{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T04:56:25Z","timestamp":1773032185757,"version":"3.50.1"},"reference-count":45,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2023,11,15]],"date-time":"2023-11-15T00:00:00Z","timestamp":1700006400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100000038","name":"Natural Sciences and Engineering Research Council of Canada","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000038","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000196","name":"Canada Foundation for Innovation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000196","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100012171","name":"Ontario Research Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100012171","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["aapm.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Medical Physics"],"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Contrast\u2010enhanced spectral mammography (CESM) with photon\u2010counting x\u2010ray detectors (PCDs) can be used to improve the classification of breast cancers as benign or malignant. Commercially\u2010available PCD\u2010based mammography systems use silicon\u2010based PCDs. Cadmium\u2010telluride (CdTe) PCDs may provide a practical advantage over silicon\u2010based PCDs because they can be implemented as large\u2010area detectors that are more easily adaptable to existing mammography\u00a0systems.<\/jats:p><\/jats:sec><jats:sec><jats:title>Purpose<\/jats:title><jats:p>The purpose of this work is to optimize CESM implemented with CdTe PCDs and to investigate the influence of the number of energy bins, electronic noise level, pixel size, and anode material on image\u00a0quality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We developed a Monte Carlo model of the energy\u2010bin\u2010dependent modulation transfer functions (MTFs) and noise power spectra, including spatioenergetic noise correlations. We validated model predictions using a CdTe PCD with analog charge summing for charge\u2010sharing suppression. Using the ideal\u2010observer detectability, we optimized CESM for the task of detecting a 7\u2010mm\u2010diameter iodine nodule embedded in a breast with 50% glandularity. We optimized the tube voltage, beam filtration, and the location of energy thresholds for 50 and 100\u2010m pixels, tungsten and molybdenum anodes, and two electronic noise levels. One of the electronic noise levels was that of the experimental system; the other was half that of the experimental system. Optimization was performed for CdTe PCDs with two or three energy bins. We also estimated the impact of anatomic noise due to background parenchymal enhancement and computed the minimum detectable iodine area density in the presence of quantum and anatomic\u00a0noise.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Model predictions of the MTFs and noise power spectra agreed well with experiment. For optimized systems, adding a third energy bin increased quantum noise levels and reduced detectability by \u223c55% compared to two\u2010bin approaches that simply suppress contrast between fibroglandular and adipose tissue. Decreasing the electronic noise standard deviation from 3.4 to 1.7\u00a0keV increased iodine detectability by \u223c5% and \u223c30% for two\u2010bin imaging and three\u2010bin imaging, respectively. After optimizing for tube voltage, beam filtration, and the location of energy thresholds, there was \u223ca 3% difference in iodine detectability between molybdenum and tungsten anodes for two\u2010bin imaging, but for three\u2010bin imaging, molybdenum anodes provided up to 14% increase in detectability relative to tungsten anodes. Anatomic noise decreased iodine detectability by 15% to 40%, with greater impact for lower electronic noise settings and larger pixel\u00a0sizes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>For CESM implemented with CdTe PCDs, (1) quantitatively\u2010accurate three\u2010material decompositions using three energy bins are associated with substantial increases in quantum noise relative to two\u2010energy\u2010bin approaches that simply suppress contrast between fibroglandular and adipose tissues; (2) tungsten and molybdenum anodes can provide nearly equal iodine detectability for two\u2010bin imaging, but molybdenum provides a modest detectability advantage for three\u2010bin imaging provided that all other technique parameters are optimized; (3) reducing pixel sizes from 100 to 50\u00a0m can reduce detectability by up to 20% due to charge sharing; (4) anatomic noise due to background parenchymal enhancement is estimated to have a substantial impact on lesion visibility, reducing detectability by approximately 30%.<\/jats:p><\/jats:sec>","DOI":"10.1002\/mp.16837","type":"journal-article","created":{"date-parts":[[2023,11,15]],"date-time":"2023-11-15T21:44:36Z","timestamp":1700084676000},"page":"2479-2498","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Monte\u2010Carlo study of contrast\u2010enhanced spectral mammography with cadmium telluride photon\u2010counting x\u2010ray detectors"],"prefix":"10.1002","volume":"51","author":[{"given":"James A.","family":"Day","sequence":"first","affiliation":[{"name":"Department of Physics Toronto Metropolitan University Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jesse","family":"Tanguay","sequence":"additional","affiliation":[{"name":"Department of Physics Toronto Metropolitan University Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,11,15]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1148\/rg.2019190079"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diii.2013.10.002"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2333031484"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-010-1944-y"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-016-5567-7"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1118\/1.3371689"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1088\/1361-6560\/aaa307"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1118\/1.2432072"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0168-9002(02)01888-0"},{"key":"e_1_2_8_11_1","article-title":"Theoretical comparison and optimization of cadmium telluride and gallium arsenide photon\u2010counting detectors for contrast\u2010enhanced spectral mammography","volume":"10","author":"Schaeffer C","year":"2023","journal-title":"J Med Imaging (Bellingham, Wash.)"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/mp.15411"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/mp.13031"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1118\/1.3681273"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1117\/12.2611134"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1118\/1.4900611"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/mp.12004"},{"key":"e_1_2_8_18_1","doi-asserted-by":"crossref","unstructured":"TanguayJ MantellaN StavroJ CunninghamIA GoldanAH ZhaoW.Cascaded\u2010systems analysis of signal and noise in contrast\u2010enhanced spectral mammography using amorphous selenium photon\u2010counting field\u2010shaping multi\u2010well avalanche detectors (SWADs). 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