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High-resolution spiral CT of the breast at very low dose: concept and feasibility considerations



Mammography, today’s standard imaging approach, has deficits with respect to the superimposition of anatomical structures. Dedicated CT of the breast so far indicated that it can provide superior soft-tissue imaging, but that it still has significant limitations with respect to spatial resolution and dose. We have assessed novel dedicated breast CT technology.


Based on simulations and measurements we developed novel technology which uses direct-conversion CdTe material and photon-counting electronics with 100 μm detector element size for close to 100% dose efficiency. We assessed the potential for the imaging of microcalcifications of 100 to 200 μm diameter and soft-tissue lesions of 1 to 5 mm diameter by simulations at dose levels between 1 and 6 mGy.


Microcalcifications of 150 μm and soft-tissue lesions of 2 mm diameter were found to be clearly detectable at an average glandular dose of 3 mGy. Separate displays are required for high-resolution microcalcification and for low-resolution soft-tissue analysis. Total CT data acquisition time will be below 10 s.


Dedicated breast CT may eventually provide comprehensive diagnostic assessment of microcalcifications and soft-tissue structures at dose levels equivalent to or below those of two-view screening mammography.

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The authors are grateful for the financial support of this work by the European Union [19], the Deutsche Forschungsgemeinschaft [20] and the Bundesministerium für Bildung und Forschung [31]. The results presented were produced in a cooperation of the Institute of Medical Physics and Artemis Imaging GmbH, a spinoff of the IMP and also located in Erlangen. Special thanks go to our colleagues Felix Althoff, Ronny Hendrych, Martin Hupfer, and Tristan Nowak for their tremendous support of this work.

W. Kalender is the founder, CEO and shareholder of Artemis Imaging GmbH, Erlangen, Germany.

M. Beister and D. Kolditz are part-time employees of Artemis Imaging, J. Boone is a consultant to Artemis Imaging.

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Correspondence to Willi A. Kalender.

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Key points

– Breast CT allows diagnosing both microcalcifications and soft tissue in one acquisition.

– Microcalcifications of 100 to 150 μm are resolved.

– Soft tissue lesions down to 2 mm diameter are discernable.

– Dose levels of 2–4 mGy AGD conform with constraints imposed on screening.

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Kalender, W.A., Beister, M., Boone, J.M. et al. High-resolution spiral CT of the breast at very low dose: concept and feasibility considerations. Eur Radiol 22, 1–8 (2012).

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  • Computed tomography (CT)
  • Breast
  • Image quality
  • Spatial resolution
  • Dose efficiency