Monte Carlo generated mammograms: development and validation

Monte Carlo simulation of breast imaging using synchrotron radiation

PURPOSE

Synchrotron radiation (SR), being the brightest artificial source of x-rays with a very promising geometry, has raised the scientific expectations that it could be used for breast imaging with optimized results. The "in situ" evaluation of this technique is difficult to perform, mostly due to the limited available SR facilities worldwide. In this study, a simulation model for SR breast imaging was developed, based on Monte Carlo simulation techniques, and validated using data acquired in the SYRMEP beamline of the Elettra facility in Trieste, Italy. Furthermore, primary results concerning the performance of SR were derived.

METHODS

The developed model includes the exact setup of the SR beamline, considering that the x-ray source is located at almost 23 m from the slit, while the photon energy was considered to originate from a very narrow Gaussian spectrum. Breast phantoms, made of Perspex and filled with air cavities, were irradiated with energies in the range of 16-28 keV. The model included a Gd(2)O(2)S detector with the same characteristics as the one available in the SYRMEP beamline. Following the development and validation of the model, experiments were performed in order to evaluate the contrast resolution of SR. A phantom made of adipose tissue and filled with inhomogeneities of several compositions and sizes was designed and utilized to simulate the irradiation under conventional mammography and SR conditions.

RESULTS

The validation results of the model showed an excellent agreement with the experimental data, with the correlation for contrast being 0.996. Significant differences only appeared at the edges of the phantom, where phase effects occur. The initial evaluation experiments revealed that SR shows very good performance in terms of the image quality indices utilized, namely subject contrast and contrast to noise ratio. The response of subject contrast to energy is monotonic; however, this does not stand for contrast to noise ratio, since there is a range of optimal performance for SR (18-21 keV). In comparison to conventional mammography, SR shows improved subject contrast for energies lower than the mean energy of each spectrum.

CONCLUSIONS

The comparison of the results of the two models, conventional and SR, proved that SR exhibits better performance in the majority of cases. The proposed simulation model offers the possibility to perform exhaustive search to evaluate the performance of SR in clinical applications such as breast imaging.

Can electronic zoom replace magnification in mammography? A comparative Monte Carlo study

Magnification, which is considered to be a relatively high "dose cost" mammographic technique, is a complementary examination performed on women exhibiting breast complaints or abnormalities. Particular attention is given to the imaging procedure as the primary aim is to confirm the existence of suspected abnormalities, despite the additional dose. The introduction of post-processing capabilities and the widespread use of digital mammography promoted some controversy in the last decades on whether electronic zoom performed on the derived initial screening mammogram can effectively replace this technique. This study used Monte Carlo simulation methods to derive simulated screening mammograms produced under several exposure conditions, aiming to electronically magnify and compare them to the corresponding magnification mammograms. Comparison was based on quantitative measurements of image quality, namely contrast to noise ratio (CNR) and spatial resolution. Results demonstrated that CNR was higher for geometric magnification compared to the case of electronic zooming. The percentage difference was higher for lesions of smaller radius and achieved 29% for 0.10 mm details. Although spatial resolution is maintained high in the zoomed images, when investigating microcalcifications of 0.05 mm radius or less, only with geometric magnification can they be visualised.

Simulation of image detectors in radiology for determination of scatter-to-primary ratios using Monte Carlo radiation transport code MCNP/MCNPX

PURPOSE

The purpose of this study was to compare and validate three methods to simulate radiographic image detectors with the Monte Carlo software MCNP/MCNPX in a time efficient way.

METHODS

The first detector model was the standard semideterministic radiography tally, which has been used in previous image simulation studies. Next to the radiography tally two alternative stochastic detector models were developed: A perfect energy integrating detector and a detector based on the energy absorbed in the detector material. Validation of three image detector models was performed by comparing calculated scatter-to-primary ratios (SPRs) with the published and experimentally acquired SPR values.

RESULTS

For mammographic applications, SPRs computed with the radiography tally were up to 44% larger than the published results, while the SPRs computed with the perfect energy integrating detectors and the blur-free absorbed energy detector model were, on the average, 0.3% (ranging from -3% to 3%) and 0.4% (ranging from -5% to 5%) lower, respectively. For general radiography applications, the radiography tally overestimated the measured SPR by as much as 46%. The SPRs calculated with the perfect energy integrating detectors were, on the average, 4.7% (ranging from -5.3% to -4%) lower than the measured SPRs, whereas for the blur-free absorbed energy detector model, the calculated SPRs were, on the average, 1.3% (ranging from -0.1% to 2.4%) larger than the measured SPRs.

CONCLUSIONS

For mammographic applications, both the perfect energy integrating detector model and the blur-free energy absorbing detector model can be used to simulate image detectors, whereas for conventional x-ray imaging using higher energies, the blur-free energy absorbing detector model is the most appropriate image detector model. The radiography tally overestimates the scattered part and should therefore not be used to simulate radiographic image detectors.

Introducing DeBRa: a detailed breast model for radiological studies

Currently, x-ray mammography is the method of choice in breast cancer screening programmes. As the mammography technology moves from 2D imaging modalities to 3D, conventional computational phantoms do not have sufficient detail to support the studies of these advanced imaging systems. Studies of these 3D imaging systems call for a realistic and sophisticated computational model of the breast. DeBRa (Detailed Breast model for Radiological studies) is the most advanced, detailed, 3D computational model of the breast developed recently for breast imaging studies. A DeBRa phantom can be constructed to model a compressed breast, as in film/screen, digital mammography and digital breast tomosynthesis studies, or a non-compressed breast as in positron emission mammography and breast CT studies. Both the cranial-caudal and mediolateral oblique views can be modelled. The anatomical details inside the phantom include the lactiferous duct system, the Cooper ligaments and the pectoral muscle. The fibroglandular tissues are also modelled realistically. In addition, abnormalities such as microcalcifications, irregular tumours and spiculated tumours are inserted into the phantom. Existing sophisticated breast models require specialized simulation codes. Unlike its predecessors, DeBRa has elemental compositions and densities incorporated into its voxels including those of the explicitly modelled anatomical structures and the noise-like fibroglandular tissues. The voxel dimensions are specified as needed by any study and the microcalcifications are embedded into the voxels so that the microcalcification sizes are not limited by the voxel dimensions. Therefore, DeBRa works with general-purpose Monte Carlo codes. Furthermore, general-purpose Monte Carlo codes allow different types of imaging modalities and detector characteristics to be simulated with ease. DeBRa is a versatile and multipurpose model specifically designed for both x-ray and gamma-ray imaging studies.

Energy, angular and spatial distributions of primary electrons inside photoconducting materials for digital mammography: Monte Carlo simulation studies

Materials such as a-Se, a-As(2)Se(3), GaSe, GaAs, Ge, CdTe, CdZnTe, Cd(0.8)Zn(0.2)Te, ZnTe, PbO, TlBr, PbI(2) and HgI(2) are potential candidates as photoconductors in direct detectors for digital mammography. The x-ray induced primary electrons inside a photoconductor's bulk comprise the initial signal that propagates and forms the final signal (image) on the detector's electrodes. An already developed model for a-Se has been properly extended to simulate the primary electron production in the materials mentioned. Primary electron characteristics, such as their energy, angular and spatial distributions that strongly influence the characteristics of the final image, were studied for both monoenergetic and polyenergetic x-ray spectra in the mammographic energy range. The characteristic feature in the electron energy distributions for PbI(2) and HgI(2) is the atomic deexcitation peaks, whereas for the rest of the materials their shape can also be influenced by the electrons produced from primary photons. The electrons have a small tendency to be forward ejected whereas they prefer to be ejected perpendicular (theta = pi/2) to the incident beam's axis and at two lobes around phi = 0 and phi = pi. At practical mammographic energies (15-40 keV) a-Se, a-As(2)Se(3) and Ge have the minimum azimuthal uniformity whereas CdZnTe, Cd(0.8)Zn(0.2)Te and CdTe the maximum one. The spatial distributions for a-Se, a-As(2)Se(3), GaSe, GaAs, Ge, PbO and TlBr are almost independent of the polyenergetic spectrum, while those for CdTe, CdZnTe, Cd(0.8)Zn(0.2)Te, ZnTe, PbI(2) and HgI(2) have a spectrum dependence. In the practical mammographic energy range and at this primitive stage of primary electron production, a-Se has the best inherent spatial resolution as compared to the rest of the photoconductors. PbO has the minimum bulk space in which electrons can be produced whereas CdTe has the maximum one.

Contrast-to-noise ratio in magnification mammography: a Monte Carlo study

Magnification views are a common way to perform a secondary examination when suspicious abnormalities are found in a screening mammogram. The visibility of microcalcifications and breast lesions is restricted by the compromise between the image quality and the absorbed dose. In this study, image quality characteristics in magnification mammography were evaluated based on Monte Carlo techniques. A breast phantom was utilized, simulating a homogeneous mixture of adipose and glandular tissue in various percentages of glandularity, containing inhomogeneities of various sizes and compositions. The effect of the magnification degree, breast glandularity, tube voltage and anode/filter material combination on image quality characteristics was investigated in terms of a contrast-to-noise ratio (CNR). A performance index PI(nu) was introduced in order to study the overall performance of various anode/filter combinations under different exposure parameters. Results demonstrate that CNR is improved with the degree of magnification and degraded as the breast glandularity is increased. Degree of magnification 1.3 offers the best overall performance for most of the anode/filter combinations utilized. Under magnification conditions, the role of dose is demoted against the image quality, as magnification views are secondary, diagnostic examinations and not screening procedures oriented to non-symptomatic women. For decreased image quality weighting, some anode/filter combinations different from Mo/0.030 mmMo can be utilized as they offer a similar performance index. However, if the desired weighting for the image quality is high, the Mo/0.030 mmMo combination has the best overall performance.

Accelerating Monte Carlo image reconstruction of a PMMA phantom through variance reduction techniques for quality control in digital mammography

Mammography is a non-invasive technique used for the detection of breast lesions. The use of this technique in a breast screening program requires a continuous quality control testing in mammography units for ensuring a minimum absorbed glandular dose without modifying image quality. Digital mammography has been progressively introduced in screening centers, since recent evolution of photostimulable phosphor detectors. The aim of this work is the validation of a methodology for reconstructing digital images of a polymethyl-methacrylate (PMMA) phantom (P01 model) under pure Monte Carlo techniques. A reference image has been acquired for this phantom under automatic exposure control (AEC) mode (28 kV and 14 mAs). Some variance reduction techniques (VRT) have been applied to improve the efficiency of the simulations, defined as the number of particles reaching the imaging system per starting particle. All images have been used and stored in DICOM format. The results prove that the signal-to-noise ratio (SNR) of the reconstructed images have been increased with the use of the VRT, showing similar values between different employed tallies. As a conclusion, these images could be used during quality control testing for showing any deviation of the exposition parameters from the desired reference level.

Monte Carlo image reconstruction of a mammographic phantom

The aim of this study is the development of a methodology to reconstruct via Monte Carlo techniques the radiographic image of the CIRS 11 A (MAMMO PHANTOM SP01) phantom. This phantom is used in image quality assessment during quality control tests in breast screening locations and other health centers. The mammographic phantom is comprised of a reference point, a glandular tissue step wedge, contrast and resolution targets, and groups of microcalcifications and fibers. The MCNP radiation transport code (version 4c2) has been modified and recompiled to let use of a large number of tallies and detectors per input file, and an azimuthal directional source biasing. The output surface air kerma (OSAK) delivered by the X-rays has been scored employing a rectangular matrix of point detectors (F5 tally) under the phantom, simulating the image system. Some variance reduction techniques have been implemented to ensure that photons reach the detectors and that weight fluctuations were reduced. The characteristic curve of the film-scanner imaging system combination has been obtained throughout several experimental measures with an aluminium sensitometric wedge and Monte Carlo simulations. The reconstructed images agree with the range of values, indicating that this method would be suitable for training purposes, phantom designing or dose calculations.

Suitability of new anode materials in mammography: Dose and subject contrast considerations using Monte Carlo simulation

Mammography is the technique with the highest sensitivity and specificity, for the early detection of nonpalpable lesions associated with breast cancer. As screening mammography refers to asymptomatic women, the task of optimization between the image quality and the radiation dose is critical. A way toward optimization could be the introduction of new anode materials. A method for producing the x-ray spectra of different anode/filter combinations is proposed. The performance of several mammographic spectra, produced by both existing and theoretical anode materials, is evaluated, with respect to their dose and subject contrast characteristics, using a Monte Carlo simulation. The mammographic performance is evaluated utilizing a properly designed mathematical phantom with embedded inhomogeneities, irradiated with different spectra, based on combinations of conventional and new (Ru, Ag) anode materials, with several filters (Mo, Rh, Ru, Ag, Nb, Al). An earlier developed and validated Monte Carlo model, for deriving both image and dose characteristics in mammography, was utilized and overall performance results were derived in terms of subject contrast to dose ratio and squared subject contrast to dose ratio. Results demonstrate that soft spectra, mainly produced from Mo, Rh, and Ru anodes and filtered with k-edge filters, provide increased subject contrast for inhomogeneities of both small size, simulating microcalcifications and low density, simulating masses. The harder spectra (W and Ag anode) come short in the discrimination task but demonstrate improved performance when considering the dose delivered to the breast tissue. As far as the overall performance is concerned, new theoretical spectra demonstrate a noticeable good performance that is similar, and in some cases better compared to commonly used systems, stressing the possibility of introducing new materials in mammographic practice as a possible contribution to its optimization task. In the overall optimization task in terms of subject contrast to dose ratio, tube voltage was found to have a minor effect, while with respect to the filter material, a lesion specific performance was noticed, with Al filtered spectra showing improved characteristics in case of the inhomogeneities simulating microcalcifications, while softer k-edge filtered spectra are more suitable for the discrimination of inhomogeneities simulating masses.

Monte Carlo generated conversion factors for the estimation of average glandular dose in contact and magnification mammography

Magnification mammography is a special technique used in the cases where breast complaints are noted by a woman or when an abnormality is found in a screening mammogram. The carcinogenic risk in mammography is related to the dose deposited in the glandular tissue of the breast rather than the adipose, and average glandular dose (AGD) is the quantity taken into consideration during a mammographic examination. Direct measurement of the AGD is not feasible during clinical practice and thus, the incident air KERMA on the breast surface is used to estimate the glandular dose, with the help of proper conversion factors. Additional conversion factors adapted for magnification and tube voltage are calculated, using Monte Carlo simulation. The effect of magnification degree, tube voltage, various anode/filter material combinations and glandularity on AGD is also studied, considering partial breast irradiation. Results demonstrate that the estimation of AGD utilizing conversion factors depends on these parameters, while the omission of correction factors for magnification and tube voltage can lead to significant underestimation or overestimation of AGD. AGD was found to increase with filter material's k-absorption edge, anode material's k-emission edge, tube voltage and magnification. Decrease of the glandularity of the breast leads to higher AGD due to the increased penetrating ability of the photon beam in thick breasts with low glandularity.

DOSIS: a Monte Carlo simulation program for dose related studies in mammography

Dosimetric studies in mammography are addressed by means of a Monte Carlo simulation program. The core of this program (DOSIS: dosimetry simulation studies) is a simulation model developed using FORTRAN 90, enriched with a graphical user interface developed in MS Visual Basic. User defined mammographic technique parameters affecting breast dose are imported to the simulation model and the produced results are provided by means of both absolute (surface dose, exposure at detector plane) and relative quantities (percentage depth dose, isodose curves). The program functionality has been demonstrated in the evaluation of various mammographic examination techniques. Specifically, the influence of tube voltage and filtration on the surface dose and the exposure at detector plane has been studied utilizing a water phantom. Increase of tube voltage from 25 to 30 kVp for a Mo/Mo system resulted in a 42% decrease of the surface dose for a thick breast (6 cm), without changing the exposure at the detector plane. Use of 1.02 mm Al filter for a W anode system operating at 30 kVp resulted in a 19.1% decrease of the surface dose delivered to a 5 cm water equivalent breast. Overall, W/Al systems appear to have improved dosimetric performance, resulting up to a 65% decrease of surface dose compared to Mo/Mo systems, for identical exposures at the detector plane and breast thicknesses.

Monte Carlo simulation of primary electron production inside an a-selenium detector for x-ray mammography: physics

Selenium is among the materials under investigation that may form effective detectors and provide a major contribution to digital mammography. Till the final image formation, there is an intervention of the x-ray photons transformation to primary electrons and their subsequent ionizing drift towards the electrodes that collect them. The characteristics of the generated primary electrons inside a-Se material such as their angular, spatial and energy distribution affect the characteristics of the final image. A Monte Carlo based model has been developed that simulates the x-ray irradiation of an a-Se detector plate, including primary photon interactions (photoelectric absorption, coherent and incoherent scattering), as well as secondary ones, such as fluorescence (Kalpha, Kbeta) and emission of Auger electrons. The angular, spatial and energy distributions for the generated primary electrons inside a-Se have been produced for various mammographic x-ray spectra and their usefulness in designing and optimizing a detector made of a-Se for digital mammography is discussed.

Experimental validation of a rapid Monte Carlo based micro-CT simulator

We describe a newly developed, accelerated Monte Carlo simulator of a small animal micro-CT scanner. Transmission measurements using aluminium slabs are employed to estimate the spectrum of the x-ray source. The simulator incorporating this spectrum is validated with micro-CT scans of physical water phantoms of various diameters, some containing stainless steel and Teflon rods. Good agreement is found between simulated and real data: normalized error of simulated projections, as compared to the real ones, is typically smaller than 0.05. Also the reconstructions obtained from simulated and real data are found to be similar. Thereafter, effects of scatter are studied using a voxelized software phantom representing a rat body. It is shown that the scatter fraction can reach tens of per cents in specific areas of the body and therefore scatter can significantly affect quantitative accuracy in small animal CT imaging.

Accelerated simulation of cone beam X-ray scatter projections

Monte Carlo (MC) methods can accurately simulate scatter in X-ray imaging. However, when low noise scatter projections have to be simulated these MC simulations tend to be very time consuming. Rapid computation of scatter estimates is essential for several applications. The aim of the work presented in this paper is to speed up the estimation of noise-free scatter projections while maintaining their accuracy. Since X-ray scatter projections are often rather smooth, an approach is chosen whereby a short MC simulation is combined with a data fitting program that is robust to projection truncation and noise. This method allows us to estimate the smooth scatter projection rapidly. The speed-up and accuracy achieved by using the fitting algorithm were validated for the projection simulation of a small animal X-ray CT system. The acceleration that can be obtained over standard MC simulations is typically two orders of magnitude, depending on the accuracy required. The proposed approach may be useful for rapid simulation of patient and animal studies and for correction of the image-degrading effects of scatter in tomography.

Digital mammography image simulation using Monte Carlo

Monte Carlo simulations of digital images of the contrast detail phantom and the ACR phantom are presented for two different x-ray digital mammography modalities: a synchrotron mammography system and a next-generation scanning slot clinical system. A combination of variance reduction methods made it possible to simulate accurate images using real pixel dimensions within reasonable computation times. The complete method of image simulation, including a simple detector response model, a simple noise model, and the incorporation of system effects (MTF), is presented. The simulated images of the phantoms show good agreement with images measured on the two systems.