Design of an Ultra-low-dose, Stationary, Tomographic Molecular Breast Imaging System

Abstract

Molecular Breast Imaging (MBI) has been shown to have high sensitivity in detection of cancer, even in patients with dense breasts where conventional mammography has issues. However the technique has limited acceptance due to the relatively high radiation dose and long imaging time. Improved lesion detection can be achieved using tomography, however this normally involves detector motion and complex mechanics. Our goal is to develop a low-dose stationary tomographic MBI system with similar or better sensitivity for lesion detection to conventional planar MBI. The proposed system utilizes state-of-the-art cadmium zinc telluride (CZT) detectors based on 2mm pixels, with sub-pixelization and depth of interaction (DOI) capability, combined with densely packed multi-pinhole collimators. Use of closely-spaced pinholes improves efficiency and angular sampling, but results in significant multiplexing. De-multiplexing algorithms have been developed that take advantage of the DOI acquisition to achieve tomographic reconstruction using two opposing planar detectors which apply mild compression to the breast. Simulation studies of multiple lesions with clinically realistic contrast have been used to demonstrate the feasibility of the design and to characterize the expected performance. Reconstruction without de-multiplexing resulted in significant artefacts. De-multiplexing without DOI had limited success but with DOI resulted in artefact-free images, with good contrast and axial plane definition. Lesion detectability was preserved even with reduction of acquisition time (or radiation dose) by a factor of 4. Further optimization has potential for even greater dose reduction. A prototype system is currently being constructed to validate these findings

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