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The photon counting detector with energy discrimination capabilities provides the spectral information and energy of each photon with single exposure. The energy-resolved photon counting detector makes it possible to improve the visualization of contrast agent by selecting the appropriate energy window. In this study, we simulated the photon counting spectral mammography system using a Monte Carlo method and compared three contrast enhancement methods (K-edge imaging, projection-based energy weighting imaging, and dual energy subtraction imaging). For the quantitative comparison, we used the homogeneous cylindrical breast phantom as a reference and the heterogeneous XCAT breast phantom. To evaluate the K-edge imaging methods, we obtained images by increasing the energy window width based on K-edge absorption energy of iodine. The iodine which has the K-edge discontinuity in the attenuation coefficient curve can be separated from the background. The projection-based energy weighting factor was defined as the difference in the transmissions between the contrast agent and the background. Each weighting factor as a function of photon energy was calculated and applied to the each energy bin. For the dual energy subtraction imaging, we acquired two images with below and above the iodine K-edge energy using single exposure. To suppress the breast tissue in high energy images, the weighting factor was applied as the ratio of the linear attenuation coefficients of the breast tissue at high and low energies. Our results demonstrated the CNR improvement of the K-edge imaging was the highest among the three methods. These imaging techniques based on the energy-resolved photon counting detector improved image quality with the spectral information.
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