Three-dimensional linear system analysis for breast tomosynthesis

In-silico study of the impact of system design parameters on microcalcification detection in wide-angle digital breast tomosynthesis

Purpose

Accurate detection of microcalcifications ( μ Calcs ) is crucial for the early detection of breast cancer. Some clinical studies have indicated that digital breast tomosynthesis (DBT) systems with a wide angular range have inferior μ Calc detectability compared with those with a narrow angular range. This study aims to (1) provide guidance for optimizing wide-angle (WA) DBT for improving μ Calcs detectability and (2) prioritize key optimization factors.

Approach

An in-silico DBT pipeline was constructed to evaluate μ Calc detectability of a WA DBT system under various imaging conditions: focal spot motion (FSM), angular dose distribution (ADS), detector pixel pitch, and detector electronic noise (EN). Images were simulated using a digital anthropomorphic breast phantom inserted with 120   μ m μ Calc clusters. Evaluation metrics included the signal-to-noise ratio (SNR) of the filtered channel observer and the area under the receiver operator curve (AUC) of multiple-reader multiple-case analysis.

Results

Results showed that FSM degraded μ Calcs sharpness and decreased the SNR and AUC by 5.2% and 1.8%, respectively. Non-uniform ADS increased the SNR by 62.8% and the AUC by 10.2% for filtered backprojection reconstruction with a typical clinical filter setting. When EN decreased from 2000 to 200 electrons, the SNR and AUC increased by 21.6% and 5.0%, respectively. Decreasing the detector pixel pitch from 85 to 50    μ m improved the SNR and AUC by 55.6% and 7.5%, respectively. The combined improvement of a 50   μ m pixel pitch and EN200 was 89.2% in the SNR and 12.8% in the AUC.

Conclusions

Based on the magnitude of impact, the priority for enhancing μ Calc detectability in WA DBT is as follows: (1) utilizing detectors with a small pixel pitch and low EN level, (2) allocating a higher dose to central projections, and (3) reducing FSM. The results from this study can potentially provide guidance for DBT system optimization in the future.

Technical note: Characterization, validation, and spectral optimization of a dedicated breast CT system for contrast-enhanced imaging

BACKGROUND

The development of a new imaging modality, such as 4D dynamic contrast-enhanced dedicated breast CT (4D DCE-bCT), requires optimization of the acquisition technique, particularly within the 2D contrast-enhanced imaging modality. Given the extensive parameter space, cascade-systems analysis is commonly used for such optimization.

PURPOSE

To implement and validate a parallel-cascaded model for bCT, focusing on optimizing and characterizing system performance in the projection domain to enhance the quality of input data for image reconstruction.

METHODS

A parallel-cascaded system model of a state-of-the-art bCT system was developed and model predictions of the presampled modulation transfer function (MTF) and the normalized noise power spectrum (NNPS) were compared with empirical data collected in the projection domain. Validation was performed using the default settings of 49 kV with 1.5 mm aluminum filter and at 65 kV and 0.257 mm copper filter. A 10 mm aluminum plate was added to replicate the breast attenuation. Air kerma at the isocenter was measured at different tube current levels. Discrepancies between the measured projection domain metrics and model-predicted values were quantified using percentage error and coefficient of variation (CoV) for MTF and NNPS, respectively. The optimal filtration was for a 5 mm iodine disk detection task at 49, 55, 60, and 65 kV. The detectability index was calculated for the default aluminum filtration and for copper thicknesses ranging from 0.05 to 0.4 mm.

RESULTS

At 49 kV, MTF errors were +5.1% and -5.1% at 1 and 2 cycles/mm, respectively; NNPS CoV was 5.3% (min = 3.7%; max = 8.5%). At 65 kV, MTF errors were -0.8% and -3.2%; NNPS CoV was 13.1% (min = 11.4%; max = 16.9%). Air kerma output was linear, with 11.67 µGy/mA (R2 = 0.993) and 19.14 µGy/mA (R2 = 0.996) at 49 and 65 kV, respectively. For iodine detection, a 0.25 mm-thick copper filter at 65 kV was found optimal, outperforming the default technique by 90%.

CONCLUSION

The model accurately predicts bCT system performance, specifically in the projection domain, under varied imaging conditions, potentially contributing to the enhancement of 2D contrast-enhanced imaging in 4D DCE-bCT.

Full 3-D modulation transfer function estimation of tomosynthesis system using modified Richardson-Lucy deconvolution

BACKGROUND

Tomosynthesis systems are three-dimensional (3-D) medical imaging devices that operate over limited acquisition angles using low radiation dosages. To measure the spatial resolution performance of a tomosynthesis system, the modulation transfer function (MTF) is widely used as a quantitative evaluation metric.

PURPOSE

We previously introduced a method to estimate the full 3-D MTF of a cone-beam computed tomography system using two-dimensional (2-D) Richardson-Lucy (RL) deconvolution with Tikhonov-Miller regularization. However, this method can not be applied directly to estimate the 3-D MTF of a tomosynthesis system, since the unique artifacts (i.e., shadow artifacts, spreading tails, directional blurring, and high-level noise) of the system produce several errors that lower the estimation performance. Varying positions of the negative pixels due to shadow artifacts and spreading tails cause inconsistent deconvolution performances at each of the directional projections, and the severe noise in the reconstructed images cause noise amplification during estimation. This work proposes several modifications to the previous method to resolve the inconsistent performance and noise amplification errors to increase the full 3-D MTF estimation accuracy.

METHODS

Three modifications were introduced to the 2-D RL deconvolution to prevent estimation errors and improve MTF estimation performance: non-negativity relaxation function, cost function to terminate the iterative process of RL deconvolution, and regularization strength for noise control. To validate the effectiveness of the proposed modifications, we reconstructed sphere phantoms from simulation and experimental tomosynthesis studies in the iso-center and offset-center positions as well as estimated the full 3-D MTFs using the previous and proposed methods. We compared the 3-D render images, central plane images, and center profiles of the estimated 3-D MTFs and calculated the full widths at half and tenth maximum for quantitative evaluation.

RESULTS

The previous method cannot estimate the full 3-D MTF of a tomosynthesis system; its inaccurate negative pixel relaxation produces circular-shaped errors, and the mean squared error based simple cost function for termination causes inconsistent estimation at each directional projection to diminish the clear edges of the low-frequency drop and missing sample regions. Noise amplification from lack of noise regularization is also seen in the previous method results. Compared to the previous method, the proposed method shows superior estimation performance at reducing errors in both the simulation and experimental studies regardless of object position. The proposed method preserves the low-frequency drop, missing sample regions from the limited acquisition angles, and missing cone region from the offset-center position; the estimated MTFs also show FWHM and FWTM values close to those of the ideal MTFs than with the previous method.

CONCLUSIONS

This work presents a method to estimate the full 3-D MTF of a tomosynthesis system. The proposed modifications prevent circular-shaped errors and noise amplification due to the geometry for limited acquisition angles and high noise levels. Compared to our previous method, the proposed scheme show better performance for estimating the 3-D MTF of the tomosynthesis system.

Typical values of z-resolution for different Digital Breast Tomosynthesis systems evaluated in a multicenter study

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.

Task-based detectability in anatomical background in digital mammography, digital breast tomosynthesis and synthetic mammography

Objective.Determining the detectability of targets for the different imaging modalities in mammography in the presence of anatomical background noise is challenging. This work proposes a method to compare the image quality and detectability of targets in digital mammography (DM), digital breast tomosynthesis (DBT) and synthetic mammography.Approach. The low-frequency structured noise produced by a water phantom with acrylic spheres was used to simulate anatomical background noise for the different types of images. A method was developed to apply the non-prewhitening observer model with eye filter (NPWE) in these conditions. A homogeneous poly(methyl) methacrylate phantom with a 0.2 mm thick aluminium disc was used to calculate 2D in-plane modulation transfer function (MTF), noise power spectrum (NPS), noise equivalent quanta, and system detective quantum efficiency for 30, 50 and 70 mm thicknesses. The in-depth MTFs of DBT volumes were determined using a thin tungsten wire. The MTF, system NPS and anatomical NPS were used in the NPWE model to calculate the threshold gold thickness of the gold discs contained in the CDMAM phantom, which was taken as reference. Main results.The correspondence between the NPWE model and the CDMAM phantom (linear Pearson correlation 0.980) yielded a threshold detectability index that was used to determine the threshold diameter of spherical microcalcifications and masses. DBT imaging improved the detection of masses, which depended mostly on the reduction of anatomical background noise. Conversely, DM images yielded the best detection of microcalcifications.Significance.The method presented in this study was able to quantify image quality and object detectability for the different imaging modalities and levels of anatomical background noise.

Quality control for digital tomosynthesis in the ECOG-ACRIN EA1151 TMIST trial

BACKGROUND

The Tomosynthesis Mammography Imaging Screening Trial (TMIST), EA1151 conducted by the Eastern Cooperative Oncology Group (ECOG)/American College of Radiology Imaging Network (ACRIN) is a randomized clinical trial designed to assess the effectiveness for breast cancer screening of digital breast tomosynthesis (TM) compared to digital mammography (DM). Equipment from multiple vendors is being used in the study.

PURPOSE

For the findings of the study to be valid and capture the true capacities of the two technology types, it is important that all equipment is operated within appropriate parameters with regard to image quality and dose. A harmonized QC program was established by a core physics team. Since there are over 120 trial sites, a centralized, automated QC program was chosen as the most practical design. This report presents results of the weekly QC testing program. A companion paper will review quality monitoring based on data from the headers of the patient images.

METHODS

Study images are collected centrally after de-identification using the "TRIAD" application developed by ACR. The core physics team devised and implemented a minimal set of quality control (QC) tests to evaluate the tomosynthesis and 2D mammography systems. Weekly, monthly and annual testing is performed by the site mammography technologists with images submitted directly to the physics core. The weekly physics QC tests are described: SDNR of a low-contrast mass object, artifact spread, spatial resolution, tracking of technical factors, and in-slice noise power spectra.

RESULTS

As of December 31, 2022 (5 years), 145 sites with 411 machines had submitted QC data. A total of 136 742 TMIST participant screening imaging studies had been performed. The 5th and 95th percentile mean glandular doses for a single tomosynthesis exposure to a 4.0 cm thick PMMA phantom ("standard breast phantom") were 1.24 and 1.68 mGy respectively. The largest sources of QC non-conformance were: operator error, not following the QC protocol exactly, unreported software updates and preventive maintenance activities that affected QC setpoints. Noise power spectra were measured, however, standardization of performance targets across machine types and software revisions was difficult. Nevertheless, for each machine type, test measurement results were very consistent when the protocol was followed. Deviations in test results were mostly related to software and hardware changes.

CONCLUSION

Most systems performed very consistently. Although this is a harmonized program using identical phantoms and testing protocols, it is not appropriate to apply universal threshold or target metrics across the machine types because the systems have different non-linear reconstruction algorithms and image display filters. It was found to be more useful to assess pass/fail criteria in terms of relative deviations from baseline values established when a system is first characterized and after equipment is changed. Generally, systems which needed repair failed suddenly, but in retrospect, for a few cases, drops in SDNR and increases in mAs were observed prior to tube failure. TMIST is registered as NCT03233191 by Clinicaltrials.gov.

Convolutional neural network-based model observer for signal known statistically task in breast tomosynthesis images

BACKGROUND

Since human observer studies are resource-intensive, mathematical model observers are frequently used to assess task-based image quality. The most common implementation of these model observers assume that the signal information is exactly known. However, these tasks cannot thoroughly represent situations where the signal information is not exactly known in terms of size and shape.

PURPOSE

Considering the limitations of the tasks for which signal information is exactly known, we proposed a convolutional neural network (CNN)-based model observer for signal known statistically (SKS) and background known statistically (BKS) detection tasks in breast tomosynthesis images.

METHODS

A wide parameter search was conducted from six different acquisition angles (i.e., 10°, 20°, 30°, 40°, 50°, and 60°) within the same dose level (i.e., 2.3 mGy) under two separate acquisition schemes: (1) constant total number of projections, and (2) constant angular separation between projections. Two different types of signals: spherical (i.e., SKE tasks) and spiculated (i.e., SKS tasks) were used. The detection performance of the CNN-based model observer was compared with that of the Hotelling observer (HO) instead of the IO. Pixel-wise gradient-weighted class activation mapping (pGrad-CAM) map was extracted from each reconstructed tomosynthesis image to provide an intuitive understanding of the trained CNN-based model observer.

RESULTS

The CNN-based model observer achieved a higher detection performance compared to that of the HO for all tasks. Moreover, the improvement in its detection performance was greater for SKS tasks compared to that for SKE tasks. These results demonstrated that the addition of nonlinearity improved the detection performance owing to the variation of the background and signal. Interestingly, the pGrad-CAM results effectively localized the class-specific discriminative region, further supporting the quantitative evaluation results of the CNN-based model observer. In addition, we verified that the CNN-based model observer required fewer images to achieve the detection performance of the HO.

CONCLUSIONS

In this work, we proposed a CNN-based model observer for SKS and BKS detection tasks in breast tomosynthesis images. Throughout the study, we demonstrated that the detection performance of the proposed CNN-based model observer was superior to that of the HO.

Xenon-enhanced dual-energy tomosynthesis for functional imaging of respiratory disease-Concept and phantom study

BACKGROUND

Xenon-enhanced dual-energy (DE) computed tomography (CT) and hyperpolarized noble-gas magnetic resonance imaging (MRI) provide maps of lung ventilation that can be used to detect chronic obstructive pulmonary disease (COPD) early in its development and predict respiratory exacerbations. However, xenon-enhanced DE-CT requires high radiation doses and hyper-polarized noble-gas MRI is expensive and only available at a handful of institutions globally.

PURPOSE

To present xenon-enhanced dual-energy tomosynthesis (XeDET) for low-dose, low-cost functional imaging of respiratory disease in an experimental phantom study.

METHODS

We propose using digital tomosynthesis to produce Xe-enhanced low-energy (LE) and high-energy (HE) coronal images. DE subtraction of the LE and HE images is used to suppress soft tissues. We used an imaging phantom to investigate image quality in terms of the area under the reciever operating characteristic curve (AUC) for the Non-PreWhitening model observer with an Eye filter and internal noise (NPWEi). The phantom simulated anatomic clutter due to lung parenchyma and attenuation due to soft tissue and lung tissue. Aluminum slats were used to simulate rib structures. A stepwedge consisting of an acrylic casing with sealed cylindrical air-filled cavities was used to simulate ventilation defects with step thicknesses of 0.5, 1, and 2 cm and cylindrical radii of 0.5, 0.75, and 1 cm. The phantom was ventilated with Xe and projection data were acquired using a flat-panel detector, a tube-voltage combination of 60/140 kV with 1.2  mm of copper filtration on the HE spectrum and an angular range of ± 15 ∘ $\pm 15^{\circ}$ in 1° increments. The AUC of a NPWEi observer that has access only to a single coronal slice was calculated from measurements of the three-dimensional noise power spectrum and signal template. The AUC was calculated as a function of ventilation defect thickness and radius for total patient entrance air kermas ranging from 1.42 to 2.84 mGy with and without rib-simulating Al slats. For the AUC analysis, the observer internal noise level was obtained from an ad hoc calibration to a high-dose data set.

RESULTS

XeDET was able to suppress parenchyma-simulating clutter in coronal images enabling visualization of the simulated ventilation defects, but the limited angle acquisition resulted in residual clutter due to out-of-plane bone-mimmicking structures. The signal power of the defects increased linearly with defect radius and showed a ten-fold to fifteen-fold increase in signal power when the defect thickness increased from 0.5 to 2 cm. These trends agreed with theoretical predictions. Along the depth dimension, the power of the defects decreased exponentially with distance from the center of the defects with full-width half maxima that varied from 1.85 to 2.85 cm depending on the defect thickness and radius. The AUCs of the 1-cm-radius defect that was 2 cm in thickness ranged from good (0.8-0.9) to excellent (0.9-1.0) over the range of air kermas considered.

CONCLUSIONS

Xenon-enhanced DE tomosynthesis has the potential to enable functional imaging of respiratory disease and should be further investigated as a low-cost alternative to MRI-based approaches and a low-dose alternative to CT-based approaches.

Image quality models for 2D and 3D x-ray imaging systems: A perspective vignette

Image quality models based on cascaded systems analysis and task-based imaging performance were an important aspect of the emergence of 2D and 3D digital x-ray systems over the last 25 years. This perspective vignette offers cursory review of such developments and personal insights that may not be obvious within previously published scientific literature. The vignette traces such models to the mid-1990s, when flat-panel x-ray detectors were emerging as a new base technology for digital radiography and benefited from the rigorous, objective characterization of imaging performance gained from such models. The connection of models for spatial resolution and noise to spatial-frequency-dependent descriptors of imaging task provided a useful framework for system optimization that helped to accelerate the development of new technologies to first clinical use. Extension of the models to new technologies and applications is also described, including dual-energy imaging, photon-counting detectors, phase contrast imaging, tomosynthesis, cone-beam CT, 3D image reconstruction, and image registration.

Performance evaluation of digital breast tomosynthesis systems: physical methods and experimental data

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.

Achieving Isotropic Super-Resolution with a Non-Isocentric Acquisition Geometry in a Next-Generation Tomosynthesis System

We have constructed a prototype next-generation tomosynthesis (NGT) system that supports a non-isocentric acquisition geometry for digital breast tomosynthesis (DBT). In this geometry, the detector gradually descends in the superior-to-inferior direction. The aim of this work is to demonstrate that this geometry offers isotropic super-resolution (SR), unlike clinical DBT systems which are characterized by anisotropies in SR. To this end, a theoretical model of a sinusoidal test object was developed with frequency exceeding the alias frequency of the detector. We simulated two geometries: (1) a conventional geometry with a stationary detector, and (2) a non-isocentric geometry. The input frequency was varied over the full 360° range of angles in the plane of the object. To investigate whether SR was achieved, we calculated the Fourier transform of the reconstruction. The amplitude of the tallest peak below the alias frequency was measured relative to the peak at the input frequency. This ratio (termed the r-factor) should approach zero to achieve high-quality SR. In the conventional geometry, the r-factor was minimized (approaching zero) if the orientation of the frequency was parallel with the source motion, yet exceeded unity (prohibiting SR) in the orientation perpendicular to the source motion. However, in the non-isocentric geometry, the r-factor was minimized (approaching zero) for all orientations of the frequency, meaning SR was achieved isotropically. In summary, isotropic SR in DBT can be achieved using the non-isocentric acquisition geometry supported by the NGT system.

Endorectal digital prostate tomosynthesis (endoDPT): a proof-of-concept study

In this study we present endorectal digital prostate tomosynthesis (endoDPT), a proposed method of high resolution prostate imaging using an endorectal x-ray sensor and an external x-ray source. endoDPT may be useful for visualizing the fine detail of small structures such as low dose rate brachytherapy (LDRBT) seeds that are difficult to visualize with current methods. The resolution of endoDPT was characterized through measurement of the modulation transfer function (MTF) and artifact spread function (ASF) in computational and physical phantoms. The qualitative resolution of endoDPT was assessed relative to computed tomography (CT) through imaging of LDRBT seeds implanted inex vivocanine prostates. The x-ray sensor MTF reached 10% at 11.50 mm^-1, the reconstruction algorithm MTF reached a maximum at 7.08 mm^-1, and the ASF was 2.5 mm (full-width at half-maximum). Fine structures in LDRBT seeds like the 0.05 mm thick shell were visible with endoDPT but not CT. All endoDPT images exhibited an overshoot artifact. The measured MTFs were consistent with other studies using similar x-ray sensors and demonstrated improved resolution compared to digital breast tomosynthesis; this result was due to the smaller endoDPT x-ray sensor detection element size and quantitatively demonstrates the high resolution of endoDPT. The ASF demonstrated worse depth resolution compared to in-plane resolution, due to partial angular sampling; partial angular sampling also caused the observed overshoot artifact in the endoDPT images. However, endoDPT still was able to visualize fine structures such as the LDRBT seed shell to a much higher degree than CT. This high-resolution visualization may be useful for improvements in patient specific LDRBT dosimetry. Overall, these results indicate endoDPT is capable of high in-plane spatial resolution and is thus well poised for optimization and studies assessing clinical utility.

In-plane image quality and NPWE detectability index in digital breast tomosynthesis

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 (DQE_sys) 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), DQE_sys 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.

Human observer performance on in-plane digital breast tomosynthesis images: Effects of reconstruction filters and data acquisition angles on signal detection

For digital breast tomosynthesis (DBT) systems, we investigate the effects of the reconstruction filters for different data acquisition angles on signal detection. We simulated a breast phantom with a 30% volume glandular fraction (VGF) of breast anatomy using the power law spectrum and modeled the breast mass as a spherical object with a 1 mm diameter. Projection data were acquired using two different data acquisition angles and numbers of projection view pairs, and in-plane breast images were reconstructed using the Feldkamp-Davis-Kress (FDK) algorithm with three different reconstruction filter schemes. To measure the ability to detect a signal, we conducted the human observer study with a binary detection task and compared the signal detectability of human to that of channelized Hotelling observer (CHO) with Laguerre-Gauss (LG) channels and dense difference-of-Gaussian (D-DOG) channels. We also measured the contrast-to-noise ratio (CNR), signal power spectrum (SPS), and β values of the anatomical noise power spectrum (NPS) to show the association between human observer performance and these traditional metrics. Our results show that using a slice thickness (ST) filter degraded the signal detection performance of human observers at the same data acquisition angle. This could be predicted by D-DOG CHO with internal noise, but the correlation between the traditional metrics and signal detectability was not observed in this work.

Proposing Rapid Source Pulsing for Improved Super-Resolution in Digital Breast Tomosynthesis

Our previous work showed that digital breast tomosynthesis (DBT) systems are capable of super-resolution, or subpixel resolution relative to the detector. Using a bar pattern phantom, it is possible to demonstrate that there are anisotropies in super-resolution throughout the reconstruction. These anisotropies are lessened in acquisition geometries with narrow spacing between source positions. This paper demonstrates that by re-arranging the source positions in the scan, the anisotropies can be minimized even further. To this end, a theoretical model of the reconstruction of a high-frequency sinusoidal test object was developed from first principles. We modeled the effect of clustering additional source positions around each conventional source position in fine increments (submillimeter). This design can be implemented by rapidly pulsing the source during a continuous sweep of the x-ray tube. It is shown that it is not possible to eliminate the anisotropies in a conventional DBT system with uniformly-spaced source positions, even if the increments of spacing are narrower than those used clinically. However, super-resolution can be achieved everywhere if the source positions are re-arranged in clusters with submillimeter spacing. Our previous work investigated a different approach for optimizing super-resolution through the use of detector motion perpendicular to the breast support. The advantage of introducing rapid source pulsing is that detector motion is no longer required; this mitigates the need for a thick detector housing, which may be cumbersome for patient positioning.

Initial Clinical Experience with Stationary Digital Breast Tomosynthesis

RATIONALE AND OBJECTIVES

A linear array of carbon nanotube-enabled x-ray sources allows for stationary digital breast tomosynthesis (sDBT), during which projection views are collected without the need to move the x-ray tube. This work presents our initial clinical experience with a first-generation sDBT device.

MATERIALS AND METHODS

Following informed consent, women with a "suspicious abnormality" (Breast Imaging Reporting and Data System 4), discovered by digital mammography and awaiting biopsy, were also imaged by the first generation sDBT. Four radiologists participated in this paired-image study, completing questionnaires while interpreting the mammograms and sDBT image stacks. Areas under the receiver operating characteristic curve were used to measure reader performance (likelihood of correctly identifying malignancy based on pathology as ground truth), while a multivariate analysis assessed preference, as readers compared one modality to the next when interpreting diagnostically important image features.

RESULTS

Findings from 43 women were available for analysis, in whom 12 cases of malignancy were identified by pathology. The mean areas under the receiver operating characteristic curve was significantly higher (p < 0.05) for sDBT than mammography for all breast density categories and breast thicknesses. Additionally, readers preferred sDBT over mammography when evaluating mass margins and shape, architectural distortion, and asymmetry, but preferred mammography when characterizing microcalcifications.

CONCLUSION

Readers preferred sDBT over mammography when interpreting soft-tissue breast features and were diagnostically more accurate using images generated by sDBT in a Breast Imaging Reporting and Data System 4 population. However, the findings also demonstrated the need to improve microcalcification conspicuity, which is guiding both technological and image-processing design changes in future sDBT devices.

Nonstationary model of oblique x-ray incidence in amorphous selenium detectors: II. Transfer functions

PURPOSE

One limitation of experimental techniques for quantifying resolution and noise in detectors is that the measurement is made in a region-of-interest (ROI). With theoretical modeling, these properties can be measured at a point, allowing for quantification of spatial anisotropy. This paper calculates nonstationary transfer functions for amorphous selenium (a-Se) detectors in breast imaging. We use this model to demonstrate the performance advantage of a "next-generation" tomosynthesis (NGT) system, which is capable of x-ray source motion with more degrees of freedom than a clinical tomosynthesis system.

METHODS

Using Swank's formulation, the optical transfer function (OTF) and presampled noise power spectra (NPS) are determined based on the point spread function derived in Part 1. The modulation transfer function (MTF) is found from the normalized modulus of the OTF. To take into account the presence of digitization, the presampled NPS is convolved with a two-dimensional comb function, for which the period along each direction is the reciprocal of the detector element size. The detective quantum efficiency (DQE) is then determined from combined knowledge of the OTF and NPS.

RESULTS

First, the model is used to demonstrate the loss of image quality due to oblique x-ray incidence. The MTF is calculated along various polar angles, corresponding to different orientations of the input frequency. The MTF is independent of the incidence angle if the polar angle is perpendicular to the ray incidence direction. However, along other polar angles, oblique incidence results in MTF degradation at high frequencies. The MTF degradation is most substantial along the ray incidence direction. Unlike the MTF, the normalized NPS (NNPS) is independent of the incidence angle. To measure the relative signal-to-noise, the DQE is also calculated. Oblique incidence yields high-frequency DQE degradation, which is more pronounced than the MTF degradation. This arises because the DQE is proportionate with the square of the MTF. Ultimately, this model is used to evaluate how the image quality varies over the detector area. For various projection images, we calculate the variation in the incidence angle over this area. With the NGT system, the source can be positioned in such a way that this variation is minimized, and hence the DQE exhibits less anisotropy. To achieve this improvement in the image quality, the source needs to have a component of motion in the posteroanterior (PA) direction, which is perpendicular to the conventional direction of source motion in tomosynthesis.

CONCLUSIONS

In a-Se detectors, the DQE at high frequencies is degraded due to oblique incidence. The DQE degradation is more pronounced than the MTF degradation. This model is used to quantify the spatial variation in DQE over the detector area. The use of PA source motion is a strategy for minimizing this variation and thus improving the image quality.

Non-stationary model of oblique x-ray incidence in amorphous selenium detectors: I. Point spread function

PURPOSE

In previous work, a theoretical model of the point spread function (PSF) for oblique x-ray incidence in amorphous selenium (a-Se) detectors was proposed. The purpose of this paper is to develop a complementary model that includes two additional features. First, the incidence angle and the directionality of ray incidence are calculated at each position, assuming a divergent x-ray beam geometry. This approach allows the non-stationarity of the PSF to be modeled. Second, this paper develops a framework that is applicable to a digital system, unlike previous work which did not model the presence of a thin-film transistor (TFT) array.

METHODS

At each point on the detector, the incidence angle and the ray incidence direction are determined using ray tracing. Based on these calculations, an existing model for the PSF of the x-ray converter (Med Phys. 1995;22:365-374) is generalized to a non-stationary model. The PSF is convolved with the product of two rectangle functions, which model the sampling of the TFT array. The rectangle functions match the detector element (del) size in two dimensions.

RESULTS

It is shown that the PSF can be calculated in closed form. This solution is used to simulate a digital mammography (DM) system at two x-ray energies (20 and 40 keV). Based on the divergence of the x-ray beam, the direction of ray incidence varies with position. Along this direction, the PSF is broader than the reference rect function matching the del size. The broadening is more pronounced with increasing obliquity. At high energy, the PSF deviates more strongly from the reference rect function, indicating that there is more blurring. In addition, the PSF is calculated along the polar angle perpendicular to the ray incidence direction. For this polar angle, the shape of the PSF is dependent upon whether the ray incidence direction is parallel with the sides of the detector. If the ray incidence direction is parallel with either dimension, the PSF is a perfect rectangle function, matching the del size. However, if the ray incidence direction is at an oblique angle relative to the sides of the detector, the PSF is not rectangular. These results illustrate the non-stationarity of the PSF.

CONCLUSIONS

This paper demonstrates that an existing model of the PSF of a-Se detectors can be generalized to include the effects of non-stationarity and digitization. The PSF is determined in closed form. This solution offers the advantage of shorter computation time relative to approaches that use numerical methods. This model is a tool for simulating a-Se detectors in future work, such as in virtual clinical trials with computational phantoms.

PHYSICAL CHARACTERISATION OF FOUR DIFFERENT COMMERCIAL DIGITAL BREAST TOMOSYNTHESIS SYSTEMS

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.

Cascaded systems analysis of shift-variant image quality in slit-scanning breast tomosynthesis

PURPOSE

Digital breast tomosynthesis (DBT) is becoming an important part of breast cancer screening and diagnosis. Compared to two-dimensional mammography, tomosynthesis introduces limited three-dimensional (3D) resolution, but maintains high in-plane resolution, low dose, and allows for similar clinical protocols. The scanning motion and oblique projections of tomosynthesis acquisitions introduce shift-variance to the image quality, in addition to effects such as source blurring and geometric magnification. Shift-variant detector response caused by oblique incidence has been extensively studied previously and is most easily mitigated by letting the source and detector move in sync. In addition, conical reconstruction grids, that is, a grid aligned with the central tomosynthesis projection, have been proposed to compensate for magnification effects. This paper introduces a shift-variant cascaded systems model for tomosynthesis and validates it against measurements. As an example, the model was used to investigate the shift-variance of a tomosynthesis system.

METHODS

The shift-variant cascaded systems model was validated on a slit-scanning photon-counting DBT system, with synchronous source-detector movement, using simple back-projection in a conical reconstruction volume. The modulation transfer function (MTF), normalized noise-power spectrum (NNPS), and detective quantum efficiency (DQE) were used as figures of merit. Simulations were performed for single points while measurements were done over a finite volume, assuming local shift invariance. To investigate the full extent of shift-variance, 80 locations across the volume were simulated, and the MTF and DQE at 2.5 lp/mm were calculated as a function of position.

RESULTS

The simulated metrics generally agreed well with their corresponding measurements. The frequency at 50% MTF along the scan direction showed a relatively small variation, ranging from 2.1 to 2.4 lp/mm for the different locations. The frequency at 50% MTF along the chest-mammilla direction showed a larger variation, ranging from 2.9 to 3.8 lp/mm. All points exhibited a similarly shaped NNPS but the noise magnitude varied with slice height. The zero-frequency DQE in reconstructed slices was lower than that of the projections, an effect likely caused by noise-aliasing increasing the zero-frequency noise.

CONCLUSIONS

A shift-variant cascaded systems model has been developed for slit-scanning tomosynthesis using simple back-projection. The model was successfully validated against measurements. Even though the study was performed on a slit-scanning system, several parts of the framework can be applied and extended to other tomosynthesis geometries. The conical reconstruction grid has low variation in image quality in the scan direction where the 3D information is acquired, but source and geometric magnification still dominate in the slit direction, causing a larger variation in image quality. We conclude that image quality is close to shift-invariant in the scan direction, but not in the height and chest-mammilla directions, and we recommend that small measurement volumes are used when measuring image quality in these directions to minimize the effects of shift variance.

Physics considerations in MV-CBCT multi-layer imager design

Megavoltage (MV) cone-beam computed tomography (CBCT) using an electronic portal imaging (EPID) offers advantageous features, including 3D mapping, treatment beam registration, high-z artifact suppression, and direct radiation dose calculation. Adoption has been slowed by image quality limitations and concerns about imaging dose. Developments in imager design, including pixelated scintillators, structured phosphors, inexpensive scintillation materials, and multi-layer imager (MLI) architecture have been explored to improve EPID image quality and reduce imaging dose. The present study employs a hybrid Monte Carlo and linear systems model to determine the effect of detector design elements, such as multi-layer architecture and scintillation materials. We follow metrics of image quality including modulation transfer function (MTF) and noise power spectrum (NPS) from projection images to 3D reconstructions to in-plane slices and apply a task based figure-of-merit, the ideal observer signal-to-noise ratio (d') to determine the effect of detector design on object detectability. Generally, detectability was limited by detector noise performance. Deploying an MLI imager with a single scintillation material for all layers yields improvement in noise performance and d' linear with the number of layers. In general, improving x-ray absorption using thicker scintillators results in improved DQE(0). However, if light yield is low, performance will be affected by electronic noise at relatively high doses, resulting in rapid image quality degradation. Maximizing image quality in a heterogenous MLI detector (i.e. multiple different scintillation materials) is most affected by limiting total noise. However, while a second-order effect, maximizing total spatial resolution of the MLI detector is a balance between the intensity contribution of each layer against its individual MTF. So, while a thinner scintillator may yield a maximal individual-layer MTF, its quantum efficiency will be relatively low in comparison to a thicker scintillator and thus, intensity contribution may be insufficient to noticeably improve the total detector MTF.

Initial evaluation of image performance of a 3-D x-ray system: phantom-based comparison of 3-D tomography with conventional computed tomography

Phantom-based initial performance assessment of a prototype three-dimensional (3-D) x-ray system and comparison of 3-D tomography with computed tomography (CT) were proposed. A 3-D image quality phantom was scanned with a prototype version of 3-D cone-beam CT imaging implemented on a twin robotic x-ray system using three trajectories (163 deg = table, 188 deg = upright, and 200 deg = side), six tube voltages (60, 70, 81, 90, 100, and 121 kV), and four detector doses (0.348, 0.696, 1.740, and [Formula: see text]). CT was obtained with a clinical protocol. Spatial resolution (line pairs/cm) and soft-tissue-contrast resolution were assessed by two independent readers. Radiation dose was assessed. Descriptive and analysis of variance (ANOVA) ([Formula: see text]) were performed. With 3-D tomography, a maximum of 16 lp/cm was visible and best soft-tissue-contrast resolution was 2 mm at 30 Hounsfield units (HU) for 160 projections. With CT, 10 lp/cm was visible and soft-tissue-contrast resolution was 4 mm at 20 HU. The upright trajectory yielded significantly better spatial resolution and soft tissue contrast, and the side trajectory yielded significantly higher soft tissue contrast than the table trajectory ([Formula: see text]). Radiation dose was higher in 3-D tomography (45 to 704 mGycm) than CT (44 mGycm). Three-dimensional tomography renders overall equal or higher spatial resolution and comparable soft tissue contrast to CT for medium- and high-dose protocols in the side and upright trajectories, but with higher radiation doses.

Development of a chest digital tomosynthesis R/F system and implementation of low-dose GPU-accelerated compressed sensing (CS) image reconstruction

PURPOSE

This work describes the hardware and software developments of a prototype chest digital tomosynthesis (CDT) R/F system. The purpose of this study was to validate the developed system for its possible clinical application on low-dose chest tomosynthesis imaging.

METHODS

The prototype CDT R/F system was operated by carefully controlling the electromechanical subsystems through a synchronized interface. Once a command signal was delivered by the user, a tomosynthesis sweep started to acquire 81 projection views (PVs) in a limited angular range of ±20°. Among the full projection dataset of 81 images, several sets of 21 (quarter view) and 41 (half view) images with equally spaced angle steps were selected to represent a sparse view condition. GPU-accelerated and total-variation (TV) regularization strategy-based compressed sensing (CS) image reconstruction was implemented. The imaged objects were a flat-field using a copper filter to measure the noise power spectrum (NPS), a Catphan^® CTP682 quality assurance (QA) phantom to measure a task-based modulation transfer function (MTF_Task ) of three different cylinders' edge, and an anthropomorphic chest phantom with inserted lung nodules. The authors also verified the accelerated computing power over CPU programming by checking the elapsed time required for the CS method. The resultant absorbed and effective doses that were delivered to the chest phantom from two-view digital radiographic projections, helical computed tomography (CT), and the prototype CDT system were compared.

RESULTS

The prototype CDT system was successfully operated, showing little geometric error with fast rise and fall times of R/F x-ray pulse less than 2 and 10 ms, respectively. The in-plane NPS presented essential symmetric patterns as predicted by the central slice theorem. The NPS images from 21 PVs were provided quite different pattern against 41 and 81 PVs due to aliased noise. The voxel variance values which summed all NPS intensities were inversely proportional to the number of PVs, and the CS method gave much lower voxel variance by the factors of 3.97-6.43 and 2.28-3.36 compared to filtered backprojection (FBP) and 20 iterations of simultaneous algebraic reconstruction technique (SART). The spatial frequencies of the f₅₀ at which the MTF_Task reduced to 50% were 1.50, 1.55, and 1.67 cycles/mm for FBP, SART, and CS methods, respectively, in the case of Bone 20% cylinder using 41 views. A variety of ranges of TV reconstruction parameters were implemented during the CS method and we could observe that the NPS and MTF_Task preserved best when the regularization and TV smoothing parameters α and τ were in a range of 0.001-0.1. For the chest phantom data, the signal difference to noise ratios (SDNRs) were higher in the proposed CS scheme images than in the FBP and SART, showing the enhanced rate of 1.05-1.43 for half view imaging. The total averaged reconstruction time during 20 iterations of the CS scheme was 124.68 s, which could match-up a clinically feasible time (<3 min). This computing time represented an enhanced speed 386 times greater than CPU programming. The total amounts of estimated effective doses were 0.12, 0.53 (half view), and 2.56 mSv for two-view radiographs, the prototype CDT system, and helical CT, respectively, showing 4.49 times higher than conventional radiography and 4.83 times lower than a CT exam, respectively.

CONCLUSIONS

The current work describes the development and performance assessment of both hardware and software for tomosynthesis applications. The authors observed reasonable outcomes by showing a potential for low-dose application in CDT imaging using GPU acceleration.

Analysis of Volume Overestimation Artifacts in the Breast Outline Segmentation in Tomosynthesis

In digital breast tomosynthesis (DBT), the reconstruction is calculated from x-ray projection images acquired over a small range of angles. One step in the reconstruction process is to identify the pixels that fall outside the shadow of the breast, to segment the breast from the background (air). In each projection, rays are back-projected from these pixels to the focal spot. All voxels along these rays are identified as air. By combining these results over all projections, a breast outline can be determined for the reconstruction. This paper quantifies the accuracy of this breast segmentation strategy in DBT. In this study, a physical phantom modeling a breast under compression was analyzed with a prototype next-generation tomosynthesis (NGT) system described in previous work. Multiple wires were wrapped around the phantom. Since the wires are thin and high contrast, their exact location can be determined from the reconstruction. Breast parenchyma was portrayed outside the outline defined by the wires. Specifically, the size of the phantom was overestimated along the posteroanterior (PA) direction; i.e., perpendicular to the plane of conventional source motion. To analyze how the acquisition geometry affects the accuracy of the breast outline segmentation, a computational phantom was also simulated. The simulation identified two ways to improve the segmentation accuracy; either by increasing the angular range of source motion laterally or by increasing the range in the PA direction. The latter approach is a unique feature of the NGT design; the advantage of this approach was validated with our prototype system.

Leveraging multi-layer imager detector design to improve low-dose performance for megavoltage cone-beam computed tomography

While megavoltage cone-beam computed tomography (CBCT) using an electronic portal imaging device (EPID) provides many advantages over kilovoltage (kV) CBCT, clinical adoption is limited by its high doses. Multi-layer imager (MLI) EPIDs increase DQE(0) while maintaining high resolution. However, even well-designed, high-performance MLIs suffer from increased electronic noise from each readout, degrading low-dose image quality. To improve low-dose performance, shift-and-bin addition (ShiBA) imaging is proposed, leveraging the unique architecture of the MLI. ShiBA combines hardware readout-binning and super-resolution concepts, reducing electronic noise while maintaining native image sampling. The imaging performance of full-resolution (FR); standard, aligned binned (BIN); and ShiBA images in terms of noise power spectrum (NPS), electronic NPS, modulation transfer function (MTF), and the ideal observer signal-to-noise ratio (SNR)-the detectability index (d')-are compared. The FR 4-layer readout of the prototype MLI exhibits an electronic NPS magnitude 6-times higher than a state-of-the-art single layer (SLI) EPID. Although the MLI is built on the same readout platform as the SLI, with each layer exhibiting equivalent electronic noise, the multi-stage readout of the MLI results in electronic noise 50% higher than simple summation. Electronic noise is mitigated in both BIN and ShiBA imaging, reducing its total by ~12 times. ShiBA further reduces the NPS, effectively upsampling the image, resulting in a multiplication by a sinc² function. Normalized NPS show that neither ShiBA nor BIN otherwise affects image noise. The LSF shows that ShiBA removes the pixilation artifact of BIN images and mitigates the effect of detector shift, but does not quantifiably improve the MTF. ShiBA provides a pre-sampled representation of the images, mitigating phase dependence. Hardware binning strategies lower the quantum noise floor, with 2  ×  2 implementation reducing the dose at which DQE(0) degrades by 10% from 0.01 MU to 0.004 MU, representing 20% improvement in d'.

Virtual assessment of stereoscopic viewing of digital breast tomosynthesis projection images

Digital breast tomosynthesis (DBT) acquires a series of projection images from different angles as an x-ray source rotates around the breast. Such imaging geometry lends DBT naturally to stereoscopic viewing as two projection images with a reasonable separation angle can easily form a stereo pair. This simulation study assessed the efficacy of stereo viewing of DBT projection images. Three-dimensional computational breast phantoms with realistically shaped synthetic lesions were scanned by three simulated DBT systems. The projection images were combined into a sequence of stereo pairs and presented to a stereomatching-based model observer for deciding lesion presence. Signal-to-noise ratio was estimated, and the detection performance with stack viewing of reconstructed slices was the benchmark. We have shown that: (1) stereo viewing of projection images may underperform stack viewing of reconstructed slices for current DBT geometries; (2) DBT geometries may impact the efficacy of the two viewing modes differently: narrow-arc and wide-arc geometries may be better for stereo viewing and stack viewing, respectively; (3) the efficacy of stereo viewing may be more robust than stack viewing to reductions in dose. While in principle stereo viewing is potentially effective for visualizing DBT data, effective stereo viewing may require specifically optimized DBT image acquisition.

Task-Based Modeling of a 5k Ultra-High-Resolution Medical Imaging System for Digital Breast Tomosynthesis

High-resolution, low-noise X-ray detectors based on CMOS active pixel sensor (APS) technology have demonstrated superior imaging performance for digital breast tomosynthesis (DBT). This paper presents a task-based model for a high-resolution medical imaging system to evaluate its ability to detect simulated microcalcifications and masses as lesions for breast cancer. A 3-D cascaded system analysis for a 50- [Formula: see text] pixel pitch CMOS APS X-ray detector was integrated with an object task function, a medical imaging display model, and the human eye contrast sensitivity function to calculate the detectability index and area under the ROC curve (AUC). It was demonstrated that the display pixel pitch and zoom factor should be optimized to improve the AUC for detecting small microcalcifications. In addition, detector electronic noise of smaller than 300 e^- and a high display maximum luminance (>1000 cd/cm ²) are desirable to distinguish microcalcifications of [Formula: see text] in size. For low contrast mass detection, a medical imaging display with a minimum of 12-bit gray levels is recommended to realize accurate luminance levels. A wide projection angle range of greater than ±30° in combination with the image gray level magnification could improve the mass detectability especially when the anatomical background noise is high. On the other hand, a narrower projection angle range below ±20° can improve the small, high contrast object detection. Due to the low mass contrast and luminance, the ambient luminance should be controlled below 5 cd/ [Formula: see text]. Task-based modeling provides important firsthand imaging performance of the high-resolution CMOS-based medical imaging system that is still at early stage development for DBT. The modeling results could guide the prototype design and clinical studies in the future.

Inverse filtering approach to measure directional in-plane modulation transfer function using a sphere phantom for a digital tomosynthesis system

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., f_0° -, f_30° -, and f_60° -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.

Optimization of contrast-enhanced breast imaging: Analysis using a cascaded linear system model

PURPOSE

Contrast-enhanced (CE) breast imaging involves the injection contrast agents (i.e., iodine) to increase conspicuity of malignant lesions. CE imaging may be used in conjunction with digital mammography (DM) or digital breast tomosynthesis (DBT) and has shown promise in improving diagnostic specificity. Both CE-DM and CE-DBT techniques require optimization as clinical diagnostic tools. Physical factors including x-ray spectra, subtraction technique, and the signal from iodine contrast, must be considered to provide the greatest object detectability and image quality. We developed a cascaded linear system model (CLSM) for the optimization of CE-DM and CE-DBT employing dual energy (DE) subtraction or temporal (TE) subtraction.

METHODS

We have previously developed a CLSM for DBT implemented with an a-Se flat panel imager (FPI) and filtered backprojection (FBP) reconstruction algorithm. The model is used to track image quality metrics - modulation transfer function (MTF) and noise power spectrum (NPS) - at each stage of the imaging chain. In this study, the CLSM is extended for CE breast imaging. The effect of x-ray spectrum (varied by changing tube potential and the filter) and DE and TE subtraction techniques on breast structural noise was measured was studied and included as a deterministic source of noise in the CLSM. From the two-dimensional (2D) and three-dimensional (3D) MTF and NPS, the ideal observer signal-to-noise ratio (SNR), also known as the detectability index (d'), may be calculated. Using d' as a FOM, we discuss the optimization of CE imaging for the task of iodinated contrast object detection within structured backgrounds.

RESULTS

Increasing x-ray energy was determined to decrease the magnitude of structural noise and not its correlation. By performing DE subtraction, the magnitude of the structural noise was further reduced at the expense of increased stochastic (quantum and electronic) noise. TE subtraction exhibited essentially no residual structural noise at the expense of increased quantum noise, even over that of the DE case. For DE subtraction, optimization of dose weighting to the HE view (f_h ) results in the minimization of quantum noise. Both subtraction weighting factor (w_Sub ) and the iodine contrast signal were dependent on the LE and HE x-ray spectra. To best detect a 5 mm Gaussian lesion with 5 mg/ml of iodine within a 4 cm thick breast, it was found that the high energy (HE) view should be acquired with a tube potential of 47 kVp (W/Ti spectrum) and the low energy (LE) view with a potential of 23 kVp (W/Rh spectrum). Due to the complete removal of structural noise, TE subtraction produced much higher d' than DE subtraction both as a function of mean glandular dose and iodine concentration.

CONCLUSIONS

We have shown the effect of increasing x-ray energy as well as projection domain subtraction on breast structural noise. Further, we have exhibited the utility of the CLSM for DE and TE subtraction CE imaging in the optimization of imaging parameters such as x-ray energy, f_h , and w_Sub as well as guiding the understanding of their effects on image contrast and noise.

Digital breast tomosynthesis: Dose and image quality assessment

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.

Digital Breast Tomosynthesis: State of the Art

This topical review on digital breast tomosynthesis (DBT) is provided with the intent of describing the state of the art in terms of technology, results from recent clinical studies, advanced applications, and ongoing efforts to develop multimodality imaging systems that include DBT. Particular emphasis is placed on clinical studies. The observations of increase in cancer detection rates, particularly for invasive cancers, and the reduction in false-positive rates with DBT in prospective trials indicate its benefit for breast cancer screening. Retrospective multireader multicase studies show either noninferiority or superiority of DBT compared with mammography. Methods to curtail radiation dose are of importance. (©) RSNA, 2015.

A Sphere Phantom Approach to Measure Directional Modulation Transfer Functions for Tomosynthesis Imaging Systems

We propose a sphere phantom approach to measure spatially varying directional modulation transfer functions (MTFs) for tomosynthesis imaging systems. Since the reconstructed tomosynthesis images contain significant artifacts, traditional background detrending techniques may not be effective to estimate the background trends accurately, which is essential to acquire sphere only data. A background detrending technique optimized for local volumes with different cone angles is presented. To measure directional MTFs, we calculate plane integrals of ideal sphere phantom and sphere only data. To minimize the effects of the high level of noise in tomosynthesis images, Richardson-Lucy deconvolution with Tikhonov-Miller is used to estimate directional plane spread function (PlSF). Then, directional MTFs are calculated by taking the modulus of the Fourier transform of the directional PlSFs. The measured directional MTFs are compared with the ideal directional MTFs calculated from a simulated point object. Our results show that the proposed method reliably measures directional MTFs along any desired directions, especially near low frequency regions.

Evaluation of back projection methods for breast tomosynthesis image reconstruction

Breast cancer is the most common cancer among women in the USA. Compared to mammography, digital breast tomosynthesis is a new imaging technique that may improve the diagnostic accuracy by removing the ambiguities of overlapped tissues and providing 3D information of the breast. Tomosynthesis reconstruction algorithms generate 3D reconstructed slices from a few limited angle projection images. Among different reconstruction algorithms, back projection (BP) is considered an important foundation of quite a few reconstruction techniques with deblurring algorithms such as filtered back projection. In this paper, two BP variants, including α-trimmed BP and principal component analysis-based BP, were proposed to improve the image quality against that of traditional BP. Computer simulations and phantom studies demonstrated that the α-trimmed BP may improve signal response performance and suppress noise in breast tomosynthesis image reconstruction.

Large area CMOS active pixel sensor x-ray imager for digital breast tomosynthesis: Analysis, modeling, and characterization

PURPOSE

Large area x-ray imagers based on complementary metal-oxide-semiconductor (CMOS) active pixel sensor (APS) technology have been proposed for various medical imaging applications including digital breast tomosynthesis (DBT). The low electronic noise (50-300 e-) of CMOS APS x-ray imagers provides a possible route to shrink the pixel pitch to smaller than 75 μm for microcalcification detection and possible reduction of the DBT mean glandular dose (MGD).

METHODS

In this study, imaging performance of a large area (29×23 cm2) CMOS APS x-ray imager [Dexela 2923 MAM (PerkinElmer, London)] with a pixel pitch of 75 μm was characterized and modeled. The authors developed a cascaded system model for CMOS APS x-ray imagers using both a broadband x-ray radiation and monochromatic synchrotron radiation. The experimental data including modulation transfer function, noise power spectrum, and detective quantum efficiency (DQE) were theoretically described using the proposed cascaded system model with satisfactory consistency to experimental results. Both high full well and low full well (LFW) modes of the Dexela 2923 MAM CMOS APS x-ray imager were characterized and modeled. The cascaded system analysis results were further used to extract the contrast-to-noise ratio (CNR) for microcalcifications with sizes of 165-400 μm at various MGDs. The impact of electronic noise on CNR was also evaluated.

RESULTS

The LFW mode shows better DQE at low air kerma (Ka<10 μGy) and should be used for DBT. At current DBT applications, air kerma (Ka∼10 μGy, broadband radiation of 28 kVp), DQE of more than 0.7 and ∼0.3 was achieved using the LFW mode at spatial frequency of 0.5 line pairs per millimeter (lp/mm) and Nyquist frequency ∼6.7 lp/mm, respectively. It is shown that microcalcifications of 165-400 μm in size can be resolved using a MGD range of 0.3-1 mGy, respectively. In comparison to a General Electric GEN2 prototype DBT system (at MGD of 2.5 mGy), an increased CNR (by ∼10) for microcalcifications was observed using the Dexela 2923 MAM CMOS APS x-ray imager at a lower MGD (2.0 mGy).

CONCLUSIONS

The Dexela 2923 MAM CMOS APS x-ray imager is capable to achieve a high imaging performance at spatial frequencies up to 6.7 lp/mm. Microcalcifications of 165 μm are distinguishable based on reported data and their modeling results due to the small pixel pitch of 75 μm. At the same time, potential dose reduction is expected using the studied CMOS APS x-ray imager.

The effect of amorphous selenium detector thickness on dual-energy digital breast imaging

PURPOSE

Contrast enhanced (CE) imaging techniques for both planar digital mammography (DM) and three-dimensional (3D) digital breast tomosynthesis (DBT) applications requires x-ray photon energies higher than the k-edge of iodine (33.2 keV). As a result, x-ray tube potentials much higher (>40 kVp) than those typical for screening mammography must be utilized. Amorphous selenium (a-Se) based direct conversion flat-panel imagers (FPI) have been widely used in DM and DBT imaging systems. The a-Se layer is typically 200 μm thick with quantum detective efficiency (QDE) >87% for x-ray energies below 26 keV. However, QDE decreases substantially above this energy. To improve the object detectability of either CE-DM or CE-DBT, it may be advantageous to increase the thickness (dSe) of the a-Se layer. Increasing the dSe will improve the detective quantum efficiency (DQE) at the higher energies used in CE imaging. However, because most DBT systems are designed with partially isocentric geometries, where the gantry moves about a stationary detector, the oblique entry of x-rays will introduce additional blur to the system. The present investigation quantifies the effect of a-Se thickness on imaging performance for both CE-DM and CE-DBT, discussing the effects of improving photon absorption and blurring from oblique entry of x-rays.

METHODS

In this paper, a cascaded linear system model (CLSM) was used to investigate the effect of dSe on the imaging performance (i.e., MTF, NPS, and DQE) of FPI in CE-DM and CE-DBT. The results from the model are used to calculate the ideal observer signal-to-noise ratio, d', which is used as a figure-of-merit to determine the total effect of increasing dSe for CE-DM and CE-DBT.

RESULTS

The results of the CLSM show that increasing dSe causes a substantial increase in QDE at the high energies used in CE-DM. However, at the oblique projection angles used in DBT, the increased length of penetration through a-Se introduces additional image blur. The reduced MTF and DQE at high spatial frequencies lead to reduced two-dimensional d'. These losses in projection image resolution may subsequently result in a decrease in the 3D d', but the degree of which is largely dependent on the DBT reconstruction algorithm. For a filtered backprojection (FBP) algorithm with spectral apodization and slice-thickness filters, which dominate the blur for reconstructed images at oblique angles, the effect of oblique entry of x-rays on 3D d' is minimal. Thus, increasing dSe results in an improvement in d' for both CE-DM and CE-DBT with typical FBP reconstruction parameters.

CONCLUSIONS

Increased dSe improves CE breast imaging performance by increasing QDE of detectors at higher energies, e.g., 49 kVp. Although there is additional blur in the oblique angled projections of a DBT scan, the overall 3D d' for DBT is not degraded because the dominant source blur at these angles results from the reconstruction filters of the employed FBP algorithm.

Evaluating the sensitivity of the optimization of acquisition geometry to the choice of reconstruction algorithm in digital breast tomosynthesis through a simulation study

Due to the limited number of views and limited angular span in digital breast tomosynthesis (DBT), the acquisition geometry design is an important factor that affects the image quality. Therefore, intensive studies have been conducted regarding the optimization of the acquisition geometry. However, different reconstruction algorithms were used in most of the reported studies. Because each type of reconstruction algorithm can provide images with its own image resolution, noise properties and artifact appearance, it is unclear whether the optimal geometries concluded for the DBT system in one study can be generalized to the DBT systems with a reconstruction algorithm different to the one applied in that study. Hence, we investigated the effect of the reconstruction algorithm on the optimization of acquisition geometry parameters through carefully designed simulation studies. Our results show that using various reconstruction algorithms, including the filtered back-projection, the simultaneous algebraic reconstruction technique, the maximum-likelihood method and the total-variation regularized least-square method, gave similar performance trends for the acquisition parameters for detecting lesions. The consistency of system ranking indicates that the choice of the reconstruction algorithm may not be critical for DBT system geometry optimization.

Task-based strategy for optimized contrast enhanced breast imaging: analysis of six imaging techniques for mammography and tomosynthesis

PURPOSE

The use of contrast agents in breast imaging has the capability of enhancing nodule detectability and providing physiological information. Accordingly, there has been a growing trend toward using iodine as a contrast medium in digital mammography (DM) and digital breast tomosynthesis (DBT). Widespread use raises concerns about the best way to use iodine in DM and DBT, and thus a comparison is necessary to evaluate typical iodine-enhanced imaging methods. This study used a task-based observer model to determine the optimal imaging approach by analyzing six imaging paradigms in terms of their ability to resolve iodine at a given dose: unsubtracted mammography and tomosynthesis, temporal subtraction mammography and tomosynthesis, and dual energy subtraction mammography and tomosynthesis.

METHODS

Imaging performance was characterized using a detectability index d', derived from the system task transfer function (TTF), an imaging task, iodine signal difference, and the noise power spectrum (NPS). The task modeled a 10 mm diameter lesion containing iodine concentrations between 2.1 mg/cc and 8.6 mg/cc. TTF was obtained using an edge phantom, and the NPS was measured over several exposure levels, energies, and target-filter combinations. Using a structured CIRS phantom, d' was generated as a function of dose and iodine concentration.

RESULTS

For all iodine concentrations and dose, temporal subtraction techniques for mammography and tomosynthesis yielded the highest d', while dual energy techniques for both modalities demonstrated the next best performance. Unsubtracted imaging resulted in the lowest d' values for both modalities, with unsubtracted mammography performing the worst out of all six paradigms.

CONCLUSIONS

At any dose, temporal subtraction imaging provides the greatest detectability, with temporally subtracted DBT performing the highest. The authors attribute the successful performance to excellent cancellation of inplane structures and improved signal difference in the lesion.

Noise, sampling, and the number of projections in cone-beam CT with a flat-panel detector

PURPOSE

To investigate the effect of the number of projection views on image noise in cone-beam CT (CBCT) with a flat-panel detector.

METHODS

This fairly fundamental consideration in CBCT system design and operation was addressed experimentally (using a phantom presenting a uniform medium as well as statistically motivated "clutter") and theoretically (using a cascaded systems model describing CBCT noise) to elucidate the contributing factors of quantum noise (σ(Q)), electronic noise (σ(E)), and view aliasing (σ(view)). Analysis included investigation of the noise, noise-power spectrum, and modulation transfer function as a function of the number of projections (N(proj)), dose (D(tot)), and voxel size (b(vox)).

RESULTS

The results reveal a nonmonotonic relationship between image noise and N(proj) at fixed total dose: for the CBCT system considered, noise decreased with increasing N(proj) due to reduction of view sampling effects in the regime N(proj) <~200, above which noise increased with N(proj) due to increased electronic noise. View sampling effects were shown to depend on the heterogeneity of the object in a direct analytical relationship to power-law anatomical clutter of the form κ/f(β)--and a general model of individual noise components (σ(Q), σ(E), and σ(view)) demonstrated agreement with measurements over a broad range in N(proj), D(tot), and b(vox).

CONCLUSIONS

The work elucidates fairly basic elements of CBCT noise in a manner that demonstrates the role of distinct noise components (viz., quantum, electronic, and view sampling noise). For configurations fairly typical of CBCT with a flat-panel detector (FPD), the analysis reveals a "sweet spot" (i.e., minimum noise) in the range N(proj) ~ 250-350, nearly an order of magnitude lower in N(proj) than typical of multidetector CT, owing to the relatively high electronic noise in FPDs. The analysis explicitly relates view aliasing and quantum noise in a manner that includes aspects of the object ("clutter") and imaging chain (including nonidealities of detector blur and electronic noise) to provide a more rigorous basis for commonly held intuition and heurism in CBCT system design and operation.

Breast mass detection using slice conspicuity in 3D reconstructed digital breast volumes

In digital breast tomosynthesis, the three dimensional (3D) reconstructed volumes only provide quasi-3D structure information with limited resolution along the depth direction due to insufficient sampling in depth direction and the limited angular range. The limitation could seriously hamper the conventional 3D image analysis techniques for detecting masses because the limited number of projection views causes blurring in the out-of-focus planes. In this paper, we propose a novel mass detection approach using slice conspicuity in the 3D reconstructed digital breast volumes to overcome the above limitation. First, to overcome the limited resolution along the depth direction, we detect regions of interest (ROIs) on each reconstructed slice and separately utilize the depth directional information to combine the ROIs effectively. Furthermore, we measure the blurriness of each slice for resolving the degradation of performance caused by the blur in the out-of-focus plane. Finally, mass features are extracted from the selected in focus slices and analyzed by a support vector machine classifier to reduce the false positives. Comparative experiments have been conducted on a clinical data set. Experimental results demonstrate that the proposed approach outperforms the conventional 3D approach by achieving a high sensitivity with a small number of false positives.

Optimization of configuration parameters in a newly developed digital breast tomosynthesis system

The purpose of the present work was to investigate the effects of variable projection-view (PV) and angular dose (AD) distributions on the reconstructed image quality for improving microcalcification detection. The PV densities at central and peripheral sites were varied through the distribution of 21 PVs acquired over ± 25° angular range. To vary the AD distribution, 7 PVs in the central region were targeted with two, four and six times the peripheral dose, and the number of central PVs receiving four times the peripheral dose was increased from 3 to 11. The contrast-to-noise ratio (CNR) for in-focus plane quality and the full width at half maximum (FWHM) of artifact spread function (ASF) for resolution in the z-direction were used. Although the ASF improved with increasing PV densities at two peripheral sites, the CNRs were inferior to those obtained with other subsets. With increasing PV density in the central area, the vertical resolution decreased but the CNR increased. Although increasing the central PV or AD concentrations improved image quality, excessive central densities reduced image quality by increasing noise in peripheral views.

Comparative power law analysis of structured breast phantom and patient images in digital mammography and breast tomosynthesis

PURPOSE

This work characterizes three candidate mammography phantoms with structured background in terms of power law analysis in the low frequency region of the power spectrum for 2D (planar) mammography and digital breast tomosynthesis (DBT).

METHODS

The study was performed using three phantoms (spheres in water, Voxmam, and BR3D CIRS phantoms) on two DBT systems from two different vendors (Siemens Inspiration and Hologic Selenia Dimensions). Power spectra (PS) were calculated for planar projection, DBT projection, and reconstructed images and curve fitted in the low frequency region from 0.2 to 0.7 mm(-1) with a power law function characterized by an exponent β and magnitude κ. The influence of acquisition dose and tube voltage on the power law parameters was first explored. Then power law parameters were calculated from images acquired with the same anode∕filter combination and tube voltage for the three test objects, and compared with each other. Finally, PS curves for automatic exposure controlled acquisitions (anode∕filter combination and tube voltages selected by the systems based on the breast equivalent thickness of the test objects) were compared against PS analysis performed on patient data (for Siemens 80 and for Hologic 48 mammograms and DBT series). Dosimetric aspects of the three test objects were also examined.

RESULTS

The power law exponent (β) was found to be independent of acquisition dose for planar mammography but varied more for DBT projections of the sphere-phantom. Systematic increase of tube voltage did not affect β but decreased κ, both in planar and DBT projection phantom images. Power spectra of the BR3D phantom were closer to those of the patients than these of the Voxmam phantom; the Voxmam phantom gave high values of κ compared to the other phantoms and the patient series. The magnitude of the PS curves of the BR3D phantom was within the patient range but β was lower than the average patient value. Finally, PS magnitude for the sphere-phantom coincided with the patient curves for Siemens but was lower for the Hologic system. Close agreement of doses for all three phantoms with patient doses was found.

CONCLUSIONS

Power law parameters of the phantoms were close to those of the patients but no single phantom matched in terms of both magnitude (κ) and texture (β) for the x-ray systems in this work. PS analysis of structured phantoms is feasible and this methodology can be used to suggest improvements in phantom design.

Oblique reconstructions in tomosynthesis. I. Linear systems theory

PURPOSE

By convention, slices in a tomosynthesis reconstruction are created on planes parallel to the detector. It has not yet been demonstrated that slices can be generated along oblique directions through the same volume, analogous to multiplanar reconstructions in computed tomography (CT). The purpose of this work is to give a proof-of-principle justification for oblique reconstructions in tomosynthesis, which acquires projection images over a smaller angular range than CT.

METHODS

To investigate the visibility of individual frequencies in an oblique reconstruction, a theoretical framework is developed in which the reconstruction of a sinusoidal input is calculated. The test frequency is pitched at an angle in a 2D parallel-beam acquisition geometry. Reconstructions are evaluated along the pitch of the object. The modulation transfer function (MTF) is calculated from the relative signal at various test frequencies. The MTF determines whether modulation is within detectable limits in oblique reconstructions. In the previous linear systems (LS) model [B. Zhao and W. Zhao, "Three-dimensional linear system analysis for breast tomosynthesis," Med. Phys. 35(12), 5219-5232 (2008)], the MTF was calculated only in reconstructed slices parallel to the detector. This paper generalizes the MTF calculation to reconstructed slices at all possible pitches. Unlike the previous LS model, this paper also analyzes the effect of object thickness on the MTF. A second test object that is considered is a rod whose long axis is pitched similar to the sinusoidal input. The rod is used to assess whether the length of an object can be correctly estimated in oblique reconstructions.

RESULTS

To simulate the conventional display of the reconstruction, slices are first created along a 0° pitch. This direction is perpendicular to the rays of the central projection. The authors show that the input frequency of a pitched sinusoidal object cannot be determined using these slices. By changing the pitch of the slice to match the object, it is shown that the input frequency is properly resolved. To prove that modulation is preserved in pitched slices, the MTF is also calculated. Modulation is within detectable limits over a broad range of pitches if the object is thin, but is detectable over a narrower range of pitches if the object is thick. Turning next to the second test object, it is shown that the length of a pitched rod can be correctly determined in oblique reconstructions. Concordant with the behavior of the MTF, the length estimate is accurate over a broad range of pitches if the object is thin, but is correct over a narrower range of pitches if the object is thick.

CONCLUSIONS

This work justifies the feasibility of oblique reconstructions in tomosynthesis. It is demonstrated that pitched test objects are most easily visualized with oblique reconstructions instead of conventional reconstructions. In order to achieve high image quality over a broad range of pitches, the object must be thin. By analyzing the effect of reconstruction pitch and object thickness on image quality, this paper generalizes the previous LS model for tomosynthesis.

Oblique reconstructions in tomosynthesis. II. Super-resolution

PURPOSE

In tomosynthesis, super-resolution has been demonstrated using reconstruction planes parallel to the detector. Super-resolution allows for subpixel resolution relative to the detector. The purpose of this work is to develop an analytical model that generalizes super-resolution to oblique reconstruction planes.

METHODS

In a digital tomosynthesis system, a sinusoidal test object is modeled along oblique angles (i.e., "pitches") relative to the plane of the detector in a 3D divergent-beam acquisition geometry. To investigate the potential for super-resolution, the input frequency is specified to be greater than the alias frequency of the detector. Reconstructions are evaluated in an oblique plane along the extent of the object using simple backprojection (SBP) and filtered backprojection (FBP). By comparing the amplitude of the reconstruction against the attenuation coefficient of the object at various frequencies, the modulation transfer function (MTF) is calculated to determine whether modulation is within detectable limits for super-resolution. For experimental validation of super-resolution, a goniometry stand was used to orient a bar pattern phantom along various pitches relative to the breast support in a commercial digital breast tomosynthesis system.

RESULTS

Using theoretical modeling, it is shown that a single projection image cannot resolve a sine input whose frequency exceeds the detector alias frequency. The high frequency input is correctly visualized in SBP or FBP reconstruction using a slice along the pitch of the object. The Fourier transform of this reconstructed slice is maximized at the input frequency as proof that the object is resolved. Consistent with the theoretical results, experimental images of a bar pattern phantom showed super-resolution in oblique reconstructions. At various pitches, the highest frequency with detectable modulation was determined by visual inspection of the bar patterns. The dependency of the highest detectable frequency on pitch followed the same trend as the analytical model. It was demonstrated that super-resolution is not achievable if the pitch of the object approaches 90°, corresponding to the case in which the test frequency is perpendicular to the breast support. Only low frequency objects are detectable at pitches close to 90°.

CONCLUSIONS

This work provides a platform for investigating super-resolution in oblique reconstructions for tomosynthesis. In breast imaging, this study should have applications in visualizing microcalcifications and other subtle signs of cancer.