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It has been proposed that breast cancer detection can be improved through the use of digital mammography. It is hypothesized that the choice of proper shape of the x-ray spectrum incident upon the breast can yield an improved image signal-to-noise ratio (SNR) for a given dose. To test this hypothesis, an energy transport model incorporating measured breast tissue attenuation coefficients and published exposure-to-dose conversion values was developed to describe the image acquisition process. The choice of applied kilovoltage and filter for Mo and W target x-ray sources has been optimized with respect to SNR and absorbed dose for detectors based on a Gd2O2S scintillating screen under the conditions of perfect coupling of light between the screen and a solid state photodetector. For the W spectra, the optimum filter-kVp combinations could provide 41%, 13%, and 42% improvements in SNR for 2-cm, 6-cm and 8-cm breasts, respectively, over the conventional Mo filtration, for a practical imaging time of 1.0 s. W and Mo spectra produce similar SNR values for a given filter thickness except for the 4-cm breast. Given the limitations of current technology, however, the W spectra produce the optimum SNRs in a shorter imaging time for breast thicknesses greater than and less than 4 cm. The maximum SNR for imaging both infiltrating ductal carcinoma and calcifications is provided by the same filter-kVp combination, allowing optimization based on breast thickness and composition only. The model can now be used to compare and improve upon novel detector designs.
Fahrig et al. (Thu,) studied this question.