Photon-counting mammography was introduced commercially in 2003 and was shown to reduce the X-ray dose to the patient by approximately 40% compared to conventional methods while maintaining image quality at an equal or higher level.<ref>{{Cite journal|last1=Weigel|first1=Stefanie|last2=Berkemeyer|first2=Shoma|last3=Girnus|first3=Ralf|last4=Sommer|first4=Alexander|last5=Lenzen|first5=Horst|last6=Heindel|first6=Walter|date=May 2014|title=Digital Mammography Screening with Photon-counting Technique: Can a High Diagnostic Performance Be Realized at Low Mean Glandular Dose?|journal=Radiology|volume=271|issue=2|pages=345–355|doi=10.1148/radiol.13131181|pmid=24495234|issn=0033-8419|doi-access=free}}</ref> The technology was subsequently developed to enable [[Spectral imaging (radiography)|spectral imaging]]<ref name="Berglund 031003">{{Cite journal|last1=Berglund|first1=Johan|last2=Johansson|first2=Henrik|last3=Lundqvist|first3=Mats|last4=Cederström|first4=Björn|last5=Fredenberg|first5=Erik|date=2014-08-28|title=Energy weighting improves dose efficiency in clinical practice: implementation on a spectral photon-counting mammography system|journal=Journal of Medical Imaging|volume=1|issue=3|pages=031003|doi=10.1117/1.JMI.1.3.031003|issn=2329-4302|pmc=4478791|pmid=26158045}}</ref> with the possibility to further improve image quality,<ref name="Berglund 031003"/> to distinguish between different tissue types,<ref>{{Cite journal|last1=Fredenberg|first1=Erik|last2=Willsher|first2=Paula|last3=Moa|first3=Elin|last4=Dance|first4=David R|last5=Young|first5=Kenneth C|last6=Wallis|first6=Matthew G|date=2018-11-22|title=Measurement of breast-tissue x-ray attenuation by spectral imaging: fresh and fixed normal and malignant tissue|journal=Physics in Medicine & Biology|volume=63|issue=23|pages=235003|doi=10.1088/1361-6560/aaea83|pmid=30465547|arxiv=2101.02755|bibcode=2018PMB....63w5003F|s2cid=53717425|issn=1361-6560|url=https://www.repository.cam.ac.uk/handle/1810/289601}}</ref> and to measure breast density.<ref>{{Cite journal|last1=Johansson|first1=Henrik|last2=von Tiedemann|first2=Miriam|last3=Erhard|first3=Klaus|last4=Heese|first4=Harald|last5=Ding|first5=Huanjun|last6=Molloi|first6=Sabee|last7=Fredenberg|first7=Erik|date=July 2017|title=Breast-density measurement using photon-counting spectral mammography|journal=Medical Physics|volume=44|issue=7|pages=3579–3593|doi=10.1002/mp.12279|pmid=28421611|bibcode=2017MedPh..44.3579J|doi-access=free}}</ref><ref>{{Cite journal|last=Ding|first=Huanjun|last2=Molloi|first2=Sabee|date=2012-08-07|title=Quantification of breast density with spectral mammography based on a scanned multi-slit photon-counting detector: a feasibility study|url=https://iopscience.iop.org/article/10.1088/0031-9155/57/15/4719|journal=Physics in Medicine and Biology|volume=57|issue=15|pages=4719–4738|doi=10.1088/0031-9155/57/15/4719|issn=0031-9155|pmc=PMC3478949|pmid=22771941}}</ref>
