ABSTRACT
Screening mammography has been very successful in contributing to the 39% reduction in breast cancer mortality over the past 30 years. Nonetheless, the sensitivity and specificity of x-ray breast imaging devices are still somewhat lacking. New technological developments such as the advent of 3D-imaging systems (breast tomosynthesis and dedicated breast CT) introduced over the last decade have potential for improving diagnostic accuracy. Possibly the next big innovation in x-ray imaging of the breast will come with new photon counting-based detector systems. This chapter first gives a brief overview of the current state-of-the-art in x-ray breast imaging devices. This will be followed by a description of some of the benefits of photon-counting detector based breast imaging systems in comparison to conventional energy integrating detector systems. There are different design requirements for photon-counting detectors used for breast imaging, and an overview of these tradeoffs are provided. Finally, this chapter concludes with a description of the most promising breast imaging applications that are made possible with photon-counting detector systems, including estimation of breast density, classification of microcalcifications, and discrimination between solid masses and cysts.
