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Dual-energy (DE) breast x-ray imaging involves acquiring images using a low- and high-energy x-ray spectral pair.
These images are then subtracted with a weighting factor that eliminates the soft-tissue signal variation present in
the breast leaving only contrast that is attributed to an exogenous imaging agent. We have previously demonstrated
the potential for silver (Ag) as a contrast material for DE breast imaging. Theoretical analysis shows that silver can
provide better contrast to clinically-used iodine. Here, we present the subtraction method developed to eliminate the
contrast between adipose and glandular tissue; the two major component materials in the breast. The weighting
factor is calculated from the attenuation coefficients of the two tissue types and varies between values of 0 and 1 for
the energy combinations studied. A spectral search was performed to identify the set of clinically-feasible imaging
parameters that will optimize the contrast of silver using our subtraction technique. The subtraction methodology
was tested experimentally using step-phantoms and demonstrated that we are able to a) nullify the soft-tissue
contrast that arises from differences in glandularity, and b) preserve an image contrast for silver that is independent
of the underlying soft-tissue composition. By applying the DE subtraction proposed, a silver-based agent will
outperform an iodinated contrast agent on a commercially-available CEDE breast x-ray imaging system.
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Roshan Karunamuni, Andrew D. A. Maidment, "Quantification of a silver contrast agent in dual-energy breast x-ray imaging," Proc. SPIE 8668, Medical Imaging 2013: Physics of Medical Imaging, 866862 (19 March 2013); https://doi.org/10.1117/12.2008105