Previous studies have suggested that iodine contrast-enhanced breast tomosynthesis can be helpful in the characterization of suspicious abnormalities. Dual-energy, contrast-enhanced breast tomosynthesis involves acquiring low- and high-energy acquisitions after the administration of the contrast agent, and therefore can simplify the procedure and reduce the effect of patient motion. In this study, a computer simulation is developed for use in investigating optimal parameters for dual-energy, contrast-enhanced breast tomosynthesis. The simulation allows for the selection of various polyenergetic x-ray spectra and x-ray filters, and models x-ray transport through a voxelized breast phantom, as well as signal and noise propagation through an indirect CsI based imager. A compressed breast phantom that models the non-uniform parenchymal structure of the breast is used. Irregular lesions were simulated by using a stochastic growth algorithm. Simulations of dual-energy subtraction, contrast-enhanced breast tomosynthesis show that using x-ray filters to form quasi-monochromatic high- and low-energy spectra above and below the iodine K-edge can substantially reduce background structure, and increase lesion conspicuity as compared to single shot contrast-enhanced BT.
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