Measurement of breast-tissue x-ray attenuation by spectral mammography: first results on cyst fluid

TL;DR

This study developed a spectral mammography method to measure x-ray attenuation of breast cyst fluid, revealing significant differences from water and demonstrating stability and validation of the technique for potential clinical use.

Contribution

A novel spectral imaging approach to accurately measure x-ray attenuation of cyst fluid, validated against chemical analysis and applicable to breast imaging.

Findings

Cyst fluid attenuation differs significantly from water.

Spectral measurements are stable and reproducible.

Method validated with chemical analysis.

Abstract

Knowledge of x-ray attenuation is essential for developing and evaluating x-ray imaging technologies. For instance, techniques to better characterize cysts at mammography screening would be highly desirable to reduce recalls, but the development is hampered by the lack of attenuation data for cysts. We have developed a method to measure x-ray attenuation of tissue samples using a prototype photon-counting spectral mammography unit. The method was applied to measure the attenuation of 50 samples of breast cyst fluid and 50 samples of water. Spectral (energy-resolved) images of the samples were acquired and the image signal was mapped to equivalent thicknesses of two known reference materials, which can be used to derive the x-ray attenuation as a function of energy. The attenuation of cyst fluid was found to be significantly different from water. There was a relatively large natural spread between different samples of cyst fluid, whereas the homogeneity of each individual sample was found to be good; the variation within samples did not reach above the quantum noise floor. The spectral method proved stable between several measurements on the same sample. Further, chemical analysis and elemental attenuation calculation were used to validate the spectral measurement on a subset of the samples. The two methods agreed within the precision of the elemental attenuation calculation over the mammographic energy range.