Comparing human observer performance in detecting microcalcifications with energy weighting and photon counting breast CT

Breast CT (BCT) using a photon counting detector (PCD) has a number of advantages that can potentially improve clinical performance. Previous computer simulation studies showed that the signal to noise ratio (SNR) for microcalcifications is higher with energy weighted photon counting BCT as compared to cesium iodide energy integrating detector (CsI-EID) based BCT. CsI-EID inherently weighs the incident x-ray photons in direct proportion to the energy (contradicting the information content) which is not an optimal approach. PCD do not inherently weigh the incident photons. By choosing optimal energy weights, higher SNR can be achieved for microcalcifications and hence better detectability. In this simulation study, forward projection data of a numerical breast phantom with microcalcifications inserted were acquired using CsI-EID and PCD. The PCD projections were optimally weighed, and reconstructed using filtered back-projection. We compared observer performance in identifying microcalcifications in the reconstructed images using ROC analysis. ROC based results show that the average area(s) under curve(s) (AUC) for AUCPCD based methods are higher than the average AUCCsI-EID method.

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