Dependence of image quality on geometric factors in breast tomosynthesis

A phantom study comparing technical image quality of five breast tomosynthesis systems

BACKGROUND

Digital breast tomosynthesis (DBT) is a three-dimensional breast imaging method. DBT vendors employ various approaches in both image acquisition and data processing, which may affect image quality and radiation exposure to patients.

OBJECTIVE

This study aimed to evaluate the performance of five DBT systems: Fujifilm Amulet Innovality (using both a standard mode and high-resolution mode), GE Senographe Essential, Hologic Selenia Dimensions, Planmed Clarity 3D, and Siemens Mammomat Inspiration.

MATERIALS AND METHODS

The performance of each device and imaging technique was evaluated and compared by phantom measurements performed with four quality assurance phantoms. Technical image quality assessments consisted of measuring artefact extent, in-plane resolution, relative noise power spectrum, and geometric accuracy.

RESULTS

Artefact spreading varied remarkably between the devices, and the full width at half maximum values of artefact spread functions varied from 3.5 mm to 10.7 mm. Noticeable in-plane resolution anisotropy, determined using modulation transfer function (MTF) analysis, was typically observed between tube travel direction and chest wall-nipple direction. The MTF₅₀ varied from 1.1 mm^-1 to 1.6 mm^-1 and from 1.5 mm^-1 to 4.1 mm^-1 in the tube travel and chest wall-nipple directions, respectively. Moreover, distinctly different noise power spectra were observed between the systems. The geometric accuracy in every system was within 0.5%.

CONCLUSION

Technical image quality assessments with image quality phantoms revealed remarkable differences in artefact spread, in-plane resolution, and noise properties between the DBT systems and imaging methods.

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.

Characterization of a high-energy in-line phase contrast tomosynthesis prototype

PURPOSE

In this research, a high-energy in-line phase contrast tomosynthesis prototype was developed and characterized through quantitative investigations and phantom studies.

METHODS

The prototype system consists of an x-ray source, a motorized rotation stage, and a CMOS detector with a pixel pitch of 0.05 mm. The x-ray source was operated at 120 kVp for this study, and the objects were mounted on the rotation stage 76.2 cm (R1) from the source and 114.3 cm (R2) from the detector. The large air gap between the object and detector guarantees sufficient phase-shift effects. The quantitative evaluation of this prototype included modulation transfer function and noise power spectrum measurements conducted under both projection mode and tomosynthesis mode. Phantom studies were performed including three custom designed phantoms with complex structures: a five-layer bubble wrap phantom, a fishbone phantom, and a chicken breast phantom with embedded fibrils and mass structures extracted from an ACR phantom. In-plane images of the phantoms were acquired to investigate their image qualities through observation, intensity profile plots, edge enhancement evaluations, and/or contrast-to-noise ratio calculations. In addition, the robust phase-attenuation duality (PAD)-based phase retrieval method was applied to tomosynthesis for the first time in this research. It was utilized as a preprocessing method to fully exhibit phase contrast on the angular projection before reconstruction.

RESULTS

The resolution and noise characteristics of this high-energy in-line phase contrast tomosynthesis prototype were successfully investigated and demonstrated. The phantom studies demonstrated that this imaging prototype can successfully remove the structure overlapping in phantom projections, obtain delineate interfaces, and achieve better contrast-to-noise ratio after applying phase retrieval to the angular projections.

CONCLUSIONS

This research successfully demonstrated a high-energy in-line phase contrast tomosynthesis prototype. In addition, the PAD-based method of phase retrieval was combined with tomosynthesis imaging for the first time, which demonstrated its capability in significantly improving the contrast-to-noise ratios in the images.

Digital breast tomosynthesis: observer performance of clustered microcalcification detection on breast phantom images acquired with an experimental system using variable scan angles, angular increments, and number of projection views

PURPOSE

To investigate the dependence of microcalcification cluster detectability on tomographic scan angle, angular increment, and number of projection views acquired at digital breast tomosynthesis ( DBT digital breast tomosynthesis ).

MATERIALS AND METHODS

A prototype DBT digital breast tomosynthesis system operated in step-and-shoot mode was used to image breast phantoms. Four 5-cm-thick phantoms embedded with 81 simulated microcalcification clusters of three speck sizes (subtle, medium, and obvious) were imaged by using a rhodium target and rhodium filter with 29 kV, 50 mAs, and seven acquisition protocols. Fixed angular increments were used in four protocols (denoted as scan angle, angular increment, and number of projection views, respectively: 16°, 1°, and 17; 24°, 3°, and nine; 30°, 3°, and 11; and 60°, 3°, and 21), and variable increments were used in three (40°, variable, and 13; 40°, variable, and 15; and 60°, variable, and 21). The reconstructed DBT digital breast tomosynthesis images were interpreted by six radiologists who located the microcalcification clusters and rated their conspicuity.

RESULTS

The mean sensitivity for detection of subtle clusters ranged from 80% (22.5 of 28) to 96% (26.8 of 28) for the seven DBT digital breast tomosynthesis protocols; the highest sensitivity was achieved with the 16°, 1°, and 17 protocol (96%), but the difference was significant only for the 60°, 3°, and 21 protocol (80%, P < .002) and did not reach significance for the other five protocols (P = .01-.15). The mean sensitivity for detection of medium and obvious clusters ranged from 97% (28.2 of 29) to 100% (24 of 24), but the differences fell short of significance (P = .08 to >.99). The conspicuity of subtle and medium clusters with the 16°, 1°, and 17 protocol was rated higher than those with other protocols; the differences were significant for subtle clusters with the 24°, 3°, and nine protocol and for medium clusters with 24°, 3°, and nine; 30°, 3°, and 11; 60°, 3° and 21; and 60°, variable, and 21 protocols (P < .002).

CONCLUSION

With imaging that did not include x-ray source motion or patient motion during acquisition of the projection views, narrow-angle DBT digital breast tomosynthesis provided higher sensitivity and conspicuity than wide-angle DBT digital breast tomosynthesis for subtle microcalcification clusters.

Research in digital mammography and tomosynthesis at the University of Toronto

There have been major advances in the field of breast cancer imaging since the early 1970s, both in technological improvements and in the use of the methods of medical physics and image analysis to optimize image quality. The introduction of digital mammography in 2000 provided a marked improvement in imaging of dense breasts. In addition, it became possible to produce tomographic and functional images on modified digital mammography systems. Digital imaging also greatly facilitated the extraction of quantitative information from images. My laboratory has been fortunate in being able to participate in some of these exciting developments. I will highlight some of the areas of our research interest which include modeling of the image formation process, development of high-resolution X-ray detectors for digital mammography and investigating new methods for analyzing image quality. I will also describe our more recent work on developing new applications of digital mammography including tomosynthesis, contrast-enhanced mammography, and measurement of breast density. Finally, I will point to a new area for our research--the application of the techniques of medical imaging to making pathology more quantitative to contribute to use of biomarkers for better characterizing breast cancer and directing therapeutic decisions.

A review of breast tomosynthesis. Part II. Image reconstruction, processing and analysis, and advanced applications

Many important post-acquisition aspects of breast tomosynthesis imaging can impact its clinical performance. Chief among them is the reconstruction algorithm that generates the representation of the three-dimensional breast volume from the acquired projections. But even after reconstruction, additional processes, such as artifact reduction algorithms, computer aided detection and diagnosis, among others, can also impact the performance of breast tomosynthesis in the clinical realm. In this two part paper, a review of breast tomosynthesis research is performed, with an emphasis on its medical physics aspects. In the companion paper, the first part of this review, the research performed relevant to the image acquisition process is examined. This second part will review the research on the post-acquisition aspects, including reconstruction, image processing, and analysis, as well as the advanced applications being investigated for breast tomosynthesis.