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A new energy-resolved photon-counting mammography (ERPCM) device with a cadmium telluride (CdTe) series detector (JOB Corporation, Japan) is currently being developed. The CdTe series detector can detect higher-energy photons with high sensitivity, enabling the use of high-energy X-rays for imaging. Our previous research, in which we compared ERPCM using high-energy X-rays (tube voltage 50 kV) with general mammography using low-energy X-rays (tube voltage about 30 kV), reported that ERPCM had a higher CNR (contrast-to-noise ratio) than general mammography. The purpose of this study was to examine the magnitude of the CNR using a simulation and ERPCM; especially we would like to examine the CNR when the tube voltage of higher than 50 kV was adopted. In the comparison of the CNRs, It was necessary to pay attention to equalizing the average glandular dose (AGD). Using the simulation and ERPCM, we compared the CNR between images taken at 50 kV and 75 kV under a constant AGD. The simulation phantom was composed of 50% mammary gland and 50% adipose tissue, and contained tumor regions. The thickness of the simulation phantom was varied. We put an acrylic plate (1 mm thickness) on an RMI-156 phantom. Furthermore, we placed the thicker acrylic plate (10, 20, 30, 40 mm) on the 156 phantom and 1 mm-thick acrylic plate to simulate thicker breast. Based on the results from the simulation, in the phantom thickness of 80 mm, the CNR of image taken by 75kV got extremely closer to that taken by 50kV. The advantage of the image taken at 75 kV for the thicker breast was also confirmed in ERPCM.
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