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Kim HJ, Kim HH, Eom HJ, Choi WJ, Chae EY, Shin HJ, Cha JH, Choi YW, Choi YJ, Kim KH, Min J, Shim WH, Lee S, Cho S. Optimizing angular range in digital breast tomosynthesis: A phantom study investigating lesion detection across varied breast density and thickness. Phys Med 2024; 124:103419. [PMID: 38986262 DOI: 10.1016/j.ejmp.2024.103419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 05/29/2024] [Accepted: 06/28/2024] [Indexed: 07/12/2024] Open
Abstract
PURPOSE To determine the optimal angular range (AR) for digital breast tomosynthesis (DBT) systems that provides highest lesion visibility across various breast densities and thicknesses. METHOD A modular DBT phantom, consisting of tissue-equivalent adipose and glandular modules, along with a module embedded with test objects (speckles, masses, fibers), was used to create combinations simulating different breast thicknesses, densities, and lesion locations. A prototype DBT system operated at four ARs (AR±7.5°, AR±12.5°, AR±19°, and AR±25°) to acquire 11 projection images for each combination, with separate fixed doses for thin and thick combinations. Three blinded radiologists independently assessed lesion visibility in reconstructed images; assessments were averaged and compared using linear mixed models. RESULTS Speckle visibility was highest with AR±7.5° or AR±12.5°, decreasing with wider ARs in all density and thickness combinations. The difference between AR±7.5° and AR±12.5° was not statistically significant, except for the tube-side speckles in thin-fatty combinations (5.83 [AR±7.5°] vs. 5.39 [AR±12.5°], P = 0.019). Mass visibility was not affected by AR in thick combinations, while AR±12.5° exhibited the highest mass visibility for both thin-fatty and thin-dense combinations (P = 0.032 and 0.007, respectively). Different ARs provided highest fiber visibility for different combinations; however, AR±12.5° consistently provided highest or comparable visibility. AR±12.5° showed highest overall lesion visibility for all density and thickness combinations. CONCLUSIONS AR±12.5° exhibited the highest overall lesion visibility across various phantom thicknesses and densities using a projection number of 11.
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Affiliation(s)
- Hee Jeong Kim
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul 05505, South Korea.
| | - Hak Hee Kim
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul 05505, South Korea.
| | - Hye Joung Eom
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul 05505, South Korea
| | - Woo Jung Choi
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul 05505, South Korea.
| | - Eun Young Chae
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul 05505, South Korea.
| | - Hee Jung Shin
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul 05505, South Korea.
| | - Joo Hee Cha
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul 05505, South Korea.
| | - Young Wook Choi
- Electro-Medical Equipment Research Division, Korea Electrotechnology Research Institute (KERI), 111, Hanggaul-ro, Sangrok-gu, Ansan-si, Gyeonggi-do 15588, South Korea.
| | - Young Jin Choi
- Electro-Medical Equipment Research Division, Korea Electrotechnology Research Institute (KERI), 111, Hanggaul-ro, Sangrok-gu, Ansan-si, Gyeonggi-do 15588, South Korea.
| | - Kee Hyun Kim
- Electro-Medical Equipment Research Division, Korea Electrotechnology Research Institute (KERI), 111, Hanggaul-ro, Sangrok-gu, Ansan-si, Gyeonggi-do 15588, South Korea.
| | - Joongkee Min
- Department of Medical Science, Asan Medical Institute of Convergence Science and Technology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul 05505, South Korea.
| | - Woo Hyun Shim
- Department of Medical Science, Asan Medical Institute of Convergence Science and Technology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul 05505, South Korea.
| | - Seoyoung Lee
- Department of Nuclear and Quantum Engineering, Korea Advanced Institute of Science and Technology (KAIST), 291, Daehak-ro, Yuseong-gu, Daejeon 34141, South Korea.
| | - Seungryong Cho
- Department of Nuclear and Quantum Engineering, Korea Advanced Institute of Science and Technology (KAIST), 291, Daehak-ro, Yuseong-gu, Daejeon 34141, South Korea.
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Dalmonte S, Golinelli P, Oberhofer N, Strocchi S, Rossetti V, Berta L, Porzio M, Angelini L, Paruccini N, Villa R, Bertolini M, Delle Canne S, Cavallari M, D'Ercole L, Guerra G, Rosasco R, Cannillo B, D'Alessio A, Di Nicola E, Origgi D, De Marco P, Maldera A, Scabbio C, Rottoli F, Castriconi R, Lorenzini E, Pasquali G, Pietrobon F, Bregant P, Giovannini G, Favuzza V, Bruschi A, D'Urso D, Maestri D, De Novellis S, Fracassi A, Boschiroli L, Quattrocchi M, Gilio MA, Roberto E, Altabella L, Califano G, Cimmino MC, Bortoli E, Deiana E, Pagan L, Berardi P, Ardu V, Azzeroni R, Campoleoni M, Ravaglia V. Typical values of z-resolution for different Digital Breast Tomosynthesis systems evaluated in a multicenter study. Phys Med 2024; 119:103300. [PMID: 38325222 DOI: 10.1016/j.ejmp.2024.103300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 12/07/2023] [Accepted: 01/23/2024] [Indexed: 02/09/2024] Open
Abstract
PURPOSE The aim of the present study, conducted by a working group of the Italian Association of Medical Physics (AIFM), was to define typical z-resolution values for different digital breast tomosynthesis (DBT) models to be used as a reference for quality control (QC). Currently, there are no typical values published in internationally agreed QC protocols. METHODS To characterize the z-resolution of the DBT models, the full width at half maximum (FWHM) of the artifact spread function (ASF), a technical parameter that quantifies the signal intensity of a detail along reconstructed planes, was analyzed. Five different commercial phantoms, CIRS Model 011, CIRS Model 015, Modular DBT phantom, Pixmam 3-D, and Tomophan, were evaluated on reconstructed DBT images and 82 DBT systems (6 vendors, 9 models) in use at 39 centers in Italy were involved. RESULTS The ASF was found to be dependent on the detail size, the DBT angular acquisition range, the reconstruction algorithm and applied image processing. In particular, a progressively greater signal spread was observed as the detail size increased and the acquisition angle decreased. However, a clear correlation between signal spread and angular range width was not observed due to the different signal reconstruction and image processing strategies implemented in the algorithms developed by the vendors studied. CONCLUSIONS The analysis led to the identification of typical z-resolution values for different DBT model-phantom configurations that could be used as a reference during a QC program.
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Affiliation(s)
- S Dalmonte
- Medical Physics Specialization School, University of Bologna, Bologna, Italy; Medical Physics Unit, AUSL Romagna, Ravenna, Italy.
| | - P Golinelli
- Medical Physics Unit, Azienda USL Modena, Modena, Italy
| | | | - S Strocchi
- Medical Physics Unit, ASST dei Sette Laghi, Varese, Italy
| | - V Rossetti
- Medical Physics Unit, Città della salute e della scienza, Torino, Italy
| | - L Berta
- Medical Physics Unit, Città della salute e della scienza, Torino, Italy
| | - M Porzio
- Medical Physics Unit, ASL CN1, Cuneo, Italy
| | - L Angelini
- Medical Physics Unit, AUSL Romagna, Ravenna, Italy
| | - N Paruccini
- Medical Physics Unit, ASST Monza, Monza, Italy
| | - R Villa
- Medical Physics Unit, ASST Monza, Monza, Italy
| | - M Bertolini
- Medical Physics Unit, Azienda AUSL - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - S Delle Canne
- Medical Physics Unit, Fatebenefratelli Isola Tiberina-Gemelli Isola, Roma, Italy
| | - M Cavallari
- Medical Physics Unit, IRCCS Fondazione Policlinico San Matteo, Pavia, Italy
| | - L D'Ercole
- Medical Physics Unit, IRCCS Fondazione Policlinico San Matteo, Pavia, Italy
| | - G Guerra
- Medical Physics Unit, Studio Associato Fisici Sanitari, Lugo, Italy
| | - R Rosasco
- Medical Physics Unit, ASL3 Sistema Sanitario Regione Liguria, Genova, Italy
| | - B Cannillo
- Medical Physics Unit, AOU Maggiore della Carità, Novara, Italy
| | - A D'Alessio
- Medical Physics Unit, AOU Maggiore della Carità, Novara, Italy
| | - E Di Nicola
- Medical Physics Unit, ASUR Marche Area Vasta3, Macerata, Italy
| | - D Origgi
- Medical Physics Unit, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - P De Marco
- Medical Physics Unit, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - A Maldera
- Medical Physics Unit, P.O. Dimiccoli - ASL BT, Barletta, Italy
| | - C Scabbio
- Medical Physics Unit, ASST Santi Paolo e Carlo - Presidio San Paolo, Milano, Italy
| | - F Rottoli
- Medical Physics Unit, ASST Santi Paolo e Carlo - Presidio San Paolo, Milano, Italy
| | - R Castriconi
- Medical Physics Unit, IRCCS Ospedale San Raffaele - Gruppo San Donato, Milano, Italy
| | - E Lorenzini
- Medical Physics Unit, Ospedale Civico di Carrara, Carrara, Italy
| | - G Pasquali
- Medical Physics Unit, ASST Bergamo Ovest, Treviglio, Italy
| | - F Pietrobon
- Medical Physics Unit, Ospedale di Belluno, Belluno, Italy
| | - P Bregant
- Medical Physics Unit, Ospedale Cattinara, Trieste, Italy
| | - G Giovannini
- Medical Physics Unit, ASL2 Ospedale Santa Corona, Pietra Ligure, Italy
| | - V Favuzza
- Medical Physics Unit, USL Toscana Centro, Empoli, Italy
| | - A Bruschi
- Medical Physics Unit, USL Toscana Centro, Empoli, Italy
| | - D D'Urso
- Medical Physics Unit, ULSS 2 Marca Trevigiana, Treviso, Italy
| | - D Maestri
- Medical Physics Unit, ULSS 2 Marca Trevigiana, Treviso, Italy
| | | | - A Fracassi
- Medical Physics Unit, ASL Pescara, Pescara, Italy
| | - L Boschiroli
- Medical Physics Unit, ASST Nord Milano, Milano, Italy
| | - M Quattrocchi
- Medical Physics Unit, Azienda Toscana Nord Ovest, Lucca, Italy
| | - M A Gilio
- Medical Physics Unit, Azienda Toscana Nord Ovest, Lucca, Italy
| | - E Roberto
- Medical Physics Unit, ASL CN2 Cuneo, Italy
| | - L Altabella
- Medical Physics Unit, AOUI VR, Verona, Italy
| | - G Califano
- Medical Physics Unit, AOR San Carlo Potenza, Potenza, Italy
| | - M C Cimmino
- Medical Physics Unit, USL Toscana sud est, Siena, Italy
| | - E Bortoli
- Medical Physics Unit, USL Toscana sud est, Grosseto, Italy
| | - E Deiana
- Medical Physics Unit, ASL Cagliari, Cagliari, Italy
| | - L Pagan
- Medical Physics Unit, Azienda USL Bologna, Bologna, Italy
| | - P Berardi
- Medical Physics Unit, Azienda USL Bologna, Bologna, Italy
| | - V Ardu
- Medical Physics Unit, Fondazione IRCCS Ca' Granda, Milano, Italy
| | - R Azzeroni
- Medical Physics Unit, Fondazione IRCCS Ca' Granda, Milano, Italy
| | - M Campoleoni
- Medical Physics Unit, Fondazione IRCCS Ca' Granda, Milano, Italy
| | - V Ravaglia
- Medical Physics Unit, AUSL Romagna, Ravenna, Italy
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Sundell VM, Jousi M, Mäkelä T, Kaasalainen T, Hukkinen K. Comparing image quality of five breast tomosynthesis systems based on radiologists' reviews of phantom data. Acta Radiol 2023; 64:1799-1807. [PMID: 36437753 DOI: 10.1177/02841851221140210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Previous studies have shown differences in technical image quality between digital breast tomosynthesis (DBT) systems. However, quantitative image quality measurements may not necessarily fully reflect the clinical performance of DBT. PURPOSE To study the subjective image quality of five DBT systems manufactured by Fujifilm, GE, Hologic, Planmed, and Siemens using phantom images. MATERIAL AND METHODS A TOR MAM test object with polymethyl methacrylate plates was imaged on five DBT systems from different vendors. Three DBT acquisitions were performed at mean glandular doses of 1.0 mGy, 2.0 mGy, and 3.5 mGy while maintaining a constant phantom set-up. Eight DBT acquisitions with different test plate positions and phantom set-up thicknesses were performed at clinically applied dose levels. Additionally, three conventional two-dimensional mammogram images were acquired with different phantom thicknesses. Six radiologists ranked the systems based on the visibilities of the targets seen in the phantom images. RESULTS In the DBT acquisitions performed at comparable dose levels, one system differed significantly from all other systems in microcalcification scores. When using site-specific DBT protocols, significant differences were found between the devices for microcalcification, filament, and low-contrast targets. A strong correlation was observed between the reviewer scores and radiation doses in DBT acquisitions, whereas no such correlation was observed in the 2D acquisitions. CONCLUSION In DBT acquisitions, dose level was found to be a major factor explaining image quality differences between the systems, regardless of other acquisition parameters. Most DBT systems performed equally well at similar dose levels.
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Affiliation(s)
- Veli-Matti Sundell
- HUS Diagnostic Center, Radiology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Department of Physics, University of Helsinki, Helsinki, Finland
| | - Mikko Jousi
- Central Hospital, Radiology, Päijät-Hämeen Sosiaali- ja Terveysyhtymä, Lahti, Finland
| | - Teemu Mäkelä
- HUS Diagnostic Center, Radiology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Department of Physics, University of Helsinki, Helsinki, Finland
| | - Touko Kaasalainen
- HUS Diagnostic Center, Radiology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Katja Hukkinen
- HUS Diagnostic Center, Radiology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
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Magni V, Cozzi A, Schiaffino S, Colarieti A, Sardanelli F. Artificial intelligence for digital breast tomosynthesis: Impact on diagnostic performance, reading times, and workload in the era of personalized screening. Eur J Radiol 2023; 158:110631. [PMID: 36481480 DOI: 10.1016/j.ejrad.2022.110631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 11/24/2022] [Indexed: 12/05/2022]
Abstract
The ultimate goals of the application of artificial intelligence (AI) to digital breast tomosynthesis (DBT) are the reduction of reading times, the increase of diagnostic performance, and the reduction of interval cancer rates. In this review, after outlining the journey from computer-aided detection/diagnosis systems to AI applied to digital mammography (DM), we summarize the results of studies where AI was applied to DBT, noting that long-term advantages of DBT screening and its crucial ability to decrease the interval cancer rate are still under scrutiny. AI has shown the capability to overcome some shortcomings of DBT in the screening setting by improving diagnostic performance and by reducing recall rates (from -2 % to -27 %) and reading times (up to -53 %, with an average 20 % reduction), but the ability of AI to reduce interval cancer rates has not yet been clearly investigated. Prospective validation is needed to assess the cost-effectiveness and real-world impact of AI models assisting DBT interpretation, especially in large-scale studies with low breast cancer prevalence. Finally, we focus on the incoming era of personalized and risk-stratified screening that will first see the application of contrast-enhanced breast imaging to screen women with extremely dense breasts. As the diagnostic advantage of DBT over DM was concentrated in this category, we try to understand if the application of AI to DM in the remaining cohorts of women with heterogeneously dense or non-dense breast could close the gap in diagnostic performance between DM and DBT, thus neutralizing the usefulness of AI application to DBT.
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Affiliation(s)
- Veronica Magni
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Via Luigi Mangiagalli 31, 20133 Milano, Italy.
| | - Andrea Cozzi
- Unit of Radiology, IRCCS Policlinico San Donato, Via Rodolfo Morandi 30, 20097 San Donato Milanese, Italy
| | - Simone Schiaffino
- Unit of Radiology, IRCCS Policlinico San Donato, Via Rodolfo Morandi 30, 20097 San Donato Milanese, Italy
| | - Anna Colarieti
- Unit of Radiology, IRCCS Policlinico San Donato, Via Rodolfo Morandi 30, 20097 San Donato Milanese, Italy
| | - Francesco Sardanelli
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Via Luigi Mangiagalli 31, 20133 Milano, Italy; Unit of Radiology, IRCCS Policlinico San Donato, Via Rodolfo Morandi 30, 20097 San Donato Milanese, Italy.
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Marshall NW, Bosmans H. Performance evaluation of digital breast tomosynthesis systems: physical methods and experimental data. Phys Med Biol 2022; 67. [DOI: 10.1088/1361-6560/ac9a35] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 10/13/2022] [Indexed: 11/17/2022]
Abstract
Abstract
Digital breast tomosynthesis (DBT) has become a well-established breast imaging technique, whose performance has been investigated in many clinical studies, including a number of prospective clinical trials. Results from these studies generally point to non-inferiority in terms of microcalcification detection and superior mass-lesion detection for DBT imaging compared to digital mammography (DM). This modality has become an essential tool in the clinic for assessment and ad-hoc screening but is not yet implemented in most breast screening programmes at a state or national level. While evidence on the clinical utility of DBT has been accumulating, there has also been progress in the development of methods for technical performance assessment and quality control of these imaging systems. DBT is a relatively complicated ‘pseudo-3D’ modality whose technical assessment poses a number of difficulties. This paper reviews methods for the technical performance assessment of DBT devices, starting at the component level in part one and leading up to discussion of system evaluation with physical test objects in part two. We provide some historical and basic theoretical perspective, often starting from methods developed for DM imaging. Data from a multi-vendor comparison are also included, acquired under the medical physics quality control protocol developed by EUREF and currently being consolidated by a European Federation of Organisations for Medical Physics working group. These data and associated methods can serve as a reference for the development of reference data and provide some context for clinical studies.
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Hori K, Koike T, Tadano K, Hashimoto T. A novel few-views arrangement of the fixed X-ray tubes for tomosynthesis. Phys Med 2021; 93:8-19. [PMID: 34894496 DOI: 10.1016/j.ejmp.2021.11.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 10/12/2021] [Accepted: 11/13/2021] [Indexed: 11/26/2022] Open
Abstract
PURPOSE Tomosynthesis is a technique that reconstructs a volume image from limited-angle projection data. In conventional tomosynthesis, the examination time is long, so it can be difficult for patients to hold their breath during certain examinations, such as chest imaging. Few-views tomosynthesis, which uses a linear arrangement of fixed X-ray tubes and enables an image to be obtained within 1 s, was found to be useful in the clinical setting in our previous study. In the present study, we attempted to develop a novel few-views tomosynthesis system that can obtain images with an improved image quality. METHODS A novel few-views arrangement of X-ray tubes was proposed and the image reconstruction method with regularization term was applied. The linear arrangement was used for the X-ray tube arrangement in our previous few-views tomosynthesis, in contrast, a circular arrangement was proposed in this study. The validation of this system was conducted with a numerical simulation and a real data experiment. RESULTS The wider the scan angle, the more the object shadow spreads from "in-plane", allowing for artifact suppression. In the circular arrangement, the constant scan angle of θ is used, but in the linear arrangement the scan angle is set from 0 to θ. The artifacts in "out-of-plane" were more strongly suppressed in the circular arrangement than in the linear arrangement. CONCLUSIONS Artifacts spreading in the z-direction were more strongly suppressed using the circular arrangement than the linear arrangement. Therefore, the circular arrangement was deemed appropriate for few-views tomosynthesis.
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Affiliation(s)
- Kensuke Hori
- Kyorin University Graduate School of Health Sciences, 5-4-1, Shimorenjaku, Mitaka, Tokyo 181-8612, Japan.
| | - Takahisa Koike
- Kyorin University Graduate School of Health Sciences, 5-4-1, Shimorenjaku, Mitaka, Tokyo 181-8612, Japan
| | - Kiichi Tadano
- Kyorin University Graduate School of Health Sciences, 5-4-1, Shimorenjaku, Mitaka, Tokyo 181-8612, Japan
| | - Takeyuki Hashimoto
- Kyorin University Graduate School of Health Sciences, 5-4-1, Shimorenjaku, Mitaka, Tokyo 181-8612, Japan
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Porzio M, Konstantinidis AC. MAMMO_QC: Free software for quality control (QC) analysis in digital mammography and digital breast tomosynthesis compliant with the European guidelines and EUREF/EFOMP protocols. Biomed Phys Eng Express 2021; 7. [PMID: 34428757 DOI: 10.1088/2057-1976/ac2076] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 08/24/2021] [Indexed: 11/11/2022]
Abstract
Quality Control (QC) tests in mammography are very important, since mammograms have been used as a population-based screening test for more than 30 years and QCs lead to better image quality and radiation safety for patients. European guidelines, EUREF and EFOMP protocols provide comprehensive QC guidelines for digital mammography (DM) and digital breast tomosynthesis (DBT) units, respectively. We developed a novel, fast, free and platform independent software (named MAMMO_QC) for QC performance tests in DM and tomosynthesis, based on the aforementioned guidelines. MAMMO_QC consists of a series of ImageJ plugins for DM and DBT. It does not require any programming knowledge and can be used to evaluate several performance parameters, such as pre-sampled modulation transfer function (pMTF), normalised noise power spectrum (NNPS), detective quantum efficiency (DQE), contrast-detail analysis based on the CDMAM 3.4 and 4.0 test tools, homogeneity and artefacts, automatic exposure control (AEC) performance. The user can use MAMMO_QC for acceptance, commissioning and routine QC performance analysis based on the European guidelines. We validated our results against well-established software products used in mammography and DBT (i.e., COQ, OBJ_IQ_reduced and Artinis CDMAM Analyzer). All the average relative differences were within 5.5%, and several years of usage and testing allows us to consider MAMMO_QC as an accurate and reliable tool for QC on DM and DBT systems. Our developed software for DM and DBT computes almost all the parameters stated in the European, EUREF and EFOMP guidelines. To the best of our knowledge, no such software has been developed so far.
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Affiliation(s)
- Massimiliano Porzio
- Medical Physics Department, ASL CN1, Via Carlo Boggio 12, 12100 Cuneo (CN), Italy
| | - Anastasios C Konstantinidis
- Medical Physics Department, Portsmouth Hospitals University NHS Trust, Queen Alexandra Hospital, Portsmouth, PO6 ELY, United Kingdom
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Vancoillie L, Cockmartin L, Marshall N, Bosmans H. The impact on lesion detection via a multi-vendor study: A phantom-based comparison of digital mammography, digital breast tomosynthesis, and synthetic mammography. Med Phys 2021; 48:6270-6292. [PMID: 34407213 DOI: 10.1002/mp.15171] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 07/27/2021] [Accepted: 07/27/2021] [Indexed: 11/09/2022] Open
Abstract
PURPOSE The aim of this study is to perform a test object-based comparison of the imaging performance of digital mammography (DM), digital breast tomosynthesis (DBT), and synthetic mammography (SM). METHODS Two test objects were used, the CDMAM and the L1-structured phantom. Small-detail detectability was assessed using CDMAM and the microcalcification simulating specks in the L1-structured background. Detection of spiculated and non-spiculated mass-like objects was assessed using the L1 phantom. Six different systems were included: Amulet Innovality (Fujifilm), Senographe Pristina (GEHC), 3Dimensions (Hologic), Giotto Class (IMS), Clarity 2D/3D (Planmed), and Mammomat Revelation (Siemens). Images were acquired under automatic exposure control (AEC) and at adjusted levels of AEC/2 and 2 × AEC level. Threshold gold thickness (Ttr ) was established for the 0.13-mm-diameter CDMAM discs. Threshold diameters for the calcifications (dtr_c ), the spiculated masses (dtr_sm ), and for the non-spiculated masses (dtr_nsm ) were established. The threshold condition was defined as the thickness or diameter for a 62.5% correct score. RESULTS Ttr for DM was generally superior to DBT, which in turn was superior to SM, but for most systems, these differences between modes were not significant. For L1, no significant differences in dtr_c were found between DM and DBT. The increase in dtr_c from DM to SM at AEC dose was 1%, 19%, 11%, 14%, 46%, and 27% for the Fujifilm, GEHC, Hologic, IMS, Planmed, and Siemens, respectively, indicating significantly poorer performance for all vendors except for Fujifilm, Hologic, and IMS. For both mass types, DBT performed better than SM, while SM showed no significant difference with DM (except for Fujifilm spiculated masses). The dose had an impact on small-detail detectability for both phantoms but did not influence the detection of either mass type. CONCLUSIONS Both phantoms indicated potentially reduced small-detail detectability for SM versus DM and DBT and should therefore not be used in stand-alone mode. The L1 phantom demonstrated no significant difference in microcalcification detection between DM and DBT and also demonstrated the superiority of DBT, compared to DM for mass detection, for all six systems.
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Affiliation(s)
- Liesbeth Vancoillie
- Department of Imaging and Pathology, KU Leuven, Division of Medical Physics & Quality Assessment, Leuven, Belgium
| | | | - Nicholas Marshall
- Department of Imaging and Pathology, KU Leuven, Division of Medical Physics & Quality Assessment, Leuven, Belgium.,Department of Radiology, UZ Leuven, Leuven, Belgium
| | - Hilde Bosmans
- Department of Imaging and Pathology, KU Leuven, Division of Medical Physics & Quality Assessment, Leuven, Belgium.,Department of Radiology, UZ Leuven, Leuven, Belgium
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Alves MS, Belinato W, Santos WS, Galeano DC, Neves LP, Perini AP, N Souza D. Dosimetry in Digital Breast Tomosynthesis Evaluated by Monte Carlo Technique. HEALTH PHYSICS 2021; 121:18-29. [PMID: 33867436 DOI: 10.1097/hp.0000000000001407] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
ABSTRACT The influence of the angular deviation of the tube during digital breast tomosynthesis (DBT) acquisition to the dose in the examined breast and in other organs and tissues is not well known. In this work, the Monte Carlo method was used with an adult female virtual anthropomorphic phantom to investigate the impact of this angular variation on the breast dose. The absorbed dose in the examined breast was normalized by the air kerma, which resulted in an absorbed dose coefficient (DT/Kair) for the breast. The absorbed dose in each organ was normalized by the glandular dose in the breast, resulting in the relative organ dose (ROD). An adult female virtual anthropomorphic phantom (FSTA_M50_H50) was incorporated into a scenario containing tomosynthesis equipment with Mo/Mo, Mo/Rh, and W/Rh target/filter combinations and tube voltages of 28 kV. The comparison between the results of the simulations considering digital mammography (DM) and DBT data showed that the DT/Kair values for the examined breast obtained with the DBT parameters were up to 24 times higher than with the DT/Kair obtained with DM parameters. A DT/Kair of 0.97 × 10-1 mGy mGy-1 was obtained in a DBT exam of the right breast. Considering the other organs, the highest ROD values were observed in the thyroid (6.45 × 10-4), eyes (3.87 × 10-4), liver (1.95 × 10-5), and eye lenses (3.21 × 10-3). A variation in the absorbed dose values for the breast and other organs was observed for all projections different from 0°.
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Affiliation(s)
- Marcos S Alves
- Departamento de Física, Universidade Federal de Sergipe (UFS), São Cristóvão, Sergipe, Brazil
| | - Walmir Belinato
- Instituto Federal da Bahia (IFBA), Vitória da Conquista, BA, Brazil
| | - William S Santos
- Instituto de Física, Universidade Federal de Uberlândia, Uberlândia, MG, Brazil
| | - Diego C Galeano
- Hospital Universitário Júlio Müller, Universidade Federal de Mato Grosso, Cuiabá, MT, Brazil
| | | | | | - Divanizia N Souza
- Departamento de Física, Universidade Federal de Sergipe (UFS), São Cristóvão, Sergipe, Brazil
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邓 耀, 朱 曼, 李 穗, 王 永, 高 杨, 马 建. [Assessment of imaging performance of digital breast tomosynthesis based on systematic simulation]. NAN FANG YI KE DA XUE XUE BAO = JOURNAL OF SOUTHERN MEDICAL UNIVERSITY 2021; 41:898-908. [PMID: 34238743 PMCID: PMC8267994 DOI: 10.12122/j.issn.1673-4254.2021.06.13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Indexed: 12/09/2022]
Abstract
OBJECTIVE To assess the imaging performance of digital breast tomography (DBT) based on systematic simulation. OBJECTIVE The raw measurements of physical phantoms at a variety of radiation dose levels and clinical patients at the normal radiation dose were acquired from a clinical DBT system for low-dose simulation and reconstruction using 3 reconstruction algorithms, namely Feldkamp-Davis-Kress (FDK), simultaneous algebraic reconstruction technique (SART) and adaptive steepest-descent projection onto convex sets with total-variation constraint (ASDPOCS-TV) algorithms. The image quality was compared across different radiation dose levels and reconstruction algorithms in terms of signal-to-noise ratio (SNR), peak signal-to-noise ratio (PSNR), noise-power spectrum (NPS), artifact spread function (ASF) and full width at half maximum (FWHM) of ASF indexes. OBJECTIVE The reliability of low-dose DBT simulation strategy was verified by the experiment. Within a suitable range of dose levels, increasing the doses resulted in reduced high-frequency noise component and significantly increased SNR (P < 0.05). But when the value of exposure was below 40 mAs, the images acquired at different dose levels had similar representation. The performance of the 3 reconstruction algorithms varied for different anatomical structures, and the image quality of ASDPOCS-TV algorithm was generally superior to SART and FDK algorithms with less through-plane artifacts and noise. OBJECTIVE The quality of DBT images is significantly affected by both radiation dose and reconstruction algorithms. A tradeoff of the parameters, the overall image quality and the clinical needs for diagnostic purposes should be considered to achieve the optimal imaging performance on a given clinical task.
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Affiliation(s)
- 耀宏 邓
- 南方医科大学生物医学工程学院,广东 广州 510515School of Biomedical Engineering, Southern Medical University, Guangzhou 510515, China
- 广州市医用放射成像与检测技术重点实验室,广东 广州 510515Guangzhou Key Laboratory of Medical Radiation Imaging and Detection Technology, Guangzhou 510515, China
| | - 曼曼 朱
- 南方医科大学生物医学工程学院,广东 广州 510515School of Biomedical Engineering, Southern Medical University, Guangzhou 510515, China
- 广州市医用放射成像与检测技术重点实验室,广东 广州 510515Guangzhou Key Laboratory of Medical Radiation Imaging and Detection Technology, Guangzhou 510515, China
| | - 穗 李
- 南方医科大学生物医学工程学院,广东 广州 510515School of Biomedical Engineering, Southern Medical University, Guangzhou 510515, China
- 广州市医用放射成像与检测技术重点实验室,广东 广州 510515Guangzhou Key Laboratory of Medical Radiation Imaging and Detection Technology, Guangzhou 510515, China
| | - 永波 王
- 南方医科大学生物医学工程学院,广东 广州 510515School of Biomedical Engineering, Southern Medical University, Guangzhou 510515, China
- 广州市医用放射成像与检测技术重点实验室,广东 广州 510515Guangzhou Key Laboratory of Medical Radiation Imaging and Detection Technology, Guangzhou 510515, China
| | - 杨 高
- 南方医科大学生物医学工程学院,广东 广州 510515School of Biomedical Engineering, Southern Medical University, Guangzhou 510515, China
| | - 建华 马
- 南方医科大学生物医学工程学院,广东 广州 510515School of Biomedical Engineering, Southern Medical University, Guangzhou 510515, China
- 广州市医用放射成像与检测技术重点实验室,广东 广州 510515Guangzhou Key Laboratory of Medical Radiation Imaging and Detection Technology, Guangzhou 510515, China
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11
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van Winkel SL, Rodríguez-Ruiz A, Appelman L, Gubern-Mérida A, Karssemeijer N, Teuwen J, Wanders AJT, Sechopoulos I, Mann RM. Impact of artificial intelligence support on accuracy and reading time in breast tomosynthesis image interpretation: a multi-reader multi-case study. Eur Radiol 2021; 31:8682-8691. [PMID: 33948701 PMCID: PMC8523448 DOI: 10.1007/s00330-021-07992-w] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 03/16/2021] [Accepted: 04/09/2021] [Indexed: 12/31/2022]
Abstract
Objectives Digital breast tomosynthesis (DBT) increases sensitivity of mammography and is increasingly implemented in breast cancer screening. However, the large volume of images increases the risk of reading errors and reading time. This study aims to investigate whether the accuracy of breast radiologists reading wide-angle DBT increases with the aid of an artificial intelligence (AI) support system. Also, the impact on reading time was assessed and the stand-alone performance of the AI system in the detection of malignancies was compared to the average radiologist. Methods A multi-reader multi-case study was performed with 240 bilateral DBT exams (71 breasts with cancer lesions, 70 breasts with benign findings, 339 normal breasts). Exams were interpreted by 18 radiologists, with and without AI support, providing cancer suspicion scores per breast. Using AI support, radiologists were shown examination-based and region-based cancer likelihood scores. Area under the receiver operating characteristic curve (AUC) and reading time per exam were compared between reading conditions using mixed-models analysis of variance. Results On average, the AUC was higher using AI support (0.863 vs 0.833; p = 0.0025). Using AI support, reading time per DBT exam was reduced (p < 0.001) from 41 (95% CI = 39–42 s) to 36 s (95% CI = 35– 37 s). The AUC of the stand-alone AI system was non-inferior to the AUC of the average radiologist (+0.007, p = 0.8115). Conclusions Radiologists improved their cancer detection and reduced reading time when evaluating DBT examinations using an AI reading support system. Key Points • Radiologists improved their cancer detection accuracy in digital breast tomosynthesis (DBT) when using an AI system for support, while simultaneously reducing reading time. • The stand-alone breast cancer detection performance of an AI system is non-inferior to the average performance of radiologists for reading digital breast tomosynthesis exams. • The use of an AI support system could make advanced and more reliable imaging techniques more accessible and could allow for more cost-effective breast screening programs with DBT.
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Affiliation(s)
- Suzanne L van Winkel
- Department of Medical Imaging, Radboud University Medical Center, PO Box 9101, 6500 HB Nijmegen, Geert Grooteplein 10, 6525 GA, Post 766, Nijmegen, The Netherlands.
| | | | - Linda Appelman
- Department of Medical Imaging, Radboud University Medical Center, PO Box 9101, 6500 HB Nijmegen, Geert Grooteplein 10, 6525 GA, Post 766, Nijmegen, The Netherlands
| | | | - Nico Karssemeijer
- Department of Medical Imaging, Radboud University Medical Center, PO Box 9101, 6500 HB Nijmegen, Geert Grooteplein 10, 6525 GA, Post 766, Nijmegen, The Netherlands.,ScreenPoint Medical BV, Toernooiveld 300, 6525 EC, Nijmegen, The Netherlands
| | - Jonas Teuwen
- Department of Medical Imaging, Radboud University Medical Center, PO Box 9101, 6500 HB Nijmegen, Geert Grooteplein 10, 6525 GA, Post 766, Nijmegen, The Netherlands.,Department of Radiation Oncology, Netherlands Cancer Institute (NKI), Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands
| | - Alexander J T Wanders
- Bevolkingsonderzoek Zuid-West Borstkanker, Laan 20, 2512 GB, Den Haag, The Netherlands
| | - Ioannis Sechopoulos
- Department of Medical Imaging, Radboud University Medical Center, PO Box 9101, 6500 HB Nijmegen, Geert Grooteplein 10, 6525 GA, Post 766, Nijmegen, The Netherlands.,Dutch Expert Centre for Screening (LRCB), Wijchenseweg 101, 6538 SW, Nijmegen, The Netherlands
| | - Ritse M Mann
- Department of Medical Imaging, Radboud University Medical Center, PO Box 9101, 6500 HB Nijmegen, Geert Grooteplein 10, 6525 GA, Post 766, Nijmegen, The Netherlands. .,Department of Radiology, Netherlands Cancer Institute (NKI), Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands.
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12
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Winter AM, Moy L, Gao Y, Bennett DL. Comparison of Narrow-angle and Wide-angle Digital Breast Tomosynthesis Systems in Clinical Practice. JOURNAL OF BREAST IMAGING 2021; 3:240-255. [PMID: 38424829 DOI: 10.1093/jbi/wbaa114] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Indexed: 03/02/2024]
Abstract
Digital breast tomosynthesis (DBT) is a pseudo 3D mammography imaging technique that has become widespread since gaining Food and Drug Administration approval in 2011. With this technology, a variable number of tomosynthesis projection images are obtained over an angular range between 15° and 50° for currently available clinical DBT systems. The angular range impacts various aspects of clinical imaging, such as radiation dose, scan time, and image quality, including visualization of calcifications, masses, and architectural distortion. This review presents an overview of the differences between narrow- and wide-angle DBT systems, with an emphasis on their applications in clinical practice. Comparison examples of patients imaged on both narrow- and wide-angle DBT systems illustrate these differences. Understanding the potential variable appearance of imaging findings with narrow- and wide-angle DBT systems is important for radiologists, particularly when comparison images have been obtained on a different DBT system. Furthermore, knowledge about the comparative strengths and limitations of DBT systems is needed for appropriate equipment selection.
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Affiliation(s)
- Andrea M Winter
- Saint Louis University, Department of Radiology, St. Louis, MO, USA
| | - Linda Moy
- NYU Langone Health, NYU School of Medicine, Department of Radiology, New York, NY, USA
| | - Yiming Gao
- NYU Langone Health, NYU School of Medicine, Department of Radiology, New York, NY, USA
| | - Debbie L Bennett
- Saint Louis University, Department of Radiology, St. Louis, MO, USA
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Procz S, Roque G, Avila C, Racedo J, Rueda R, Santos I, Fiederle M. Investigation of CdTe, GaAs, Se and Si as Sensor Materials for Mammography. IEEE TRANSACTIONS ON MEDICAL IMAGING 2020; 39:3766-3778. [PMID: 32746121 DOI: 10.1109/tmi.2020.3004648] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Despite the benefits of mammography investigations, some studies have shown that X-ray exposure from the mammography screening itself can statistically cause breast cancer in a small fraction of women. Therefore, a dose reduction in mammography is desirable. At the same time, there is a demand for a higher spatial resolution in mammographic imaging. The most promising way to achieve these goals is the use of advanced photon-processing semiconductor X-ray detectors with optimum sensor materials. This study addresses the investigation of the optimum semiconductor sensor material for mammography in combination with the photon-processing detector Medipix3RX. The influence of K-shell fluorescence from the sensor material on the achievable contrast-to-noise ratio is investigated, as well as the attenuation efficiency. The three different sensor materials, CdTe, GaAs, and Si are studied, showing advances of CdTe-sensors for mammography. Furthermore, a comparison of the contrast-to-noise ratio between a clinical Se-detector and Medipix3RX detectors with Si- and CdTe-sensors is shown using a self-produced mammography phantom that is based on real human tissue.
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14
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Barca P, Lamastra R, Tucciariello RM, Traino A, Marini C, Aringhieri G, Caramella D, Fantacci ME. Technical evaluation of image quality in synthetic mammograms obtained from 15° and 40° digital breast tomosynthesis in a commercial system: a quantitative comparison. Phys Eng Sci Med 2020; 44:23-35. [PMID: 33226534 DOI: 10.1007/s13246-020-00948-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 11/15/2020] [Indexed: 11/25/2022]
Abstract
Digital breast tomosynthesis (DBT) has recently gained interest both for breast cancer screening and diagnosis. Its employment has increased also in conjunction with digital mammography (DM), to improve cancer detection and reduce false positive recall rate. Synthetic mammograms (SMs) reconstructed from DBT data have been introduced to replace DM in the DBT + DM approach, for preserving the benefits of the dual-acquisition modality whilst reducing radiation dose and compression time. Therefore, different DBT models have been commercialized and the effective potential of each system has been investigated. In particular, wide-angle DBT was shown to provide better depth resolution than narrow-angle DBT, while narrow-angle DBT allows better identification of microcalcifications compared to wide-angle DBT. Given the increasing employment of SMs as supplement to DBT, a comparison of image quality between SMs obtained in narrow-angle and wide-angle DBT is of practical interest. Therefore, the aim of this phantom study was to evaluate and compare the image quality of SMs reconstructed from 15° (SM15) and 40° (SM40) DBT in a commercial system. Spatial resolution, noise and contrast properties were evaluated through the modulation transfer function (MTF), noise power spectrum, maps of signal-to-noise ratio (SNR), image contrast, contrast-to-noise ratio (CNR) and contrast-detail (CD) thresholds. SM40 expressed higher MTF than SM15, but also lower SNR and CNR levels. SM15 and SM40 were characterized by slight different texture, and a different behavior in terms of contrast was found. SM15 provided better CD performances than SM40. These results suggest that the employment of wide/narrow-angle DBT + SM images should be optimized based on the specific image task.
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Affiliation(s)
- Patrizio Barca
- Department of Physics, University of Pisa, Largo Bruno Pontecorvo 3, 56127, Pisa, Italy.
| | - Rocco Lamastra
- Department of Physics, University of Pisa, Largo Bruno Pontecorvo 3, 56127, Pisa, Italy
- INFN, Pisa Section, Pisa, Italy
| | - Raffaele Maria Tucciariello
- Department of Physics, University of Pisa, Largo Bruno Pontecorvo 3, 56127, Pisa, Italy
- INFN, Pisa Section, Pisa, Italy
| | - Antonio Traino
- Unit of Medical Physics, Pisa University Hospital "Azienda Ospedaliero-Universitaria Pisana", Pisa, Italy
| | - Carolina Marini
- S.D. Radiologia Senologica, "Azienda Ospedaliero-Universitaria Pisana", Pisa, Italy
| | - Giacomo Aringhieri
- Department of Translational Research and of New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Davide Caramella
- Department of Translational Research and of New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Maria Evelina Fantacci
- Department of Physics, University of Pisa, Largo Bruno Pontecorvo 3, 56127, Pisa, Italy
- INFN, Pisa Section, Pisa, Italy
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15
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Traino AC, Barca P, Lamastra R, Tucciariello RM, Sottocornola C, Marini C, Aringhieri G, Caramella D, Fantacci ME. Average absorbed breast dose (2ABD): an easy radiation dose index for digital breast tomosynthesis. Eur Radiol Exp 2020; 4:38. [PMID: 32632827 PMCID: PMC7338293 DOI: 10.1186/s41747-020-00165-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Accepted: 05/07/2020] [Indexed: 11/23/2022] Open
Abstract
Background To propose a practical and simple method to individually evaluate the average absorbed dose for digital breast tomosynthesis. Methods The method is based on the estimate of incident air kerma (ka,i) on the breast surface. An analytical model was developed to calculate the ka,i from the tube voltage, tube load, breast thickness, x-ray tube yield, and anode-filter combination. A homogeneous phantom was employed to simulate the breast in experimental measurements and to assess the dose-depth relationship. The ka,i values were employed to calculate the “average absorbed breast dose” (2ABD) index. Four mammographic units were used to develop and test our method under many conditions close to clinical settings. The average glandular dose (AGD) calculated following the method described by Dance et al., and the 2ABD computed through our method (i.e., from the exposure parameters) were compared in a number of conditions. Results A good agreement was obtained between the ka,i computed through our model and that measured under different clinical conditions: discrepancies < 6% were found in all conditions. 2ABD matches with a good accuracy the AGD for a 100% glandular-breast: the minimum, maximum, and mean differences were < 0.1%, 7%, and 2.4%, respectively; the discrepancies increase with decreasing breast glandularity. Conclusions The proposed model, based on only few exposure parameters, represents a simple way to individually calculate an index, 2ABD, which can be interpreted as the average absorbed dose in a homogeneous phantom, approximating a 100% glandular breast. The method could be easily implemented in any mammographic device performing DBT.
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Affiliation(s)
- Antonio C Traino
- U.O.Fisica Sanitaria, Azienda Ospedaliero-Universitaria Pisana, Via Roma n.67, 56125, Pisa, Italy.
| | - Patrizio Barca
- U.O.Fisica Sanitaria, Azienda Ospedaliero-Universitaria Pisana, Via Roma n.67, 56125, Pisa, Italy.,Dipartimento di Fisica E.Fermi, Università di Pisa, L.go B.Pontecorvo n.3, 56127, Pisa, Italy
| | - Rocco Lamastra
- U.O.Fisica Sanitaria, Azienda Ospedaliero-Universitaria Pisana, Via Roma n.67, 56125, Pisa, Italy.,Dipartimento di Fisica E.Fermi, Università di Pisa, L.go B.Pontecorvo n.3, 56127, Pisa, Italy
| | - Raffaele M Tucciariello
- Dipartimento di Fisica E.Fermi, Università di Pisa, L.go B.Pontecorvo n.3, 56127, Pisa, Italy
| | - Chiara Sottocornola
- U.O.S.D. Fisica Sanitaria, Azienda Usl Toscana Sud-Est, Ospedale San Donato, Via P. Nenni 20, 52100, Arezzo, Italy
| | - Carolina Marini
- S.D.Radiologia Senologica, Azienda Ospedaliero-Universitaria Pisana, Via Roma n.67, 56125, Pisa, Italy
| | - Giacomo Aringhieri
- Radiologia Diagnostica e Interventistica, Università di Pisa, Via Paradisa n.2, 56100, Pisa, Italy
| | - Davide Caramella
- Radiologia Diagnostica e Interventistica, Università di Pisa, Via Paradisa n.2, 56100, Pisa, Italy
| | - Maria E Fantacci
- Dipartimento di Fisica E.Fermi, Università di Pisa, L.go B.Pontecorvo n.3, 56127, Pisa, Italy
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Monnin P, Verdun FR, Bosmans H, Marshall NW. In-plane image quality and NPWE detectability index in digital breast tomosynthesis. Phys Med Biol 2020; 65:095013. [PMID: 32191923 DOI: 10.1088/1361-6560/ab8147] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
A rigorous 2D analysis of signal and noise transfer applied to reconstructed planes in digital breast tomosynthesis (DBT) is necessary for system characterization and optimization. This work proposes a method for assessing technical image quality and system detective quantum efficiency (DQEsys) for reconstructed planes in DBT. Measurements of 2D in-plane modulation transfer function (MTF) and noise power spectrum (NPS) were made on five DBT systems using different acquisition parameters, reconstruction algorithms and plane spacing. This work develops the noise equivalent quanta (NEQ), DQEsys and detectability index (d') calculated using a non-prewhitening model observer with eye filter (NPWE) for reconstructed DBT planes. The images required for this implementation were acquired using a homogeneous test object of thickness 40 mm poly(methyl) methacrylate plus 0.5 mm Al; 2D MTF was calculated from an Al disc of thickness 0.2 mm and diameter 50 mm positioned within the phantom. The radiant contrast of the MTF disc and the air kerma at the system input were used as normalization factors. The NPWE detectability index was then compared to the in-plane contrast-detail (c-d) threshold measured using the CDMAM phantom. The MTF and NPS measured on the different systems showed a strong anisotropy, consistent with the cascaded models developed in the literature for DBT. Detectability indices calculated from the measured MTF and NPS successfully predicted changes in c-d detectability for details between 0.1 mm and 2.0 mm, for DBT plane spacings between 0.5 mm and 10 mm, and for air kerma values at the system input between 157 µGy and 1170 μGy. The linear Pearson correlation between the detectability index and threshold gold thickness of the CDMAM phantom was -0.996. The method implements a parametric means of assessing the technical image quality of reconstructed DBT planes, providing valuable information for optimization of DBT systems.
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Affiliation(s)
- P Monnin
- Institute of Radiation Physics (IRA), Lausanne University Hospital (CHUV) and University of Lausanne, Rue du Grand-Pré 1, 1007 Lausanne, Switzerland. Author to whom any correspondence should be addressed
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17
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Krammer J, Zolotarev S, Hillman I, Karalis K, Stsepankou D, Vengrinovich V, Hesser J, M. Svahn T. Evaluation of a new image reconstruction method for digital breast tomosynthesis: effects on the visibility of breast lesions and breast density. Br J Radiol 2019; 92:20190345. [PMID: 31453718 PMCID: PMC6849672 DOI: 10.1259/bjr.20190345] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Revised: 08/15/2019] [Accepted: 08/19/2019] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To compare image quality and breast density of two reconstruction methods, the widely-used filtered-back projection (FBP) reconstruction and the iterative heuristic Bayesian inference reconstruction (Bayesian inference reconstruction plus the method of total variation applied, HBI). METHODS Thirty-two clinical DBT data sets with malignant and benign findings, n = 27 and 17, respectively, were reconstructed using FBP and HBI. Three experienced radiologists evaluated the images independently using a 5-point visual grading scale and classified breast density according to the American College of Radiology Breast Imaging-Reporting And Data System Atlas, fifth edition. Image quality metrics included lesion conspicuity, clarity of lesion borders and spicules, noise level, artifacts surrounding the lesion, visibility of parenchyma and breast density. RESULTS For masses, the image quality of HBI reconstructions was superior to that of FBP in terms of conspicuity,clarity of lesion borders and spicules (p < 0.01). HBI and FBP were not significantly different in calcification conspicuity. Overall, HBI reduced noise and supressed artifacts surrounding the lesions better (p < 0.01). The visibility of fibroglandular parenchyma increased using the HBI method (p < 0.01). On average, five cases per radiologist were downgraded from BI-RADS breast density category C/D to A/B. CONCLUSION HBI significantly improves lesion visibility compared to FBP. HBI-visibility of breast parenchyma increased, leading to a lower breast density rating. Applying the HBIR algorithm should improve the diagnostic performance of DBT and decrease the need for additional imaging in patients with dense breasts. ADVANCES IN KNOWLEDGE Iterative heuristic Bayesian inference (HBI) image reconstruction substantially improves the image quality of breast tomosynthesis leading to a better visibility of breast carcinomas and reduction of the perceived breast density compared to the widely-used filtered-back projection (FPB) reconstruction. Applying HBI should improve the accuracy of breast tomosynthesis and reduce the number of unnecessary breast biopsies. It may also reduce the radiation dose for the patients, which is especially important in the screening context.
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Affiliation(s)
- Julia Krammer
- Department of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Heidelberg University Mannheim, Mannheim, Germany
| | - Sergei Zolotarev
- National Academy of Science of Belarus, Institute of Applied Physics, Minsk, Belarus
| | - Inge Hillman
- Mammography Section, Gävle Hospital, Gävle, Sweden
| | | | - Dzmitry Stsepankou
- Department of Experimental Radiooncology, Medical Faculty Mannheim, Heidelberg University, Germany
| | - Valeriy Vengrinovich
- National Academy of Science of Belarus, Institute of Applied Physics, Minsk, Belarus
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18
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Luckner C, Herbst M, Weber T, Beister M, Ritschl L, Kappler S, Maier A. High‐speed slot‐scanning radiography using small‐angle tomosynthesis: Investigation of spatial resolution. Med Phys 2019; 46:5454-5466. [DOI: 10.1002/mp.13828] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2019] [Revised: 09/10/2019] [Accepted: 09/10/2019] [Indexed: 12/29/2022] Open
Affiliation(s)
- Christoph Luckner
- Pattern Recognition Lab Friedrich‐Alexander University Erlangen‐Nürnberg Martensstraße 3 91058Erlangen Germany
- X‐ray Products Siemens Healthcare GmbH Siemensstraße 3 91301Forchheim Germany
| | - Magdalena Herbst
- X‐ray Products Siemens Healthcare GmbH Siemensstraße 3 91301Forchheim Germany
| | - Thomas Weber
- X‐ray Products Siemens Healthcare GmbH Siemensstraße 3 91301Forchheim Germany
| | - Marcel Beister
- X‐ray Products Siemens Healthcare GmbH Siemensstraße 3 91301Forchheim Germany
| | - Ludwig Ritschl
- X‐ray Products Siemens Healthcare GmbH Siemensstraße 3 91301Forchheim Germany
| | - Steffen Kappler
- X‐ray Products Siemens Healthcare GmbH Siemensstraße 3 91301Forchheim Germany
| | - Andreas Maier
- Pattern Recognition Lab Friedrich‐Alexander University Erlangen‐Nürnberg Martensstraße 3 91058Erlangen Germany
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González-López A. SNR of MTF calculations in non wide sense stationary systems. Biomed Phys Eng Express 2019. [DOI: 10.1088/2057-1976/ab2b94] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Sundell VM, Jousi M, Hukkinen K, Blanco R, Mäkelä T, Kaasalainen T. A phantom study comparing technical image quality of five breast tomosynthesis systems. Phys Med 2019; 63:122-130. [PMID: 31221403 DOI: 10.1016/j.ejmp.2019.06.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Revised: 06/03/2019] [Accepted: 06/07/2019] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Digital breast tomosynthesis (DBT) is a three-dimensional breast imaging method. DBT vendors employ various approaches in both image acquisition and data processing, which may affect image quality and radiation exposure to patients. OBJECTIVE This study aimed to evaluate the performance of five DBT systems: Fujifilm Amulet Innovality (using both a standard mode and high-resolution mode), GE Senographe Essential, Hologic Selenia Dimensions, Planmed Clarity 3D, and Siemens Mammomat Inspiration. MATERIALS AND METHODS The performance of each device and imaging technique was evaluated and compared by phantom measurements performed with four quality assurance phantoms. Technical image quality assessments consisted of measuring artefact extent, in-plane resolution, relative noise power spectrum, and geometric accuracy. RESULTS Artefact spreading varied remarkably between the devices, and the full width at half maximum values of artefact spread functions varied from 3.5 mm to 10.7 mm. Noticeable in-plane resolution anisotropy, determined using modulation transfer function (MTF) analysis, was typically observed between tube travel direction and chest wall-nipple direction. The MTF50 varied from 1.1 mm-1 to 1.6 mm-1 and from 1.5 mm-1 to 4.1 mm-1 in the tube travel and chest wall-nipple directions, respectively. Moreover, distinctly different noise power spectra were observed between the systems. The geometric accuracy in every system was within 0.5%. CONCLUSION Technical image quality assessments with image quality phantoms revealed remarkable differences in artefact spread, in-plane resolution, and noise properties between the DBT systems and imaging methods.
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Affiliation(s)
- Veli-Matti Sundell
- HUS Medical Imaging Center, Radiology, University of Helsinki and Helsinki University Hospital, Finland; Department of Physics, University of Helsinki, Finland.
| | - Mikko Jousi
- Päijät-Hämeen Sosiaali- ja Terveysyhtymä, Central Hospital, Radiology, Finland
| | - Katja Hukkinen
- HUS Medical Imaging Center, Radiology, University of Helsinki and Helsinki University Hospital, Finland
| | - Roberto Blanco
- Medical Imaging Centre of Southwest Finland, Turku University Hospital, Finland
| | - Teemu Mäkelä
- HUS Medical Imaging Center, Radiology, University of Helsinki and Helsinki University Hospital, Finland; Department of Physics, University of Helsinki, Finland
| | - Touko Kaasalainen
- HUS Medical Imaging Center, Radiology, University of Helsinki and Helsinki University Hospital, Finland; Department of Physics, University of Helsinki, Finland
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Petrov D, Marshall NW, Young KC, Bosmans H. Systematic approach to a channelized Hotelling model observer implementation for a physical phantom containing mass-like lesions: Application to digital breast tomosynthesis. Phys Med 2019; 58:8-20. [PMID: 30824154 DOI: 10.1016/j.ejmp.2018.12.033] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Revised: 12/05/2018] [Accepted: 12/25/2018] [Indexed: 10/27/2022] Open
Abstract
PURPOSE to develop a channelized model observer (CHO) that matches human reader (HR) scoring of a physical phantom containing breast simulating structure and mass lesion-like targets for use in quality control of digital breast tomosynthesis (DBT) imaging systems. METHODS A total of 108 DBT scans of the phantom was acquired using a Siemens Inspiration DBT system. The detectability of mass-like targets was evaluated by human readers using a 4-alternative forced choice (4-AFC) method. The percentage correct (PC) values were then used as the benchmark for CHO tuning, again using a 4-AFC method. Three different channel functions were considered: Gabor, Laguerre-Gauss and Difference of Gaussian. With regard to the observer template, various methods for generating the expected signal were studied along with the influence of the number of training images used to form the covariance matrix for the observer template. Impact of bias in the training process on the observer template was evaluated next, as well as HR and CHO reproducibility. RESULTS HR performance was most closely matched by 8 Gabor channels with tuned phase, orientation and frequency, using an observer template generated from training image data. Just 24 DBT image stacks were required to give robust CHO performance with 0% bias, although a bias of up to 33% in the training images also gave acceptable performance. CHO and HR reproducibility were similar (on average 3.2 PC versus 3.4 PC). CONCLUSIONS The CHO algorithm developed matches human reader performance and is therefore a promising candidate for automated readout of phantom studies.
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Affiliation(s)
- Dimitar Petrov
- Dept. of Medical Physics and Quality Assessment, KU Leuven, Leuven, Belgium.
| | - Nicholas W Marshall
- Dept. of Medical Physics and Quality Assessment, KU Leuven, Leuven, Belgium; Dept. of Radiology, UZ Leuven, Belgium
| | | | - Hilde Bosmans
- Dept. of Medical Physics and Quality Assessment, KU Leuven, Leuven, Belgium; Dept. of Radiology, UZ Leuven, Belgium
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75. Image quality and dose measurements in digital breast tomosynthesis. Phys Med 2018. [DOI: 10.1016/j.ejmp.2018.04.085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Comparison of breast cancer detection and depiction between planar and rotating synthetic mammography generated from breast tomosynthesis. Eur J Radiol 2018; 108:78-83. [DOI: 10.1016/j.ejrad.2018.09.022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Revised: 09/17/2018] [Accepted: 09/18/2018] [Indexed: 11/19/2022]
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Berggren K, Eriksson M, Hall P, Wallis MG, Fredenberg E. In vivo measurement of the effective atomic number of breast skin using spectral mammography. ACTA ACUST UNITED AC 2018; 63:215023. [DOI: 10.1088/1361-6560/aae78c] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Ortenzia O, Rossi R, Bertolini M, Nitrosi A, Ghetti C. PHYSICAL CHARACTERISATION OF FOUR DIFFERENT COMMERCIAL DIGITAL BREAST TOMOSYNTHESIS SYSTEMS. RADIATION PROTECTION DOSIMETRY 2018; 181:277-289. [PMID: 29462366 DOI: 10.1093/rpd/ncy024] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Accepted: 01/25/2018] [Indexed: 06/08/2023]
Abstract
The aim of this article was to characterise the performance of four different digital breast tomosynthesis (DBT) systems in terms of dose and image quality parameters. One of them, GE Pristina, has never been tested before. Average glandular doses were measured both in DBT and 2D full field digital mammography mode. Several phantoms were employed to perform signal difference to noise ratio, slice sensitivity profile, slice to slice incrementation, chest wall offset, z-axis geometry, artefact spread function, low contrast detectability, contrast detail evaluations, image uniformity and in-plane MTF in chest wall-nipple and in tube-travel directions. There are many differences in DBT systems explored: the angular range, detector type, reconstruction algorithms, and the presence or not of the grid. Even if it is not simple to calculate a global figure of merit, the analysis of all the collected data can be useful in a contest of a quality assurance program to define a set of values that could be used as benchmarks.
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Affiliation(s)
- O Ortenzia
- Department of Medical Physics, University Hospital of Parma, Parma, Italy
| | - R Rossi
- Department of Medical Physics, University Hospital of Parma, Parma, Italy
| | - M Bertolini
- Department of Medical Physics, Santa Maria Nuova Hospital of Reggio Emilia, Reggio Emilia, Italy
| | - A Nitrosi
- Department of Medical Physics, Santa Maria Nuova Hospital of Reggio Emilia, Reggio Emilia, Italy
| | - C Ghetti
- Department of Medical Physics, University Hospital of Parma, Parma, Italy
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Kuramoto T, Morishita J, Kato T, Nakamura Y. Variations in slice sensitivity profile for various height settings in tomosynthesis imaging: Phantom study. Phys Med 2018; 53:108-117. [PMID: 30241745 DOI: 10.1016/j.ejmp.2018.08.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Revised: 07/14/2018] [Accepted: 08/12/2018] [Indexed: 11/26/2022] Open
Abstract
Understanding the properties of slice sensitivity profile (SSP), or slice thickness, is crucial for an accurate and highly reproducible diagnosis using tomosynthesis imaging. The objectives of the present study are therefore to quantitatively evaluate how the SSP with the use of a small metal bead is affected by different settings of the height from the table and the height of the center of rotation (COR) in tomosynthesis imaging except for the digital breast tomosynthesis, and visually verify the effects on tomosynthesis images. The reconstruction filters used were three types of filtered back-projection and iterative reconstructions. The SSP was measured from the full width at half maximum (FWHM-SSP) of the profile curve of the bead in the perpendicular direction (z direction) relative to the table. Two types of anthropomorphic phantoms simulating the human body, with bones and soft tissues, were used to study the effects of different settings for the COR height. In all reconstruction filters, the FWHM-SSP changed as the height of the bead varied when the bead and COR were set to the same height from the table. If the bead and the COR were set to different heights, the FWHM-SSP increased (decreased) when the height of the bead was set to be greater (less) than the height of the COR. These changes were also confirmed on the anthropomorphic phantom images of the bones and soft tissues.
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Affiliation(s)
- Taku Kuramoto
- Department of Health Sciences, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan; Division of Radiology, Department of Medical Technology, Kyushu University Hospital, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan.
| | - Junji Morishita
- Department of Health Sciences, Faculty of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
| | - Toyoyuki Kato
- Division of Radiology, Department of Medical Technology, Kyushu University Hospital, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
| | - Yasuhiko Nakamura
- Department of Radiological Science, Faculty of Health Sciences, Junshin Gakuen University, 1-1-1, Chikushigaoka, Minami-ku, Fukuoka 815-8510, Japan
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Rodriguez-Ruiz A, Teuwen J, Vreemann S, Bouwman RW, van Engen RE, Karssemeijer N, Mann RM, Gubern-Merida A, Sechopoulos I. New reconstruction algorithm for digital breast tomosynthesis: better image quality for humans and computers. Acta Radiol 2018; 59:1051-1059. [PMID: 29254355 PMCID: PMC6088454 DOI: 10.1177/0284185117748487] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Background The image quality of digital breast tomosynthesis (DBT) volumes depends
greatly on the reconstruction algorithm. Purpose To compare two DBT reconstruction algorithms used by the Siemens Mammomat
Inspiration system, filtered back projection (FBP), and FBP with iterative
optimizations (EMPIRE), using qualitative analysis by human readers and
detection performance of machine learning algorithms. Material and Methods Visual grading analysis was performed by four readers specialized in breast
imaging who scored 100 cases reconstructed with both algorithms (70
lesions). Scoring (5-point scale: 1 = poor to 5 = excellent quality) was
performed on presence of noise and artifacts, visualization of skin-line and
Cooper’s ligaments, contrast, and image quality, and, when present, lesion
visibility. In parallel, a three-dimensional deep-learning convolutional
neural network (3D-CNN) was trained (n = 259 patients, 51 positives with
BI-RADS 3, 4, or 5 calcifications) and tested (n = 46 patients, nine
positives), separately with FBP and EMPIRE volumes, to discriminate between
samples with and without calcifications. The partial area under the receiver
operating characteristic curve (pAUC) of each 3D-CNN was used for
comparison. Results EMPIRE reconstructions showed better contrast (3.23 vs. 3.10,
P = 0.010), image quality (3.22 vs. 3.03,
P < 0.001), visibility of calcifications (3.53 vs.
3.37, P = 0.053, significant for one reader), and fewer
artifacts (3.26 vs. 2.97, P < 0.001). The 3D-CNN-EMPIRE
had better performance than 3D-CNN-FBP (pAUC-EMPIRE = 0.880 vs.
pAUC-FBP = 0.857; P < 0.001). Conclusion The new algorithm provides DBT volumes with better contrast and image
quality, fewer artifacts, and improved visibility of calcifications for
human observers, as well as improved detection performance with
deep-learning algorithms.
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Affiliation(s)
- Alejandro Rodriguez-Ruiz
- Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Jonas Teuwen
- Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Suzan Vreemann
- Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Ramona W Bouwman
- Dutch Expert Centre for Screening (LRCB), Nijmegen, the Netherlands
| | | | - Nico Karssemeijer
- Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Ritse M Mann
- Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Albert Gubern-Merida
- Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Ioannis Sechopoulos
- Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Nijmegen, the Netherlands
- Dutch Expert Centre for Screening (LRCB), Nijmegen, the Netherlands
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Sarno A, Mettivier G, Tucciariello RM, Bliznakova K, Boone JM, Sechopoulos I, Di Lillo F, Russo P. Monte Carlo evaluation of glandular dose in cone-beam X-ray computed tomography dedicated to the breast: Homogeneous and heterogeneous breast models. Phys Med 2018; 51:99-107. [DOI: 10.1016/j.ejmp.2018.05.021] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Revised: 05/04/2018] [Accepted: 05/23/2018] [Indexed: 12/11/2022] Open
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Goodenough D, Levy J, Olafsdottir H, Olafsson I. Design and development of a phantom for tomosynthesis with potential for automated analysis via the cloud. J Appl Clin Med Phys 2018; 19:291-300. [PMID: 29508535 PMCID: PMC5978640 DOI: 10.1002/acm2.12297] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2017] [Revised: 10/25/2017] [Accepted: 01/07/2018] [Indexed: 11/29/2022] Open
Abstract
This paper describes Development of a Phantom for Tomosynthesis with Potential for Automated Analysis via the Cloud. Several studies are underway to investigate the effectiveness of Tomosynthesis Mammographic Image Screening, including the large TMIST project as funded by the National Cancer Institute https://www.cancer.gov/about-cancer/treatment/clinical-trials/nci-supported/tmist. The development of the phantom described in this paper follows initiatives from the FDA, the AAPM TG245 task group, and European Reference Organization (EUREF) for Quality Assured Breast Screening and Diagnostic Services Committee report noting, that no formal endorsement nor recommendation for use has been sought, or granted by any of these groups. This paper reports on the possibility of using this newly developed Tomosynthesis Phantom for Quality Assurance, field testing of image performance, including remote monitoring of DBT system performance, e.g., via transmission over the cloud. The phantom includes tests for: phantom positioning and alignment (important for remote analysis), scan geometry (x and y), chest wall offset, scan slice width and Slice Sensitivity Profile (SSP(z)) slice geometry (slice width), scan slice incrementation (z), z axis geometry bead, low contrast detectability using low contrast spheres, spatial resolution via Point Spread Function (PSF), Image uniformity, Signal to Noise Ratio (SNR), and Contrast to Noise Ratio (CNR) via readings over an Aluminum square. The phantom is designed for use with automated analysis via transmission of images over the cloud and the analysis package includes test of positioning accuracy (roll, pitch, and yaw). Data are shown from several commercial Tomosynthesis Scanners including Fuji, GE, Hologic, IMS‐Giotti, and Siemens; however, the focus of this paper is on phantom design, and not in general aimed at direct commercial comparisons, and wherever possible the identity of the data is anonymized. Results of automated analysis of the phantom are shown, and it is demonstrated that reliable analysis of such a phantom can be achieved remotely, including transmission of data through the cloud.
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Affiliation(s)
- David Goodenough
- Department of Radiology; The George Washington University; NW Washington DC USA
- The Institute For Radiological Image Sciences; Myersville MD USA
| | - Josh Levy
- The Phantom Laboratory; Salem NY USA
- Image Owl; Salem NY USA
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Garrett JW, Li Y, Li K, Chen GH. Reduced anatomical clutter in digital breast tomosynthesis with statistical iterative reconstruction. Med Phys 2018. [PMID: 29542821 DOI: 10.1002/mp.12864] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
PURPOSE Digital breast tomosynthesis (DBT) has been shown to somewhat alleviate the breast tissue overlapping issues of two-dimensional (2D) mammography. However, the improvement in current DBT systems over mammography is still limited. Statistical image reconstruction (SIR) methods have the potential to reduce through-plane artifacts in DBT, and thus may be used to further reduce anatomical clutter. The purpose of this work was to study the impact of SIR on anatomical clutter in the reconstructed DBT image volumes. METHODS An SIR with a slice-wise total variation (TV) regularizer was implemented to reconstruct DBT images which were compared with the clinical reconstruction method (filtered backprojection). The artifact spread function (ASF) was measured to quantify the reduction of the through-plane artifacts level in phantom studies and microcalcifications in clinical cases. The anatomical clutter was quantified by the anatomical noise power spectrum with a power law fitting model: NPSa ( f) = α f-β . The β values were measured from the reconstructed image slices when the two reconstruction methods were applied to a cohort of clinical breast exams (N = 101) acquired using Hologic Selenia Dimensions DBT systems. RESULTS The full width half maximum (FWHM) of the measured ASF was reduced from 8.7 ± 0.1 mm for clinical reconstruction to 6.5 ± 0.1 mm for SIR which yields a 25% reduction in FWHM in phantom studies and the same amount of ASF reduction was also found in clinical measurements from microcalcifications. The measured β values for the two reconstruction methods were 3.17 ± 0.36 and 2.14 ± 0.39 for the clinical reconstruction method and the SIR method, respectively. This difference was statistically significant (P << 0.001). The dependence of β on slice location using either method was negligible. CONCLUSIONS Statistical image reconstruction enabled a significant reduction of both the through-plane artifacts level and anatomical clutter in the DBT reconstructions. The β value was found to be β≈2.14 with the SIR method. This value stays in the middle between the β≈1.8 for cone beam CT and β≈3.2 for mammography. In contrast, the measured β value in the clinical reconstructions (β≈3.17) remains close to that of mammography.
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Affiliation(s)
- John W Garrett
- Department of Medical Physics, School of Medicine and Public Health, University of Wisconsin-Madison, 1111 Highland Avenue, Madison, WI, 53705, USA
| | - Yinsheng Li
- Department of Medical Physics, School of Medicine and Public Health, University of Wisconsin-Madison, 1111 Highland Avenue, Madison, WI, 53705, USA
| | - Ke Li
- Department of Medical Physics, School of Medicine and Public Health, University of Wisconsin-Madison, 1111 Highland Avenue, Madison, WI, 53705, USA.,Department of Radiology, School of Medicine and Public Health, University of Wisconsin-Madison, 600 Highland Avenue, Madison, WI, 53792, USA
| | - Guang-Hong Chen
- Department of Medical Physics, School of Medicine and Public Health, University of Wisconsin-Madison, 1111 Highland Avenue, Madison, WI, 53705, USA.,Department of Radiology, School of Medicine and Public Health, University of Wisconsin-Madison, 600 Highland Avenue, Madison, WI, 53792, USA
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González-López A. Chirp phantom for MTF calculations. A study of its precision in noisy environments. Phys Med 2018; 48:65-71. [DOI: 10.1016/j.ejmp.2018.04.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2017] [Revised: 03/31/2018] [Accepted: 04/02/2018] [Indexed: 11/30/2022] Open
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Eghtedari M, Tsai C, Robles J, Blair SL, Ojeda-Fournier H. Tomosynthesis in Breast Cancer Imaging. Surg Oncol Clin N Am 2018; 27:33-49. [DOI: 10.1016/j.soc.2017.07.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Rodriguez-Ruiz A, Gubern-Merida A, Imhof-Tas M, Lardenoije S, Wanders AJT, Andersson I, Zackrisson S, Lång K, Dustler M, Karssemeijer N, Mann RM, Sechopoulos I. One-view digital breast tomosynthesis as a stand-alone modality for breast cancer detection: do we need more? Eur Radiol 2017; 28:1938-1948. [PMID: 29230524 PMCID: PMC5882639 DOI: 10.1007/s00330-017-5167-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Revised: 10/17/2017] [Accepted: 11/02/2017] [Indexed: 11/27/2022]
Abstract
Purpose To compare the performance of one-view digital breast tomosynthesis (1v-DBT) to that of three other protocols combining DBT and mammography (DM) for breast cancer detection. Materials and methods Six radiologists, three experienced with 1v-DBT in screening, retrospectively reviewed 181 cases (76 malignant, 50 benign, 55 normal) in two sessions. First, they scored sequentially: 1v-DBT (medio-lateral oblique, MLO), 1v-DBT (MLO) + 1v-DM (cranio-caudal, CC) and two-view DM + DBT (2v-DM+2v-DBT). The second session involved only 2v-DM. Lesions were scored using BI-RADS® and level of suspiciousness (1–10). Sensitivity, specificity, receiver operating characteristic (ROC) and jack-knife alternative free-response ROC (JAFROC) were computed. Results On average, 1v-DBT was non-inferior to any of the other protocols in terms of JAFROC figure-of-merit, area under ROC curve, sensitivity or specificity (p>0.391). While readers inexperienced with 1v-DBT screening improved their sensitivity when adding more images (69–79 %, p=0.019), experienced readers showed similar sensitivity (76 %) and specificity (70 %) between 1v-DBT and 2v-DM+2v-DBT (p=0.482). Subanalysis by lesion type and breast density showed no difference among modalities. Conclusion Detection performance with 1v-DBT is not statistically inferior to 2v-DM or to 2v-DM+2v-DBT; its use as a stand-alone modality might be sufficient for readers experienced with this protocol. Key points • One-view breast tomosynthesis is not inferior to two-view digital mammography. • One-view DBT is not inferior to 2-view DM plus 2-view DBT. • Training may lead to 1v-DBT being sufficient for screening.
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Rodríguez-Ruiz A, Agasthya GA, Sechopoulos I. The compressed breast during mammography and breast tomosynthesis: in vivo shape characterization and modeling. Phys Med Biol 2017; 62:6920-6937. [PMID: 28665291 DOI: 10.1088/1361-6560/aa7cd0] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
To characterize and develop a patient-based 3D model of the compressed breast undergoing mammography and breast tomosynthesis. During this IRB-approved, HIPAA-compliant study, 50 women were recruited to undergo 3D breast surface imaging with structured light (SL) during breast compression, along with simultaneous acquisition of a tomosynthesis image. A pair of SL systems were used to acquire 3D surface images by projecting 24 different patterns onto the compressed breast and capturing their reflection off the breast surface in approximately 12-16 s. The 3D surface was characterized and modeled via principal component analysis. The resulting surface model was combined with a previously developed 2D model of projected compressed breast shapes to generate a full 3D model. Data from ten patients were discarded due to technical problems during image acquisition. The maximum breast thickness (found at the chest-wall) had an average value of 56 mm, and decreased 13% towards the nipple (breast tilt angle of 5.2°). The portion of the breast not in contact with the compression paddle or the support table extended on average 17 mm, 18% of the chest-wall to nipple distance. The outermost point along the breast surface lies below the midline of the total thickness. A complete 3D model of compressed breast shapes was created and implemented as a software application available for download, capable of generating new random realistic 3D shapes of breasts undergoing compression. Accurate characterization and modeling of the breast curvature and shape was achieved and will be used for various image processing and clinical tasks.
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Affiliation(s)
- Alejandro Rodríguez-Ruiz
- Department of Radiology and Nuclear Medicine, Radboud University Medical Centre, Geert Grooteplein 10, 6525 GA, Nijmegen, Netherlands
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Lee C, Baek J. Inverse filtering approach to measure directional in-plane modulation transfer function using a sphere phantom for a digital tomosynthesis system. OPTICS EXPRESS 2017; 25:17280-17293. [PMID: 28789221 DOI: 10.1364/oe.25.017280] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2017] [Accepted: 07/04/2017] [Indexed: 06/07/2023]
Abstract
We propose a method to measure the directional in-plane modulation transfer function (MTF) of a digital tomosynthesis system using a sphere phantom. To assess the spatial resolution of an in-plane image of the tomosynthesis system, projection data of a sphere phantom were generated within a limited data acquisition range of 40°, and reconstructed by the FDK algorithm. To measure the in-plane MTF, we divided the Fourier transform of the reconstructed sphere phantom by that of the ideal sphere phantom, and then performed plane integral along the fz-direction. When dividing, small values in the denominator can introduce estimation errors, and these errors were reduced by the proposed method. To evaluate the performance of the proposed method, the in-plane MTF estimated by simulation and experimental data was compared to the ideal in-plane MTF generated by computer simulations using a point object. For quantitative evaluation, we measured frequency values at half-maximum and full-maximum of the directional in-plane MTF along the three different directions (i.e., f0° -, f30° -, and f60° -directions) and compared them with those of the ideal in-plane MTF. Although the sphere phantom has been regarded as an inappropriate object due to the anisotropic characteristics of tomosynthesis image, our results show that the proposed method has a reliable estimation performance, demonstrating the sphere phantom is still suitable for measuring the directional in-plane MTF for a digital tomosynthesis system.
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Castillo-García M, Chevalier M, Garayoa J, Rodriguez-Ruiz A, García-Pinto D, Valverde J. Automated Breast Density Computation in Digital Mammography and Digital Breast Tomosynthesis: Influence on Mean Glandular Dose and BIRADS Density Categorization. Acad Radiol 2017; 24:802-810. [PMID: 28214227 DOI: 10.1016/j.acra.2017.01.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2016] [Revised: 12/16/2016] [Accepted: 01/08/2017] [Indexed: 12/20/2022]
Abstract
RATIONALE AND OBJECTIVES The study aimed to compare the breast density estimates from two algorithms on full-field digital mammography (FFDM) and digital breast tomosynthesis (DBT) and to analyze the clinical implications. MATERIALS AND METHODS We selected 561 FFDM and DBT examinations from patients without breast pathologies. Two versions of a commercial software (Quantra 2D and Quantra 3D) calculated the volumetric breast density automatically in FFDM and DBT, respectively. Other parameters such as area breast density and total breast volume were evaluated. We compared the results from both algorithms using the Mann-Whitney U non-parametric test and the Spearman's rank coefficient for data correlation analysis. Mean glandular dose (MGD) was calculated following the methodology proposed by Dance et al. RESULTS Measurements with both algorithms are well correlated (r ≥ 0.77). However, there are statistically significant differences between the medians (P < 0.05) of most parameters. The volumetric and area breast density median values from FFDM are, respectively, 8% and 77% higher than DBT estimations. Both algorithms classify 35% and 55% of breasts into BIRADS (Breast Imaging-Reporting and Data System) b and c categories, respectively. There are no significant differences between the MGD calculated using the breast density from each algorithm. DBT delivers higher MGD than FFDM, with a lower difference (5%) for breasts in the BIRADS d category. MGD is, on average, 6% higher than values obtained with the breast glandularity proposed by Dance et al. CONCLUSIONS Breast density measurements from both algorithms lead to equivalent BIRADS classification and MGD values, hence showing no difference in clinical outcomes. The median MGD values of FFDM and DBT examinations are similar for dense breasts (BIRADS d category).
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Mackenzie A, Marshall NW, Hadjipanteli A, Dance DR, Bosmans H, Young KC. Characterisation of noise and sharpness of images from four digital breast tomosynthesis systems for simulation of images for virtual clinical trials. Phys Med Biol 2017; 62:2376-2397. [PMID: 28151431 DOI: 10.1088/1361-6560/aa5dd9] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
In-depth evaluation of the noise and sharpness characteristics of FujiFilm Innovality, GE SenoClaire, Hologic Selenia Dimensions and Siemens Inspiration digital breast tomosynthesis (DBT) systems was performed with the intention of improving image simulation for virtual clinical trials. Noise power spectra (NPS) and modulation transfer function curves (MTF) were measured for planar modes and for the first and central projections for DBT modes. In DBT mode, the x-ray beam was blocked for the projections before the central projection in order to remove the influence of lag and ghosting from the previous images. A quadratic fit between the NPS and linearised pixel value gave the noise coefficients for planar and DBT imaging modes. The spatial frequencies corresponding to an MTF of 0.5 (MTF0.5) were calculated from the MTF measurements made on the breast support and at 40 mm above the breast support. This was done for the first and the central projections. The percentage of signal carried over from the first projection to subsequent images (lag) was measured using a slit. The noise associated with lag was also evaluated. The DBT modes typically had lower electronic noise coefficients but higher structural noise coefficients compared to the respective planar mode MTF0.5 measured 40 mm above the table was between 6% and 47% lower for continuous scanning systems compared to 1% lower for step and shoot systems. For wide angle DBT, the MTF0.5 of the first projection was 18% (FujiFilm) and 28% (Siemens) lower than for the central projection. Lag in the second projection was 2.2%, 0.3%, 0.8% for the FujiFilm, GE and Hologic systems respectively. In all cases, the noise associated with lag was negligible. Current modelling frameworks for virtual clinical trials of breast DBT systems need to be adapted to account for signals from lag and variations in the MTF at wide angles.
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Affiliation(s)
- Alistair Mackenzie
- National Coordinating Centre for the Physics of Mammography, Royal Surrey County Hospital, Guildford, Surrey GU2 7XX, United Kingdom
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Whelehan P, Heywang-Köbrunner S, Vinnicombe S, Hacker A, Jänsch A, Hapca A, Gray R, Jenkin M, Lowry K, Oeppen R, Reilly M, Stahnke M, Evans A. Clinical performance of Siemens digital breast tomosynthesis versus standard supplementary mammography for the assessment of screen-detected soft-tissue abnormalities: a multi-reader study. Clin Radiol 2017; 72:95.e9-95.e15. [DOI: 10.1016/j.crad.2016.08.011] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2016] [Revised: 08/18/2016] [Accepted: 08/31/2016] [Indexed: 11/25/2022]
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Maldera A, De Marco P, Colombo PE, Origgi D, Torresin A. Digital breast tomosynthesis: Dose and image quality assessment. Phys Med 2016; 33:56-67. [PMID: 28010921 DOI: 10.1016/j.ejmp.2016.12.004] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2016] [Revised: 10/31/2016] [Accepted: 12/04/2016] [Indexed: 12/01/2022] Open
Abstract
The aim of this work was to evaluate how different acquisition geometries and reconstruction parameters affect the performance of four digital breast tomosynthesis (DBT) systems (Senographe Essential - GE, Mammomat Inspiration - Siemens, Selenia Dimensions - Hologic and Amulet Innovality - Fujifilm) on the basis of a physical characterization. Average Glandular Dose (AGD) and image quality parameters such as in-plane/in-depth resolution, signal difference to noise ratio (SDNR) and artefact spread function (ASF) were examined. Measured AGD values resulted below EUREF limits for 2D imaging. A large variability was recorded among the investigated systems: the mean dose ratio DBT/2D ranged between 1.1 and 1.9. In-plane resolution was in the range: 2.2mm-1-3.8mm-1 in chest wall-nipple direction. A worse resolution was found for all devices in tube travel direction. In-depth resolution improved with increasing scan angle but was also affected by the choice of reconstruction and post-processing algorithms. The highest z-resolution was provided by Siemens (50°, FWHM=2.3mm) followed by GE (25°, FWHM=2.8mm), while the Fujifilm HR showed the lowest one, despite its wide scan angle (40°, FWHM=4.1mm). The ASF was dependent on scan angle: smaller range systems showed wider ASF curves; however a clear relationship was not found between scan angle and ASF, due to the different post processing and reconstruction algorithms. SDNR analysis, performed on Fujifilm system, demonstrated that pixel binning improves detectability for a fixed dose/projection. In conclusion, we provide a performance comparison among four DBT systems under a clinical acquisition mode.
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Affiliation(s)
- A Maldera
- Medical Physics Dept, ASST Grande Ospedale Metropolitano Niguarda, Piazza Ospedale Maggiore, 3, 20162 Milano, Italy; Post Graduate School of Medical Physics, Università degli Studi di Milano, Physics Dept, Via Celoria, 16, 20133 Milano, Italy.
| | - P De Marco
- Medical Physics Dept, Istituto Europeo di Oncologia, Via Ripamonti, 435, 20141 Milano, Italy; Post Graduate School of Medical Physics, Università degli Studi di Milano, Physics Dept, Via Celoria, 16, 20133 Milano, Italy
| | - P E Colombo
- Medical Physics Dept, ASST Grande Ospedale Metropolitano Niguarda, Piazza Ospedale Maggiore, 3, 20162 Milano, Italy
| | - D Origgi
- Medical Physics Dept, Istituto Europeo di Oncologia, Via Ripamonti, 435, 20141 Milano, Italy
| | - A Torresin
- Medical Physics Dept, ASST Grande Ospedale Metropolitano Niguarda, Piazza Ospedale Maggiore, 3, 20162 Milano, Italy
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