamic flow phantom has been constructed to provide the same types of imaging challenges anticipated, in the clinical setting. These challenges include a low-contrast tumour space, relevant temporal contrast agent uptake and washout profiles, and a need for quantitative analysis of enhancement levels. The design of a flow phantom will be presented that includes a dynamic tumour space, a background that masks the tumour space in images without contrast enhancement, and flow characteristics that simulate tumour contrast agent uptake and washout kinetics. The system is calibrated to relate signal to concentration of the contrast agent using a well plate filled with iodinated water. Iodine detectability in the flow phantom is evaluated in terms of the signal-difference-to-noise ratio for various tomosynthesis image acquisition parameters including number of acquired angular views, angular extent, and reconstruction voxel size.