Impact of image acquisition timing on image quality for dual energy contrast-enhanced breast tomosynthesis

Dual-energy contrast-enhanced digital breast tomosynthesis (DE CE-DBT) image quality is affected by a large parameter space including the tomosynthesis acquisition geometry, imaging technique factors, the choice of reconstruction algorithm, and the subject breast characteristics. The influence of most of these factors on reconstructed image quality is well understood for DBT. However, due to the contrast agent uptake kinetics in CE imaging, the subject breast characteristics change over time, presenting a challenge for optimization . In this work we experimentally evaluate the sensitivity of the reconstructed image quality to timing of the low-energy and high-energy images and changes in iodine concentration during image acquisition. For four contrast uptake patterns, a variety of acquisition protocols were tested with different timing and geometry. The influence of the choice of reconstruction algorithm (SART or FBP) was also assessed. Image quality was evaluated in terms of the lesion signal-difference-to-noise ratio (LSDNR) in the central slice of DE CE-DBT reconstructions. Results suggest that for maximum image quality, the low- and high-energy image acquisitions should be made within one x-ray tube sweep, as separate low- and high-energy tube sweeps can degrade LSDNR. In terms of LSDNR per square-root dose, the image quality is nearly equal between SART reconstructions with 9 and 15 angular views, but using fewer angular views can result in a significant improvement in the quantitative accuracy of the reconstructions due to the shorter imaging time interval.