Due to its limited angular scan range, breast tomosynthesis has lower resolution in the depth direction, which may limit its accuracy in quantifying tissue density. This study assesses the quantitative potential of breast tomosynthesis using relatively simple reconstruction and image processing algorithms. This quantitation could allow improved characterization of lesions as well as image processing to present tomosynthesisimages with the familiar appearance of mammography by preserving more low-frequency information.Methods:
All studies were based on a Siemens prototype MAMMOMAT Novation TOMO breast tomo system with a 45° total angular span. This investigation was performed using both simulations and empirical measurements. Monte Carlo simulations were conducted using the breast tomosynthesis geometry and tissue-equivalent, uniform, voxelized phantoms with cuboid lesions of varying density embedded within. Empirical studies were then performed using tissue-equivalent plastic phantoms which were imaged on the actual prototype system. The material surrounding the lesions was set to either fat-equivalent or glandular-equivalent plastic. From the simulation experiments, the effects of scatter, lesion depth, and background material density were studied. The empirical experiments studied the effects of lesion depth, background material density, x-ray tube energy, and exposure level. Additionally, the proposed analysis methods were independently evaluated using a commercially available QA breast phantom (CIRS Model 11A). All image reconstruction was performed with a filtered backprojection algorithm. Reconstructed voxel values within each slice were corrected to reduce background nonuniformities.Results:
The resulting lesion voxel values varied linearly with known glandular fraction (correlation coefficient) under all simulated and empirical conditions, including for the independent tests with the QA phantom. Analysis of variance performed on the fit line parameters revealed statistically significant differences between the two different background materials and between 28 kVp and the remaining energies (26, 30, and 32 kVp) for the dense experimental phantom. However, no significant differences arose between different energies for the fatty phantom, nor for any of the many other combinations of parameters.Conclusions:
These strong linear relationships suggest that breast tomosynthesisimage voxel values, after being corrected by our outlined methods, are highly positively correlated with true tissue density. This consistent linearity implies that breast tomosynthesisimaging indeed has potential to be quantitative.
This work was supported in part by NIH/NCI Grant No. R01 CA112437, Siemens Healthcare, Cancer Research and Prevention Foundation, Clare Boothe Luce Fellowship Program, and Susan G. Komen for the Cure. Special thanks also go to Craig Beam of the University of Illinois at Chicago for statistical advice, to Thomas Mertelmeier of Siemens Healthcare for providing insightful explanations of tomo FBP reconstruction, and to Martin Tornai of Duke Radiology and Moustafa Zerhouni of CIRS for providing phantom materials.
I. INTRODUCTION AND BACKGROUND
II. MATERIALS AND METHODS
II.A. Breast tomosynthesis geometry
II.B. Monte Carlo simulations
II.C. Empirical measurements
II.D. Image reconstruction and analysis
II.E. Nonuniform background correction
III.A. Simulation results
III.A.1. Simulation experiments 1 and 2: Effects of scattered radiation and background density
III.A.2. Simulation experiment 2: Effect of depth
III.B. Empirical results
III.B.1. Empirical experiment 1: Effect of depth
III.B.2. Empirical experiment 2: Effect of background material
III.B.3. Empirical experiment 3: Effect of energy
III.B.4. Empirical experiment 4: Effect of exposure
III.B.5. Phantom testing
III.B.6. Investigation of out-of-plane effects
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