Computer simulation of double-exposure, dual-energy mammography is used to quantify (1) the accuracy of adipose/glandular tissue cancellation, and (2) microcalcification SNR across the tissue-cancelled mammogramme, under conditions of non-isotropic photon emission from tungsten anodes. The results show that a non-isotropic property in the dual-energy spectra, combined with aluminium/lucite calibration at the central-axis of x-ray emisssion, introduces tissue-cancellation errors of 2-3% into a mammogramme that covers a 16 degree emission angle. These errors are sufficient to mask or obscure the presence of small calcifications. The tissue-cancelled image also contains variations in SNR (of a 200 micron calcification) ranging from 0% to 15% for thick breasts and from 0% to 25% for thin breasts. These values depend on the spatial location of the calcification within the breast. The results are relevant to the design/choice of tungsten-anode x-ray tubes for dual-energy mammography and also stress the importance of breast positioning.
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