Including the effect of motion artifacts in noise and performance analysis of dual-energy contrast-enhanced mammography

In contrast-enhanced mammography (CEM), the dual-energy dual-exposure technique, which can leverage existing conventional mammography infrastructure, relies on acquiring the low- and high-energy images using two separate exposures. The finite time between image acquisition leads to motion artifacts in the combined image. Motion artifacts can lead to greater anatomical noise in the combined image due to increased mismatch of the background tissue in the images to be combined, however the impact has not yet been quantified. In this study we investigate a method to include motion artifacts in the dual-energy noise and performance analysis. The motion artifacts are included via an extended cascaded systems model. To validate the model, noise power spectra of a previous dual-energy clinical study are compared to that of the model. The ideal observer detectability is used to quantify the effect of motion artifacts on tumor detectability. It was found that the detectability can be significantly degraded when motion is present (e.g., detectability of 2.5 mm radius tumor decreased by approximately a factor of 2 for translation motion on the order of 1000 mu m). The method presented may be used for a more comprehensive theoretical noise and performance analysis and fairer theoretical performance comparison between dual-exposure techniques, where motion artifacts are present, and single-exposure techniques, where low- and high-energy images are acquired simultaneously and motion artifacts are absent.