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The purpose of this study was to make single\u2010scan contrast\u2010enhanced imaging feasible for photon\u2010counting breast CT (pcBCT) and to assess the spectral performance of a pcBCT scanner by evaluating iodine maps and virtual non\u2010contrast (VNC) images.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We optimized the settings of a pcBCT to maximize the signal\u2010to\u2010noise ratio between iodinated contrast agent and breast tissue. Therefore, an electronic energy threshold dividing the x\u2010ray spectrum used into two energy bins was swept from 23.17\u00a0keV to 50.65\u00a0keV. Validation measurements were performed by placing syringes with contrast agent (2.5\u00a0mg\/ml to 40\u00a0mg\/ml) in phantoms with 7.5\u00a0cm and 12\u00a0cm in diameter. Images were acquired at different tube currents and reconstructed with 300\u00a0\u03bcm isotropic voxel size. Iodine maps and VNC images were generated using image\u2010based material decomposition. Iodine concentrations and CT values were measured for each syringe and compared to the known concentrations and reference CT values.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Maximal signal\u2010to\u2010noise ratios were found at a threshold position of 32.59\u00a0keV. Accurate iodine quantification (average root mean square error of 0.56\u00a0mg\/ml) was possible down to a concentration of 2.5\u00a0mg\/ml for all tube currents investigated. The enhancement has been sufficiently removed in the VNC images, so they can be interpreted as unenhanced CT images. Only minor changes of CT values compared to a conventional CT scan were observed. Noise was increased by the decomposition by a factor of 2.62 and 4.87 (7.5\u00a0cm and 12\u00a0cm phantoms) but did not compromise the accuracy of the iodine quantification.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Accurate iodine quantification and generation of VNC images can be achieved using contrast\u2010enhanced pcBCT from a single CT scan in the absence of temporal or spatial misalignment. Using iodine maps and VNC images, pcBCT has the potential to reduce dose, shorten examination and reading time, and to increase cancer detection rates.<\/jats:p><\/jats:sec>","DOI":"10.1002\/mp.14133","type":"journal-article","created":{"date-parts":[[2020,3,10]],"date-time":"2020-03-10T23:10:08Z","timestamp":1583881808000},"page":"2826-2837","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Investigation of spectral performance for single\u2010scan contrast\u2010enhanced breast CT using photon\u2010counting technology: A phantom study"],"prefix":"10.1002","volume":"47","author":[{"given":"Veikko","family":"Ruth","sequence":"first","affiliation":[{"name":"Institute of Medical Physics Friedrich\u2010Alexander University Erlangen\u2010N\u00fcrnberg (FAU) Erlangen 91052 Germany"},{"name":"AB\u2010CT \u2013 Advanced Breast\u2010CT GmbH Erlangen 91052 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