Scatter correction for contrast-enhanced digital breast tomosynthesis with a dual-layer detector

Purpose: Contrast-enhanced digital breast tomosynthesis (CEDBT) highlights breast tumors with neo-angiogenesis. A recently proposed CEDBT system with a dual-layer (DL) flat-panel detector enables simultaneous acquisition of high-energy (HE) and low-energy (LE) projection images with a single exposure, which reduces acquisition time and eliminates motion artifacts. However, x-ray scatter degrades image quality and lesion detectability. We propose a practical method for accurate and robust scatter correction (SC) for DL-CEDBT. Approach: The proposed hybrid SC method combines the advantages of a twokernel iterative convolution method and an empirical interpolation strategy, which accounts for the reduced scatter from the peripheral breast region due to thickness roll-off and the scatter contribution from the region outside the breast. Scatter point spread functions were generated using Monte Carlo simulations with different breast glandular fractions, compressed thicknesses, and projection angles. Projection images and ground truth scatter maps of anthropomorphic digital breast phantoms were simulated to evaluate the performance of the proposed SC method and three other kernel- and interpolation-based methods. The mean absolute relative error (MARE) between scatter estimates and ground truth was used as the metric for SC accuracy. Results: DL-CEDBT shows scatter characteristics different from dual-shot, primarily due to the two energy peaks of the incident spectrum and the structure of the DL detector. Compared with the other methods investigated, the proposed hybrid SC method showed superior accuracy and robustness, with MARE of ∼3.1% for all LE and HE projection images of different phantoms in both cranialcaudal and mediolateral-oblique views. After SC, cupping artifacts in the dualenergy image were removed, and the signal difference-to-noise ratio was improved by 82.0% for 8 mm iodine objects. Conclusions: A practical SC method was developed, which provided accurate and robust scatter estimates to improve image quality and lesion detectability for DLCEDBT.