{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:01:14Z","timestamp":1792785674378,"version":"4.5.0"},"reference-count":35,"publisher":"IOP Publishing","issue":"20","license":[{"start":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T00:00:00Z","timestamp":1792454400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T00:00:00Z","timestamp":1792454400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/iopscience.iop.org\/info\/page\/text-and-data-mining"}],"funder":[{"name":"Direcci\u00f3n General de Asuntos del Personal Acad\u00e9mico, Universidad Nacional Aut\u00f3noma de M\u00e9xico","award":["IN103025"],"award-info":[{"award-number":["IN103025"]}],"id":[{"id":"https:\/\/ror.org\/01tmp8f25","id-type":"ROR","asserted-by":"crossref"}]},{"name":"Secretar\u00eda de Ciencia, Humanidades, Tecnolog\u00eda e Innovaci\u00f3n","award":["2019-1311307"],"award-info":[{"award-number":["2019-1311307"]}],"id":[{"id":"https:\/\/ror.org\/059ex5q34","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":["iopscience.iop.org"],"crossmark-restriction":false},"short-container-title":["Phys. Med. Biol."],"published-print":{"date-parts":[[2026,10,28]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    <jats:italic>Objective.<\/jats:italic>\n                    This work evaluates variability and bias in the calculation of iodine uptake from contrast-enhanced dual-energy mammography (CEM) images using an adaptive background subtraction method.\n                    <jats:italic>Approach.<\/jats:italic>\n                    The iodine uptake images were custom-generated using weighted subtraction, followed by subtraction of a smooth background estimated by interpolation from neighboring regions outside the lesion (adaptive background subtraction). Three main sources of variability and bias were assessed: differences in breast tissue linear attenuation coefficients, stability of the mammography system, and intra- and inter-observer variability in lesion segmentation. Tissue-related effects were evaluated theoretically. System stability was assessed using weekly phantom measurements acquired over a 4-year period. For observer variability, four radiologists performed two segmentation rounds of iodine-enhancing regions in 40 CEM studies. Typical uptake values were below 5 mg cm\n                    <jats:sup>\u22122<\/jats:sup>\n                    . Whenever possible, variability was expressed as the 95% coverage interval (2\u03c3), where \u03c3 represents the standard deviation\n                    <jats:italic>. Main results.<\/jats:italic>\n                    Theoretical evaluation showed that tissue composition differences may introduce biases in iodine uptake exceeding 0.5 mg cm\n                    <jats:sup>\u22122<\/jats:sup>\n                    , although typical lesion compositions produce biases below the visual detection threshold. Long-term phantom measurements demonstrated excellent system stability over four years (2\u03c3 \u22480.2 mg cm\n                    <jats:sup>\u22122<\/jats:sup>\n                    , and limit of detection = 0.24 mg cm\n                    <jats:sup>\u22122<\/jats:sup>\n                    ), with a 7% change in calibration following a workstation upgrade. In the clinical dataset, the four radiologists achieved high detection agreement when segmenting the primary lesions and greater variability for secondary lesions; the inter-observer variability in mean uptake was approximately 2\u03c3 \u22480.6 mg cm\n                    <jats:sup>\u22122<\/jats:sup>\n                    .\n                    <jats:italic>Significance.<\/jats:italic>\n                    These findings indicate that iodine uptake quantification in CEM using an adaptive background subtraction method is technically robust, which is a key element for exploring its potential usefulness as an imaging biomarker.\n                  <\/jats:p>","DOI":"10.1088\/1361-6560\/aeaac1","type":"journal-article","created":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T22:54:39Z","timestamp":1790031279000},"page":"205015","update-policy":"https:\/\/doi.org\/10.1088\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Variability and bias in the calculation of iodine uptake with an adaptive background subtraction method in contrast-enhanced mammography"],"prefix":"10.1088","volume":"71","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4556-5262","authenticated-orcid":true,"given":"Jorge Patricio","family":"Castillo-Lopez","sequence":"first","affiliation":[{"name":"Instituto Nacional de Cancerolog\u00eda"},{"name":"Universidad Nacional Aut\u00f3noma de M\u00e9xico"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"formal-analysis","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"},{"role":"project-administration","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"given":"Liliana Moreno","family":"Astudillo","sequence":"additional","affiliation":[{"name":"Instituto Nacional de Cancerolog\u00eda"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"},{"role":"visualization","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"given":"Yolanda","family":"Villase\u00f1or-Navarro","sequence":"additional","affiliation":[{"name":"Instituto Nacional de Cancerolog\u00eda"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"funding-acquisition","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"},{"role":"supervision","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1165-3440","authenticated-orcid":true,"given":"Mar\u00eda-Ester","family":"Brandan","sequence":"additional","affiliation":[{"name":"Universidad Nacional Aut\u00f3noma de M\u00e9xico"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"funding-acquisition","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"},{"role":"project-administration","vocabulary":"credit"},{"role":"supervision","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]}],"member":"266","published-online":{"date-parts":[[2026,10,20]]},"reference":[{"key":"pmbaeaac1bib1","doi-asserted-by":"publisher","first-page":"6041","DOI":"10.1088\/0031-9155\/54\/20\/002","type":"journal-article","article-title":"Quantitative contrast-enhanced mammography for contrast medium kinetics studies","volume":"54","author":"Arvanitis","year":"2009","journal-title":"Phys. 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Published on behalf of Institute of Physics and Engineering in Medicine by IOP Publishing Ltd","name":"copyright_information","label":"Copyright Information"},{"value":"2026-03-31","name":"date_received","label":"Date Received","group":{"name":"publication_dates","label":"Publication dates"}},{"value":"2026-09-21","name":"date_accepted","label":"Date Accepted","group":{"name":"publication_dates","label":"Publication dates"}},{"value":"2026-10-20","name":"date_epub","label":"Online publication date","group":{"name":"publication_dates","label":"Publication dates"}}]}}