Impact of Using Uniform Attenuation Coefficients for Heterogeneously Dense Breasts in a Dedicated Breast PET/X-ray Scanner.

We investigated PET image quantification when using a uniform attenuation coefficient (µ) for attenuation correction (AC) of anthropomorphic density phantoms derived from high-resolution breast CT scans. A breast PET system was modeled with perfect data corrections except for AC. Using uniform µ for AC resulted in quantitative errors roughly proportional to the difference between µ used in AC (µ AC) and local µ, yielding approximately ± 5% bias, corresponding to the variation of µ for 511 keV photons in breast tissue. Global bias was lowest when uniform µ AC was equal to the phantom mean µ (µ mean). Local bias in 10-mm spheres increased as the sphere µ deviated from µ mean, but remained only 2-3% when the µ sphere was 6.5% higher than µ mean. Bias varied linearly with and was roughly proportional to local µ mismatch. Minimizing local bias, e.g., in a small sphere, required the use of a uniform µ value between the local µ and the µ mean. Thus, biases from using uniform-µ AC are low when local µ sphere is close to µ mean. As the µ sphere increasingly differs from the phantom µ mean, bias increases, and the optimal uniform µ is less predictable, having a value between µ sphere and the phantom µ mean.