Measurements of breast density have the potential to improve the efficiency and reduce the cost of screening mammography through personalized screening. Breast density has traditionally been evaluated from the dense area in a mammogram, but volumetric assessment methods, which measure the volumetric fraction of fibro-glandular tissue in the breast, are potentially more consistent and physically sound. The purpose of the present study is to evaluate a method for measuring the volumetric breast density using photon-counting spectral tomosynthesis. The performance of the method was evaluated using phantom measurements and clinical data from a small population (n=18). The precision was determined to 2.4 percentage points (pp) of volumetric breast density. Strong correlations were observed between contralateral (R^2=0.95) and ipsilateral (R^2=0.96) breast-density measurements. The measured breast density was anti-correlated to breast thickness, as expected, and exhibited a skewed distribution in the range [3.7%, 55%] and with a median of 18%. We conclude that the method yields promising results that are consistent with expectations. The relatively high precision of the method may enable novel applications such as treatment monitoring.
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