Four-dimensional dynamic contrast-enhanced dedicated breast CT (4D DCE-bCT) is a novel breast imaging technique being developed for personalized breast cancer treatment. Its optimization and validation requires phantoms that reproduce the x-ray attenuation of adipose and glandular tissue and allow controlled contrast-agent flow.

To develop a reproducible and accessible workflow for 3D printing functional anthropomorphic breast phantoms with patient-derived anatomy and tissue-specific x-ray attenuation suitable for 4D DCE-bCT experiments.

A previously acquired patient bCT scan was retrieved, and the adipose and glandular tissues were segmented. The whole breast was imported into 3D-printing software as a part and the adipose tissue as a modifier, allowing separate printing parameters for each tissue. The breasts were printed with PLA Aero material on a BambuLab FDM printer. Flow ratios were optimized using five test slabs. X-ray attenuation values were evaluated in two volumes of interest (VOIs) for each tissue type and compared with average patient values. The complete breast was printed four times using three filament rolls to assess repeatability and reproducibility. Three tubing configurations were evaluated for contrast-agent flow.

Mean x-ray linear attenuation values of glandular and adipose tissue were within 2.7% and 3.5%, respectively, of corresponding reference values. Attenuation values were consistent between prints, with a maximum relative difference of 3.2%. However, printing quality varied between filament rolls, with one roll producing more air bubbles.

A reproducible workflow was developed for producing anthropomorphic breast phantoms with tissue-specific x-ray attenuation and integrated fluid-flow capabilities.