Breast CT is a promising modality whose inherent scatter could be used to reconstruct electron density (rho_e) images. This has led us to investigate the benefits of reconstructing linear attenuation coefficient (mu) and (rho_e) images of the breast. First generation CT provides a cost-effective and simple approach to reconstruct (rho_e) images in a laboratory but is limited by the anisotropic probability of scatter, attenuation, noise and contaminating scatter (coherent and multiple scatter). These issues were investigated using Monte Carlo (MC) simulations of a first generation breast scatter enhanced CT (B-SECT) system. A reconstruction algorithm was developed for the B-SECT system and is based on a ring of detectors which eliminates the scatter dependence on the relative position of the scattering centre. The algorithm incorporates an attenuation correction based on the (mu) image and was tested against analytical and MC simulations. MC simulations were also used to quantify the dose per scan. The ring measures a fraction of the total single incoherent scatter which is proportional to ray integrals of (rho_e) and can be quantified even when electron binding is non negligible. The algorithm typically reconstructs accurate (rho_e) images using a single correction for attenuation but has the capability for multiple iterations if required. MC simulations show that the dose coefficients are similar to those of cone beam breast CT. Coherent and multiple scatter can not be directly related to (rho_e) and lead to capping artifacts and overestimated (rho_e) by a factor greater than 2. This issue can be addressed using empirical corrections based on the radiological path of the incident beam and result in (rho_e) images of breast soft tissue with 1% accuracy, 3% precision and a mean glandular dose of 4 mGy for a 3D scan. The reconstructed (rho_e) image was more accurate than the (rho_e) estimate derived from the (mu) image. An alternative correction based on the thickness of breast traversed by the beam provides an enhanced contrast image reflecting the breast scatter properties. These results demonstrate the feasibility of detecting small (rho_e) changes in the intact breast and shows that further experimental evaluation of this technique is warranted.

Breast CT is a promising modality whose inherent scatter could be used to reconstruct electron density (rho_e) images. This has led us to investigate the benefits of reconstructing linear attenuation coefficient (mu) and (rho_e) images of the breast. First generation CT provides a cost-effective and simple approach to reconstruct (rho_e) images in a laboratory but is limited by the anisotropic probability of scatter, attenuation, noise and contaminating scatter (coherent and multiple scatter). These issues were investigated using Monte Carlo (MC) simulations of a first generation breast scatter enhanced CT (B-SECT) system. A reconstruction algorithm was developed for the B-SECT system and is based on a ring of detectors which eliminates the scatter dependence on the relative position of the scattering centre. The algorithm incorporates an attenuation correction based on the (mu) image and was tested against analytical and MC simulations. MC simulations were also used to quantify the dose per scan. The ring measures a fraction of the total single incoherent scatter which is proportional to ray integrals of (rho_e) and can be quantified even when electron binding is non negligible. The algorithm typically reconstructs accurate (rho_e) images using a single correction for attenuation but has the capability for multiple iterations if required. MC simulations show that the dose coefficients are similar to those of cone beam breast CT. Coherent and multiple scatter can not be directly related to (rho_e) and lead to capping artifacts and overestimated (rho_e) by a factor greater than 2. This issue can be addressed using empirical corrections based on the radiological path of the incident beam and result in (rho_e) images of breast soft tissue with 1% accuracy, 3% precision and a mean glandular dose of 4 mGy for a 3D scan. The reconstructed (rho_e) image was more accurate than the (rho_e) estimate derived from the (mu) image. An alternative correction based on the thickness of breast traversed by the beam provides an enhanced contrast image reflecting the breast scatter properties. These results demonstrate the feasibility of detecting small (rho_e) changes in the intact breast and shows that further experimental evaluation of this technique is warranted.