Imaging performance of an amorphous selenium digital mammography detector in a breast tomosynthesis system

International Nuclear Information System (INIS)

Zhao Bo; Zhao Wei

2008-01-01

In breast tomosynthesis a rapid sequence of N images is acquired when the x-ray tube sweeps through different angular views with respect to the breast. Since the total dose to the breast is kept the same as that in regular mammography, the exposure used for each image of tomosynthesis is 1/N. The low dose and high frame rate pose a tremendous challenge to the imaging performance of digital mammography detectors. The purpose of the present work is to investigate the detector performance in different operational modes designed for tomosynthesis acquisition, e.g., binning or full resolution readout, the range of view angles, and the number of views N. A prototype breast tomosynthesis system with a nominal angular range of ±25 deg. was used in our investigation. The system was equipped with an amorphous selenium (a-Se) full field digital mammography detector with pixel size of 85 μm. The detector can be read out in full resolution or 2x1 binning (binning in the tube travel direction). The focal spot blur due to continuous tube travel was measured for different acquisition geometries, and it was found that pixel binning, instead of focal spot blur, dominates the detector modulation transfer function (MTF). The noise power spectrum (NPS) and detective quantum efficiency (DQE) of the detector were measured with the exposure range of 0.4-6 mR, which is relevant to the low dose used in tomosynthesis. It was found that DQE at 0.4 mR is only 20% less than that at highest exposure for both detector readout modes. The detector temporal performance was categorized as lag and ghosting, both of which were measured as a function of x-ray exposure. The first frame lags were 8% and 4%, respectively, for binning and full resolution mode. Ghosting is negligible and independent of the frame rate. The results showed that the detector performance is x-ray quantum noise limited at the low exposures used in each view of tomosynthesis, and the temporal performance at high frame rate (up to

Radiation dosimetry in digital breast tomosynthesis: Report of AAPM Tomosynthesis Subcommittee Task Group 223

Energy Technology Data Exchange (ETDEWEB)

Sechopoulos, Ioannis, E-mail: isechop@emory.edu [Departments of Radiology and Imaging Sciences, Hematology and Medical Oncology and Winship Cancer Institute, Emory University, 1701 Uppergate Drive Northeast, Suite 5018, Atlanta, Georgia 30322 (United States); Sabol, John M. [GE Healthcare, Global Diagnostic X-Ray, Mailstop W-701, 3000 North Grandview Boulevard, Waukesha, Wisconsin 53188 (United States); Berglund, Johan [Research and Development, Philips Women' s Healthcare, Solna (Sweden); Bolch, Wesley E. [J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, Florida 32611 (United States); Brateman, Libby [University of Florida, Gainesville, Florida 32611 (United States); Christodoulou, Emmanuel; Goodsitt, Mitchell [Department of Radiology, University of Michigan, 1500 East Medical Center Drive, Ann Arbor, Michigan 48109 (United States); Flynn, Michael [Department of Radiology, Henry Ford Health System, Radiology Research 2F, 1 Ford Place, Detroit, Michigan 48202 (United States); Geiser, William [Department of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030-4009 (United States); Kyle Jones, A. [Department of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030 (United States); Lo, Joseph Y.; Paul Segars, W. [Department of Radiology, Medical Physics Graduate Program, and Department of Biomedical Engineering, Carl E. Ravin Advanced Imaging Laboratories, Duke University, Durham, North Carolina 27705 (United States); Maidment, Andrew D. A. [Department of Radiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania 19104-4206 (United States); Nishino, Kazuyoshi [R and D X-ray Products Group, Shimadzu Corporation, Tokyo (Japan); Nosratieh, Anita [Biomedical Engineering Graduate Group, Department of Radiology, University of California, Davis, California 95817 (United States); and others

2014-09-15

The radiation dose involved in any medical imaging modality that uses ionizing radiation needs to be well understood by the medical physics and clinical community. This is especially true of screening modalities. Digital breast tomosynthesis (DBT) has recently been introduced into the clinic and is being used for screening for breast cancer in the general population. Therefore, it is important that the medical physics community have the required information to be able to understand, estimate, and communicate the radiation dose levels involved in breast tomosynthesis imaging. For this purpose, the American Association of Physicists in Medicine Task Group 223 on Dosimetry in Tomosynthesis Imaging has prepared this report that discusses dosimetry in breast imaging in general, and describes a methodology and provides the data necessary to estimate mean breast glandular dose from a tomosynthesis acquisition. In an effort to maximize familiarity with the procedures and data provided in this Report, the methodology to perform the dose estimation in DBT is based as much as possible on that used in mammography dose estimation.

Radiation dosimetry in digital breast tomosynthesis: Report of AAPM Tomosynthesis Subcommittee Task Group 223

International Nuclear Information System (INIS)

Sechopoulos, Ioannis; Sabol, John M.; Berglund, Johan; Bolch, Wesley E.; Brateman, Libby; Christodoulou, Emmanuel; Goodsitt, Mitchell; Flynn, Michael; Geiser, William; Kyle Jones, A.; Lo, Joseph Y.; Paul Segars, W.; Maidment, Andrew D. A.; Nishino, Kazuyoshi; Nosratieh, Anita

2014-01-01

The radiation dose involved in any medical imaging modality that uses ionizing radiation needs to be well understood by the medical physics and clinical community. This is especially true of screening modalities. Digital breast tomosynthesis (DBT) has recently been introduced into the clinic and is being used for screening for breast cancer in the general population. Therefore, it is important that the medical physics community have the required information to be able to understand, estimate, and communicate the radiation dose levels involved in breast tomosynthesis imaging. For this purpose, the American Association of Physicists in Medicine Task Group 223 on Dosimetry in Tomosynthesis Imaging has prepared this report that discusses dosimetry in breast imaging in general, and describes a methodology and provides the data necessary to estimate mean breast glandular dose from a tomosynthesis acquisition. In an effort to maximize familiarity with the procedures and data provided in this Report, the methodology to perform the dose estimation in DBT is based as much as possible on that used in mammography dose estimation

Breast tomosynthesis in clinical practice: initial results

International Nuclear Information System (INIS)

Teertstra, Hendrik J.; Loo, Claudette E.; Bosch, Maurice A.A.J. van den; Muller, Sara H.; Gilhuijs, Kenneth G.A.; Tinteren, Harm van; Rutgers, Emiel J.T.

2010-01-01

The purpose of this study was to assess the potential value of tomosynthesis in women with an abnormal screening mammogram or with clinical symptoms. Mammography and tomosynthesis investigations of 513 woman with an abnormal screening mammogram or with clinical symptoms were prospectively classified according to the ACR BI-RADS criteria. Sensitivity and specificity of both techniques for the detection of cancer were calculated. In 112 newly detected cancers, tomosynthesis and mammography were each false-negative in 8 cases (7%). In the false-negative mammography cases, the tumor was detected with ultrasound (n=4), MRI (n=2), by recall after breast tomosynthesis interpretation (n=1), and after prophylactic mastectomy (n=1). Combining the results of mammography and tomosynthesis detected 109 cancers. Therefore in three patients, both mammography and tomosynthesis missed the carcinoma. The sensitivity of both techniques for the detection of breast cancer was 92.9%, and the specificity of mammography and tomosynthesis was 86.1 and 84.4%, respectively. Tomosynthesis can be used as an additional technique to mammography in patients referred with an abnormal screening mammogram or with clinical symptoms. Additional lesions detected by tomosynthesis, however, are also likely to be detected by other techniques used in the clinical work-up of these patients. (orig.)

TU-AB-207-02: Testing of Body and Breast Tomosynthesis Sytems

Energy Technology Data Exchange (ETDEWEB)

Jones, A. [UT MD Anderson Cancer Center (United States)

2015-06-15

Digital Tomosynthesis (DT) is becoming increasingly common in breast imaging and many other applications. DT is a form of computed tomography in which a limited set of projection images are acquired over a small angular range and reconstructed into a tomographic data set. The angular range and number of projections is determined both by the imaging task and equipment manufacturer. For example, in breast imaging between 9 and 25 projections are acquired over a range of 15° to 60°. It is equally valid to treat DT as the digital analog of classical tomography - for example, linear tomography. In fact, the name “tomosynthesis” is an acronym for “synthetic tomography”. DT shares many common features with classical tomography, including the radiographic appearance, dose, and image quality considerations. As such, both the science and practical physics of DT systems is a hybrid between CT and classical tomographic methods. This lecture will consist of three presentations that will provide a complete overview of DT, including a review of the fundamentals of DT, a discussion of testing methods for DT systems, and a description of the clinical applications of DT. While digital breast tomosynthesis will be emphasized, analogies will be drawn to body imaging to illustrate and compare tomosynthesis methods. Learning Objectives: To understand the fundamental principles behind tomosynthesis, including the determinants of image quality and dose. To learn how to test the performance of tomosynthesis imaging systems. To appreciate the uses of tomosynthesis in the clinic and the future applications of tomosynthesis.

TU-AB-207-02: Testing of Body and Breast Tomosynthesis Sytems

International Nuclear Information System (INIS)

Jones, A.

2015-01-01

Digital Tomosynthesis (DT) is becoming increasingly common in breast imaging and many other applications. DT is a form of computed tomography in which a limited set of projection images are acquired over a small angular range and reconstructed into a tomographic data set. The angular range and number of projections is determined both by the imaging task and equipment manufacturer. For example, in breast imaging between 9 and 25 projections are acquired over a range of 15° to 60°. It is equally valid to treat DT as the digital analog of classical tomography - for example, linear tomography. In fact, the name “tomosynthesis” is an acronym for “synthetic tomography”. DT shares many common features with classical tomography, including the radiographic appearance, dose, and image quality considerations. As such, both the science and practical physics of DT systems is a hybrid between CT and classical tomographic methods. This lecture will consist of three presentations that will provide a complete overview of DT, including a review of the fundamentals of DT, a discussion of testing methods for DT systems, and a description of the clinical applications of DT. While digital breast tomosynthesis will be emphasized, analogies will be drawn to body imaging to illustrate and compare tomosynthesis methods. Learning Objectives: To understand the fundamental principles behind tomosynthesis, including the determinants of image quality and dose. To learn how to test the performance of tomosynthesis imaging systems. To appreciate the uses of tomosynthesis in the clinic and the future applications of tomosynthesis

TU-EF-207-04: Advances in Detector Technology for Breast Tomosynthesis

Energy Technology Data Exchange (ETDEWEB)

Zhao, W. [SUNY Stony Brook (United States)

2015-06-15

Breast imaging technology is advancing on several fronts. In digital mammography, the major technological trend has been on optimization of approaches for performing combined mammography and tomosynthesis using the same system. In parallel, photon-counting slot-scan mammography is now in clinical use and more efforts are directed towards further development of this approach for spectral imaging. Spectral imaging refers to simultaneous acquisition of two or more energy-windowed images. Depending on the detector and associated electronics, there are a number of ways this can be accomplished. Spectral mammography using photon-counting detectors can suppress electronic noise and importantly, it enables decomposition of the image into various material compositions of interest facilitating quantitative imaging. Spectral imaging can be particularly important in intravenously injected contrast mammography and eventually tomosynthesis. The various approaches and applications of spectral mammography are discussed. Digital breast tomosynthesis relies on the mechanical movement of the x-ray tube to acquire a number of projections in a predefined arc, typically from 9 to 25 projections over a scan angle of +/−7.5 to 25 degrees depending on the particular system. The mechanical x-ray tube motion requires relatively long acquisition time, typically between 3.7 to 25 seconds depending on the system. Moreover, mechanical scanning may have an effect on the spatial resolution due to internal x-ray filament or external mechanical vibrations. New x-ray source arrays have been developed and they are aimed at replacing the scanned x-ray tube for improved acquisition time and potentially for higher spatial resolution. The potential advantages and challenges of this approach are described. Combination of digital mammography and tomosynthesis in a single system places increased demands on certain functional aspects of the detector and overall performance, particularly in the tomosynthesis

TU-EF-207-04: Advances in Detector Technology for Breast Tomosynthesis

International Nuclear Information System (INIS)

Zhao, W.

2015-01-01

Breast imaging technology is advancing on several fronts. In digital mammography, the major technological trend has been on optimization of approaches for performing combined mammography and tomosynthesis using the same system. In parallel, photon-counting slot-scan mammography is now in clinical use and more efforts are directed towards further development of this approach for spectral imaging. Spectral imaging refers to simultaneous acquisition of two or more energy-windowed images. Depending on the detector and associated electronics, there are a number of ways this can be accomplished. Spectral mammography using photon-counting detectors can suppress electronic noise and importantly, it enables decomposition of the image into various material compositions of interest facilitating quantitative imaging. Spectral imaging can be particularly important in intravenously injected contrast mammography and eventually tomosynthesis. The various approaches and applications of spectral mammography are discussed. Digital breast tomosynthesis relies on the mechanical movement of the x-ray tube to acquire a number of projections in a predefined arc, typically from 9 to 25 projections over a scan angle of +/−7.5 to 25 degrees depending on the particular system. The mechanical x-ray tube motion requires relatively long acquisition time, typically between 3.7 to 25 seconds depending on the system. Moreover, mechanical scanning may have an effect on the spatial resolution due to internal x-ray filament or external mechanical vibrations. New x-ray source arrays have been developed and they are aimed at replacing the scanned x-ray tube for improved acquisition time and potentially for higher spatial resolution. The potential advantages and challenges of this approach are described. Combination of digital mammography and tomosynthesis in a single system places increased demands on certain functional aspects of the detector and overall performance, particularly in the tomosynthesis

Initial results of the FUSION-X-US prototype combining 3D automated breast ultrasound and digital breast tomosynthesis.

Science.gov (United States)

Schaefgen, Benedikt; Heil, Joerg; Barr, Richard G; Radicke, Marcus; Harcos, Aba; Gomez, Christina; Stieber, Anne; Hennigs, André; von Au, Alexandra; Spratte, Julia; Rauch, Geraldine; Rom, Joachim; Schütz, Florian; Sohn, Christof; Golatta, Michael

2018-06-01

To determine the feasibility of a prototype device combining 3D-automated breast ultrasound (ABVS) and digital breast tomosynthesis in a single device to detect and characterize breast lesions. In this prospective feasibility study, the FUSION-X-US prototype was used to perform digital breast tomosynthesis and ABVS in 23 patients with an indication for tomosynthesis based on current guidelines after clinical examination and standard imaging. The ABVS and tomosynthesis images of the prototype were interpreted separately by two blinded experts. The study compares the detection and BI-RADS® scores of breast lesions using only the tomosynthesis and ABVS data from the FUSION-X-US prototype to the results of the complete diagnostic workup. Image acquisition and processing by the prototype was fast and accurate, with some limitations in ultrasound coverage and image quality. In the diagnostic workup, 29 solid lesions (23 benign, including three cases with microcalcifications, and six malignant lesions) were identified. Using the prototype, all malignant lesions were detected and classified as malignant or suspicious by both investigators. Solid breast lesions can be localized accurately and fast by the Fusion-X-US system. Technical improvements of the ultrasound image quality and ultrasound coverage are needed to further study this new device. The prototype combines tomosynthesis and automated 3D-ultrasound (ABVS) in one device. It allows accurate detection of malignant lesions, directly correlating tomosynthesis and ABVS data. The diagnostic evaluation of the prototype-acquired data was interpreter-independent. The prototype provides a time-efficient and technically reliable diagnostic procedure. The combination of tomosynthesis and ABVS is a promising diagnostic approach.

Baseline Screening Mammography: Performance of Full-Field Digital Mammography Versus Digital Breast Tomosynthesis.

Science.gov (United States)

McDonald, Elizabeth S; McCarthy, Anne Marie; Akhtar, Amana L; Synnestvedt, Marie B; Schnall, Mitchell; Conant, Emily F

2015-11-01

Baseline mammography studies have significantly higher recall rates than mammography studies with available comparison examinations. Digital breast tomosynthesis reduces recalls when compared with digital mammographic screening alone, but many sites operate in a hybrid environment. To maximize the effect of screening digital breast tomosynthesis with limited resources, choosing which patient populations will benefit most is critical. This study evaluates digital breast tomosynthesis in the baseline screening population. Outcomes were compared for 10,728 women who underwent digital mammography screening, including 1204 (11.2%) baseline studies, and 15,571 women who underwent digital breast tomosynthesis screening, including 1859 (11.9%) baseline studies. Recall rates, cancer detection rates, and positive predictive values were calculated. Logistic regression estimated the odds ratios of recall for digital mammography versus digital breast tomosynthesis for patients undergoing baseline screening and previously screened patients, adjusted for age, race, and breast density. In the baseline subgroup, recall rates for digital mammography and digital breast tomosynthesis screening were 20.5% and 16.0%, respectively (p = 0.002); digital breast tomosynthesis screening in the baseline subgroup resulted in a 22% reduction in recall compared with digital mammography, or 45 fewer patients recalled per 1000 patients screened. Digital breast tomosynthesis screening in the previously screened patients resulted in recall reduction of 14.3% (p tomosynthesis than from digital mammography alone.

Characterization of photon-counting multislit breast tomosynthesis.

Science.gov (United States)

Berggren, Karl; Cederström, Björn; Lundqvist, Mats; Fredenberg, Erik

2018-02-01

It has been shown that breast tomosynthesis may improve sensitivity and specificity compared to two-dimensional mammography, resulting in increased detection-rate of cancers or lowered call-back rates. The purpose of this study is to characterize a spectral photon-counting multislit breast tomosynthesis system that is able to do single-scan spectral imaging with multiple collimated x-ray beams. The system differs in many aspects compared to conventional tomosynthesis using energy-integrating flat-panel detectors. The investigated system was a prototype consisting of a dual-threshold photon-counting detector with 21 collimated line detectors scanning across the compressed breast. A review of the system is done in terms of detector, acquisition geometry, and reconstruction methods. Three reconstruction methods were used, simple back-projection, filtered back-projection and an iterative algebraic reconstruction technique. The image quality was evaluated by measuring the modulation transfer-function (MTF), normalized noise-power spectrum, detective quantum-efficiency (DQE), and artifact spread-function (ASF) on reconstructed spectral tomosynthesis images for a total-energy bin (defined by a low-energy threshold calibrated to remove electronic noise) and for a high-energy bin (with a threshold calibrated to split the spectrum in roughly equal parts). Acquisition was performed using a 29 kVp W/Al x-ray spectrum at a 0.24 mGy exposure. The difference in MTF between the two energy bins was negligible, that is, there was no energy dependence on resolution. The MTF dropped to 50% at 1.5 lp/mm to 2.3 lp/mm in the scan direction and 2.4 lp/mm to 3.3 lp/mm in the slit direction, depending on the reconstruction method. The full width at half maximum of the ASF was found to range from 13.8 mm to 18.0 mm for the different reconstruction methods. The zero-frequency DQE of the system was found to be 0.72. The fraction of counts in the high-energy bin was measured to be 59% of the

A review of breast tomosynthesis. Part I. The image acquisition process

Science.gov (United States)

Sechopoulos, Ioannis

2013-01-01

Mammography is a very well-established imaging modality for the early detection and diagnosis of breast cancer. However, since the introduction of digital imaging to the realm of radiology, more advanced, and especially tomographic imaging methods have been made possible. One of these methods, breast tomosynthesis, has finally been introduced to the clinic for routine everyday use, with potential to in the future replace mammography for screening for breast cancer. In this two part paper, the extensive research performed during the development of breast tomosynthesis is reviewed, with a focus on the research addressing the medical physics aspects of this imaging modality. This first paper will review the research performed on the issues relevant to the image acquisition process, including system design, optimization of geometry and technique, x-ray scatter, and radiation dose. The companion to this paper will review all other aspects of breast tomosynthesis imaging, including the reconstruction process. PMID:23298126

Digital tomosynthesis in breast cancer: A systematic review.

Science.gov (United States)

García-León, F J; Llanos-Méndez, A; Isabel-Gómez, R

2015-01-01

To estimate and compare the diagnostic validity of tomosynthesis and digital mammography for screening and diagnosing breast cancer. We systematically searched MedLine, EMBASE, and Web of Science for the terms breast cancer, screening, tomosynthesis, mammography, sensitivity, and specificity in publications in the period comprising June 2010 through February 2013. We included studies on diagnostic tests and systematic reviews. Two reviewers selected and evaluated the articles. We used QUADAS 2 to evaluate the risk of bias and the NICE criteria to determine the level of evidence. We compiled a narrative synthesis. Of the 151 original studies identified, we selected 11 that included a total of 2475 women. The overall quality was low, with a risk of bias and follow-up and limitations regarding the applicability of the results. The level of evidence was not greater than level II. The sensitivity of tomosynthesis ranged from 69% to 100% and the specificity ranged from 54% to 100%. The negative likelihood ratio was good, and this makes tomosynthesis useful as a test to confirm a diagnosis. One-view tomosynthesis was no better than two-view digital mammography, and the evidence for the superiority of two-view tomosynthesis was inconclusive. The results for the diagnostic validity of tomosynthesis in the diagnosis of breast cancer were inconclusive and there were no results for its use in screening. Copyright © 2014 SERAM. Published by Elsevier España, S.L.U. All rights reserved.

Evaluation of tomosynthesis elastography in a breast-mimicking phantom

International Nuclear Information System (INIS)

Engelken, Florian Jan; Sack, Ingolf; Klatt, Dieter; Fischer, Thomas; Fallenberg, Eva Maria; Bick, Ulrich; Diekmann, Felix

2012-01-01

Objective: To evaluate whether measurement of strain under static compression in tomosynthesis of a breast-mimicking phantom can be used to distinguish tumor-simulating lesions of different elasticities and to compare the results to values predicted by rheometric analysis as well as results of ultrasound elastography. Materials and methods: We prepared three soft breast-mimicking phantoms containing simulated tumors of different elasticities. The phantoms were imaged using a wide angle tomosynthesis system with increasing compression settings ranging from 0 N to 105 N in steps of 15 N. Strain of the inclusions was measured in two planes using a commercially available mammography workstation. The elasticity of the phantom matrix and inclusion material was determined by rheometric analysis. Ultrasound elastography of the inclusions was performed using two different ultrasound elastography algorithms. Results: Strain at maximal compression was 24.4%/24.5% in plane 1/plane 2, respectively, for the soft inclusion, 19.6%/16.9% for the intermediate inclusion, and 6.0%/10.2% for the firm inclusion. The strain ratios predicted by rheometrical testing were 0.41, 0.83 and 1.26 for the soft, intermediate, and firm inclusions, respectively. The strain ratios obtained for the soft, intermediate, and firm inclusions were 0.72 ± 0.13, 1.02 ± 0.21 and 2.67 ± 1.70, respectively for tomosynthesis elastography, 0.91, 1.64 and 2.07, respectively, for ultrasound tissue strain imaging, and 0.97, 2.06 and 2.37, respectively, for ultrasound real-time elastography. Conclusions: Differentiation of tumor-simulating inclusions by elasticity in a breast mimicking phantom may be possible by measuring strain in tomosynthesis. This method may be useful for assessing elasticity of breast lesions tomosynthesis of the breast

Stationary Digital Tomosynthesis System for Early Detection of Breast Tumors

Science.gov (United States)

2012-05-01

Vol. 5745. 2005. 14. Y. Zhang, et al., A comparative study of limited-angle cone-beam reconstruction methods 505 for breast tomosynthesis. Med...opening angl em integratio designed line nia Dimension determine the try calibration th the detector ain is sent fro between XC urce not fou here...screening mammography. AJR, 2007. 189: p. 616. 12. P. Baldelli, et al., A prototype of a quasi-monochromatic system for mammography applications . Phys

Digital breast tomosynthesis; Digitale Tomosynthese der Brust

Energy Technology Data Exchange (ETDEWEB)

Haegele, Julian; Barkhausen, Joerg [Universtiaetsklinikum Schleswig-Holstein, Luebeck (Germany). Klinik fuer Radiologie und Nuklearmedizin; Pursche, Telja [Universtiaetsklinikum Schleswig-Holstein, Luebeck (Germany). Brustzentrum; Schaefer, Fritz K.W. [Universtiaetsklinikum Schleswig-Holstein, Kiel (Germany). Bereich Mammadiagnostik und Intervention

2015-09-15

In digital breast tomosynthesis a digital tomographic data set with a very high spatial resolution is reconstructed from low-dose projections collected over a limited rotation angle. This allows a very detailed assessment of e. g. masses and architectural distortions. The average glandular dose is comparable to 2 D mammography. First clinical studies demonstrated that tomosynthesis is able to supply important additional information in suspicious mammographic findings. In comparison to projection mammography, tomosynthesis shows an at least comparable diagnostic accuracy. In everyday practice, tomosynthesis is currently mostly used for further evaluation of suspicious findings in mammography.

Optimized image acquisition for breast tomosynthesis in projection and reconstruction space

OpenAIRE

Chawla, Amarpreet S.; Lo, Joseph Y.; Baker, Jay A.; Samei, Ehsan

2009-01-01

Breast tomosynthesis has been an exciting new development in the field of breast imaging. While the diagnostic improvement via tomosynthesis is notable, the full potential of tomosynthesis has not yet been realized. This may be attributed to the dependency of the diagnostic quality of tomosynthesis on multiple variables, each of which needs to be optimized. Those include dose, number of angular projections, and the total angular span of those projections. In this study, the authors investigat...

Overview of digital breast tomosynthesis: Clinical cases, benefits and disadvantages.

Science.gov (United States)

Nguyen, T; Levy, G; Poncelet, E; Le Thanh, T; Prolongeau, J F; Phalippou, J; Massoni, F; Laurent, N

2015-09-01

In France, the national breast cancer-screening program is based on mammography combined with clinical breast examination, and sometimes breast ultrasound for patients with high breast density. Digital breast tomosynthesis is a currently assessed 3D imaging technique in which angular projections of the stationary compressed breast are acquired automatically. When combined with mammography, clinicians can review both conventional (2D) as well as three-dimensional (3D) data. The purpose of this article is to review recent reports on this new breast imaging technique and complements this information with our personal experience. The main advantages of tomosynthesis are that it facilitates the detection and characterization of breast lesions, as well as the diagnosis of occult lesions in dense breasts. However, to do this, patients are exposed to higher levels of radiation than with 2D mammography. In France, the indications for tomosynthesis and its use in breast cancer-screening (individual and organized) are yet to be defined, as is its role in the diagnosis and staging of breast cancer (multiple lesions). Further studies assessing in particular the combined reconstruction of the 2D view using 3D tomosynthesis data acquired during a single breast compression event, and therefore reducing patient exposure to radiation, are expected to provide valuable insight. Copyright © 2015 Éditions françaises de radiologie. Published by Elsevier Masson SAS. All rights reserved.

Experimental phantom lesion detectability study using a digital breast tomosynthesis prototype system

International Nuclear Information System (INIS)

Schulz-Wendtland, R.; Wenkel, E.; Lell, M.; Boehner, C.; Bautz, W.A.; Mertelmeier, T.

2006-01-01

Purpose: To compare the sensitivity of conventional two-dimensional (2D) projection imaging with tomosynthesis with respect to the detectability of mammographic phantom lesions. Materials and Methods: Using a breast tomosynthesis prototype based on a commercial FFDM system (Siemens MAMMOMAT Novation DR ), but modified for a wide angle tube motion and equipped with a fast read-out amorphous selenium detector, we acquired standard 2D images and tomosynthesis series of projection views. We used the Wisconsin mammographic random phantom, model RMI 152A. The anode filter combinations Mo/Mo and W/Rh at two different doses were used as typical radiographic techniques. Slice images through the phantom parallel to the detector were reconstructed with a distance of 1 mm employing a filtered back-projection algorithm. The image data sets were read by five radiologists and evaluated with respect to the detectability of the phantom details. Results: For all studied radiographic techniques, the detection rate in the tomosynthesis mode was 100%, i.e. 75 true positive findings out of 75 possible hits. In contrast, the conventional projection mode yielded a detection rate between 80 and 93% (corresponding to 60 and 70 detected details) depending on the dose and X-ray spectrum. Conclusion: Tomosynthesis has the potential to increase the sensitivity of digital mammography. Overlapping structures from out-of-plane tissue can be removed in the tomosynthesis reconstruction process, thereby enhancing the diagnostic accuracy. (orig.)

Automatic correspondence detection in mammogram and breast tomosynthesis images

Science.gov (United States)

Ehrhardt, Jan; Krüger, Julia; Bischof, Arpad; Barkhausen, Jörg; Handels, Heinz

2012-02-01

Two-dimensional mammography is the major imaging modality in breast cancer detection. A disadvantage of mammography is the projective nature of this imaging technique. Tomosynthesis is an attractive modality with the potential to combine the high contrast and high resolution of digital mammography with the advantages of 3D imaging. In order to facilitate diagnostics and treatment in the current clinical work-flow, correspondences between tomosynthesis images and previous mammographic exams of the same women have to be determined. In this paper, we propose a method to detect correspondences in 2D mammograms and 3D tomosynthesis images automatically. In general, this 2D/3D correspondence problem is ill-posed, because a point in the 2D mammogram corresponds to a line in the 3D tomosynthesis image. The goal of our method is to detect the "most probable" 3D position in the tomosynthesis images corresponding to a selected point in the 2D mammogram. We present two alternative approaches to solve this 2D/3D correspondence problem: a 2D/3D registration method and a 2D/2D mapping between mammogram and tomosynthesis projection images with a following back projection. The advantages and limitations of both approaches are discussed and the performance of the methods is evaluated qualitatively and quantitatively using a software phantom and clinical breast image data. Although the proposed 2D/3D registration method can compensate for moderate breast deformations caused by different breast compressions, this approach is not suitable for clinical tomosynthesis data due to the limited resolution and blurring effects perpendicular to the direction of projection. The quantitative results show that the proposed 2D/2D mapping method is capable of detecting corresponding positions in mammograms and tomosynthesis images automatically for 61 out of 65 landmarks. The proposed method can facilitate diagnosis, visual inspection and comparison of 2D mammograms and 3D tomosynthesis images for

Characterization of Breast Lesions: Comparison of Digital Breast Tomosynthesis and Ultrasonography

International Nuclear Information System (INIS)

Kim, Sun Ah; Chang, Jung Min; Cho, Nariya; Yi, Ann; Moon, Woo Kyung

2015-01-01

To compare the diagnostic performance of digital breast tomosynthesis (DBT) and conventional breast ultrasound (US) to characterize breast lesions as benign or malignant. A total of 332 women, presenting for screening examinations or for breast biopsy between March and June 2012 were recruited to undergo digital mammography (DM), DBT, and breast US examination. Among them, 113 patients with 119 breast lesions depicted on DM were finally included. Three blinded radiologists performed an enriched reader study and reviewed the DBT and US images. Each reader analyzed the lesions in random order, assigned Breast Imaging Reporting and Data System (BI-RADS) descriptors, rated the images for the likelihood of malignancy (%) and made a BI-RADS final assessment. Diagnostic accuracy, as assessed by the area under the receiver operating characteristic curve, sensitivity, and specificity of DBT and US were compared. Among the 119 breast lesions depicted on DM, 75 were malignant and the remaining 44 were benign. The average diagnostic performance for characterizing breast lesions as benign or malignant in terms of area under the curve was 0.899 for DBT and 0.914 for US (p = 0.394). Mean sensitivity (97.3% vs. 98.7%, p = 0.508) and specificity (44.7% vs. 39.4%, p = 0.360) were also not significantly different. Digital breast tomosynthesis may provide similar reader lesion characterization performance to that of US for breast lesions depicted on DM

Characterization of Breast Lesions: Comparison of Digital Breast Tomosynthesis and Ultrasonography

Energy Technology Data Exchange (ETDEWEB)

Kim, Sun Ah [Department of Radiology, Human Medical Imaging & Intervention Center, Seoul 135-120 (Korea, Republic of); Chang, Jung Min; Cho, Nariya [Department of Radiology, Seoul National University Hospital, Seoul 110-744 (Korea, Republic of); Yi, Ann [Department of Radiology, Seoul National University Hospital Healthcare System Gangnam Center, Seoul 135-984 (Korea, Republic of); Moon, Woo Kyung [Department of Radiology, Seoul National University Hospital, Seoul 110-744 (Korea, Republic of)

2015-11-01

To compare the diagnostic performance of digital breast tomosynthesis (DBT) and conventional breast ultrasound (US) to characterize breast lesions as benign or malignant. A total of 332 women, presenting for screening examinations or for breast biopsy between March and June 2012 were recruited to undergo digital mammography (DM), DBT, and breast US examination. Among them, 113 patients with 119 breast lesions depicted on DM were finally included. Three blinded radiologists performed an enriched reader study and reviewed the DBT and US images. Each reader analyzed the lesions in random order, assigned Breast Imaging Reporting and Data System (BI-RADS) descriptors, rated the images for the likelihood of malignancy (%) and made a BI-RADS final assessment. Diagnostic accuracy, as assessed by the area under the receiver operating characteristic curve, sensitivity, and specificity of DBT and US were compared. Among the 119 breast lesions depicted on DM, 75 were malignant and the remaining 44 were benign. The average diagnostic performance for characterizing breast lesions as benign or malignant in terms of area under the curve was 0.899 for DBT and 0.914 for US (p = 0.394). Mean sensitivity (97.3% vs. 98.7%, p = 0.508) and specificity (44.7% vs. 39.4%, p = 0.360) were also not significantly different. Digital breast tomosynthesis may provide similar reader lesion characterization performance to that of US for breast lesions depicted on DM.

Quantitative breast density analysis using tomosynthesis and comparison with MRI and digital mammography.

Science.gov (United States)

Moon, Woo Kyung; Chang, Jie-Fan; Lo, Chung-Ming; Chang, Jung Min; Lee, Su Hyun; Shin, Sung Ui; Huang, Chiun-Sheng; Chang, Ruey-Feng

2018-02-01

Breast density at mammography has been used as markers of breast cancer risk. However, newly introduced tomosynthesis and computer-aided quantitative method could provide more reliable breast density evaluation. In the experiment, 98 tomosynthesis image volumes were obtained from 98 women. For each case, an automatic skin removal was used and followed by a fuzzy c-mean (FCM) classifier which separated the fibroglandular tissues from other tissues in breast area. Finally, percent of breast density and breast volume were calculated and the results were compared with MRI. In addition, the percent of breast density and breast area of digital mammography calculated using the software Cumulus (University of Toronto, Toronto, ON, Canada.) were also compared with 3-D modalities. Percent of breast density and breast volume, which were computed from tomosynthesis, MRI and digital mammography were 17.37% ± 4.39% and 607.12 cm 3  ± 323.01 cm 3 , 20.3% ± 8.6% and 537.59 cm 3  ± 287.74 cm 3 , and 12.03% ± 4.08%, respectively. There were significant correlations on breast density as well as volume between tomosynthesis and MRI (R = 0.482 and R = 0.805), tomosynthesis and breast density with breast area of digital mammography (R = 0.789 and R = 0.877), and MRI and breast density with breast area of digital mammography (R = 0.482 and R = 0.857) (all P values density and breast volume evaluated from tomosynthesis, MRI and breast density and breast area of digital mammographic images have significant correlations and indicate that tomosynthesis could provide useful 3-D information on breast density through proposed method. Copyright © 2017 Elsevier B.V. All rights reserved.

Review and management of breast lesions detected with breast tomosynthesis but not visible on mammography and ultrasonography.

Science.gov (United States)

Taskin, Fusun; Durum, Yasemin; Soyder, Aykut; Unsal, Alparslan

2017-12-01

Background Breast tomosynthesis is more sensitive than mammography and can detect lesions that are not always visible with conventional methods such as digital mammography (MG) and ultrasonography (US). No standardized approach is available for the management of lesions that are detectable with tomosynthesis but are not visible on MG or US. Purpose To review suspicious breast lesions detected with tomosynthesis but not visible on two-dimensional (2D) MG or US and to determine the management options for these lesions. Material and Methods Ethical committee approval was obtained. The radiological records, biopsy or surgery results, and follow-up findings of 107 patients who had a tomosynthesis-positive but MG- or US-negative breast lesion between 2011 and 2016 were retrospectively evaluated. Results Of 107 lesions visible only with tomosynthesis, 74% were architectural distortions and 26% were asymmetrical opacities. All patients underwent magnetic resonance imaging (MRI) for further evaluation. Among the 48 (45%) MRI-negative lesions, none had a suspicious alteration during the follow-up period. Among the MRI-positive lesions, 28% of the 50 architectural distortions and 11% of the nine asymmetrical opacities were malignant. Conclusion Given the inherent high false-positive rate of breast tomosynthesis, breast MRI prior to biopsy may reduce the number of unnecessary biopsies for suspicious breast lesions that are tomosynthesis-positive only.

Computation of the glandular radiation dose in digital tomosynthesis of the breast

International Nuclear Information System (INIS)

Sechopoulos, Ioannis; Suryanarayanan, Sankararaman; Vedantham, Srinivasan; D'Orsi, Carl; Karellas, Andrew

2007-01-01

Tomosynthesis of the breast is currently a topic of intense interest as a logical next step in the evolution of digital mammography. This study reports on the computation of glandular radiation dose in digital tomosynthesis of the breast. Previously, glandular dose estimations in tomosynthesis have been performed using data from studies of radiation dose in conventional planar mammography. This study evaluates, using Monte Carlo methods, the normalized glandular dose (D g N) to the breast during a tomosynthesis study, and characterizes its dependence on breast size, tissue composition, and x-ray spectrum. The conditions during digital tomosynthesis imaging of the breast were simulated using a computer program based on the Geant4 toolkit. With the use of simulated breasts of varying size, thickness and tissue composition, the D g N to the breast tissue was computed for varying x-ray spectra and tomosynthesis projection angle. Tomosynthesis projections centered about both the cranio-caudal (CC) and medio-lateral oblique (MLO) views were simulated. For each projection angle, the ratio of the glandular dose for that projection to the glandular dose for the zero degree projection was computed. This ratio was denoted the relative glandular dose (RGD) coefficient, and its variation under different imaging parameters was analyzed. Within mammographic energies, the RGD was found to have a weak dependence on glandular fraction and x-ray spectrum for both views. A substantial dependence on breast size and thickness was found for the MLO view, and to a lesser extent for the CC view. Although RGD values deviate substantially from unity as a function of projection angle, the RGD averaged over all projections in a complete tomosynthesis study varies from 0.91 to 1.01. The RGD results were fit to mathematical functions and the resulting equations are provided

Quality control in breast tomosynthesis

Energy Technology Data Exchange (ETDEWEB)

Jakubiak, R.R.; Messias, P.C.; Santos, M.F., E-mail: requi@utfpr.edu.br [Universidade Tecnologia Federal do Parana (UTFPR), Curitiba, PR (Brazil). Departamento Academico de Fisica; Urban, L.A.B.D., E-mail: lineiurban@hotmail.com [Diagnostico Avancado por Imagem, Curitiba, PR (Brazil)

2015-07-01

In Brazil, breast cancer is the most common and the leading cause of death among women, with estimated 57,000 new cases in 2014. The mammography (2D) plays an important role in the early detection of breast cancer, but in some cases can be difficult to detect malignant lesions due overlap of breast tissues. The Digital Breasts Tomosynthesis (DBT: 3D) reduces the effects of overlap, providing improved characterization of mammographic findings. However, the dose may double as compared with mammography. This study presents results of Contrast to Noise Ratio (CNR) and image quality evaluation on Siemens mammography equipment Mammomat Inspiration with tomosynthesis. The CNR was determined with Polymethylmethacrylate (PMMA) layers of 20 to 70 mm thick and an aluminum foils of 0,2 mm thickness and area of 10 mm². Image quality was assessed with the ACR Breast Simulator. In the evaluation of image quality, the detectability of fibers and masses was identical in 2D and 3D systems. Displaying fibers were 4,5 and 4 mass in both modes. In 2D mode were identified 3,5 microcalcifications groups, and 3D showed 3 groups. The Mean Glandular Dose (MGD) for the simulator in 2D mode was 1,17 mGy and 2,35 mGy for the 3D mode. The result reinforces the importance of quality control in the process of obtaining the images and obtained in accordance CNR values, ensuring image quality and compatible dose in 2D and 3D processes. (author)

Quality control in breast tomosynthesis

International Nuclear Information System (INIS)

Jakubiak, R.R.; Messias, P.C.; Santos, M.F.

2015-01-01

In Brazil, breast cancer is the most common and the leading cause of death among women, with estimated 57,000 new cases in 2014. The mammography (2D) plays an important role in the early detection of breast cancer, but in some cases can be difficult to detect malignant lesions due overlap of breast tissues. The Digital Breasts Tomosynthesis (DBT: 3D) reduces the effects of overlap, providing improved characterization of mammographic findings. However, the dose may double as compared with mammography. This study presents results of Contrast to Noise Ratio (CNR) and image quality evaluation on Siemens mammography equipment Mammomat Inspiration with tomosynthesis. The CNR was determined with Polymethylmethacrylate (PMMA) layers of 20 to 70 mm thick and an aluminum foils of 0,2 mm thickness and area of 10 mm². Image quality was assessed with the ACR Breast Simulator. In the evaluation of image quality, the detectability of fibers and masses was identical in 2D and 3D systems. Displaying fibers were 4,5 and 4 mass in both modes. In 2D mode were identified 3,5 microcalcifications groups, and 3D showed 3 groups. The Mean Glandular Dose (MGD) for the simulator in 2D mode was 1,17 mGy and 2,35 mGy for the 3D mode. The result reinforces the importance of quality control in the process of obtaining the images and obtained in accordance CNR values, ensuring image quality and compatible dose in 2D and 3D processes. (author)

Quality control in breast tomosynthesis

International Nuclear Information System (INIS)

Jakubiak, Rosangela Requi; Messias, Pricila Cordeiro; Santos, Marilia Fernanda; Urban, Linei Augusta B.D.

2014-01-01

In Brazil breast cancer is the most common and the leading cause of death among women, with estimated 57,000 new cases in 2014. The mammography (2D) plays an important role in the early detection of breast cancer, but in some cases can be difficult to detect malignant lesions due overlap of breast tissues. The Breast Digital Tomosynthesis (BDT: 3D) reduces the effects of overlap, providing improved characterization of mammographic findings. However, the dose may double as compared to the mammography. This study presents results of Contrast Ratio Noise tests (CRN) and quality image on a Siemens mammography equipment Mammomat Inspiration with tomosynthesis. The CRN was determined with plates Polymethylmethacrylate (PMMA) of 20 to 70 mm thickness and an aluminum plate of 10 mm 2 and 0.2 mm thickness. Image quality was assessed with the ACR Breast Simulator. In assessment of image quality, the detectability of fibers and masses was identical in 2D and 3D systems. Were visualized 4.5 fibers and 4 mass in both modes. In 2D mode groups have been identified 3.5 microcalcifications, and 3D were 3 groups. The Mean Glandular Dose for the simulator in 2D mode was 1.17 mGy and 2.35 mGy for the 3D mode. The result reinforces the importance of quality control in the process of obtaining the images and obtained in accordance CRN values, ensuring image quality and dose compatible in 2D and 3D processes

Investigation of absorbed radiation dose in refraction-enhanced breast tomosynthesis by a Laue case analyser

International Nuclear Information System (INIS)

Sato, H.; Ando, M.; Shimao, D.

2011-01-01

An early diagnosis system for breast cancer using refraction-enhanced breast tomosynthesis is under development. Tomograms of breast specimens based on refraction-contrast were demonstrated using the simplest shift-and-add tomosynthesis algorithm. Raw projection image data of breast specimens for tomosynthesis were acquired for a total of 51 views over an angle of 50 deg., in increments of 1 deg., by rotating the object. The incident X ray was monochromatic synchrotron radiation with 20 keV. The purpose of this study was to estimate the absorbed dose of a new X-ray imaging method. As breast cancer almost always arises in glandular breast tissue, the average absorbed dose in such glandular tissue should be measured to estimate the radiation risk associated with mammography. The absorbed dose of the mammary gland due to monochromatic X rays was calculated by the Monte Carlo method, and the optimal X ray energy range for refraction-enhanced breast tomosynthesis was investigated through actual measurements. Compared with the conventional method, it was found to be below one-sixth per inspection. (authors)

Optimized image acquisition for breast tomosynthesis in projection and reconstruction space

International Nuclear Information System (INIS)

Chawla, Amarpreet S.; Lo, Joseph Y.; Baker, Jay A.; Samei, Ehsan

2009-01-01

Breast tomosynthesis has been an exciting new development in the field of breast imaging. While the diagnostic improvement via tomosynthesis is notable, the full potential of tomosynthesis has not yet been realized. This may be attributed to the dependency of the diagnostic quality of tomosynthesis on multiple variables, each of which needs to be optimized. Those include dose, number of angular projections, and the total angular span of those projections. In this study, the authors investigated the effects of these acquisition parameters on the overall diagnostic image quality of breast tomosynthesis in both the projection and reconstruction space. Five mastectomy specimens were imaged using a prototype tomosynthesis system. 25 angular projections of each specimen were acquired at 6.2 times typical single-view clinical dose level. Images at lower dose levels were then simulated using a noise modification routine. Each projection image was supplemented with 84 simulated 3 mm 3D lesions embedded at the center of 84 nonoverlapping ROIs. The projection images were then reconstructed using a filtered backprojection algorithm at different combinations of acquisition parameters to investigate which of the many possible combinations maximizes the performance. Performance was evaluated in terms of a Laguerre-Gauss channelized Hotelling observer model-based measure of lesion detectability. The analysis was also performed without reconstruction by combining the model results from projection images using Bayesian decision fusion algorithm. The effect of acquisition parameters on projection images and reconstructed slices were then compared to derive an optimization rule for tomosynthesis. The results indicated that projection images yield comparable but higher performance than reconstructed images. Both modes, however, offered similar trends: Performance improved with an increase in the total acquisition dose level and the angular span. Using a constant dose level and angular

Tomosynthesis Breast Imaging Early Detection and Characterization of Breast Cancer

National Research Council Canada - National Science Library

Hamberg, Leena

2000-01-01

A digital tomosynthesis mammography method was developed with which to obtain tomographic images of the breast by acquiring a series of low radiation dose images as the x-ray tube moves in an arc above the breast...

TU-EF-207-03: Advances in Stationary Breast Tomosynthesis Using Distributed X-Ray Sources

Energy Technology Data Exchange (ETDEWEB)

Zhou, O. [The University of North Carolina at Chapel Hill (United States)

2015-06-15

Breast imaging technology is advancing on several fronts. In digital mammography, the major technological trend has been on optimization of approaches for performing combined mammography and tomosynthesis using the same system. In parallel, photon-counting slot-scan mammography is now in clinical use and more efforts are directed towards further development of this approach for spectral imaging. Spectral imaging refers to simultaneous acquisition of two or more energy-windowed images. Depending on the detector and associated electronics, there are a number of ways this can be accomplished. Spectral mammography using photon-counting detectors can suppress electronic noise and importantly, it enables decomposition of the image into various material compositions of interest facilitating quantitative imaging. Spectral imaging can be particularly important in intravenously injected contrast mammography and eventually tomosynthesis. The various approaches and applications of spectral mammography are discussed. Digital breast tomosynthesis relies on the mechanical movement of the x-ray tube to acquire a number of projections in a predefined arc, typically from 9 to 25 projections over a scan angle of +/−7.5 to 25 degrees depending on the particular system. The mechanical x-ray tube motion requires relatively long acquisition time, typically between 3.7 to 25 seconds depending on the system. Moreover, mechanical scanning may have an effect on the spatial resolution due to internal x-ray filament or external mechanical vibrations. New x-ray source arrays have been developed and they are aimed at replacing the scanned x-ray tube for improved acquisition time and potentially for higher spatial resolution. The potential advantages and challenges of this approach are described. Combination of digital mammography and tomosynthesis in a single system places increased demands on certain functional aspects of the detector and overall performance, particularly in the tomosynthesis

TU-EF-207-03: Advances in Stationary Breast Tomosynthesis Using Distributed X-Ray Sources

International Nuclear Information System (INIS)

Zhou, O.

2015-01-01

Breast imaging technology is advancing on several fronts. In digital mammography, the major technological trend has been on optimization of approaches for performing combined mammography and tomosynthesis using the same system. In parallel, photon-counting slot-scan mammography is now in clinical use and more efforts are directed towards further development of this approach for spectral imaging. Spectral imaging refers to simultaneous acquisition of two or more energy-windowed images. Depending on the detector and associated electronics, there are a number of ways this can be accomplished. Spectral mammography using photon-counting detectors can suppress electronic noise and importantly, it enables decomposition of the image into various material compositions of interest facilitating quantitative imaging. Spectral imaging can be particularly important in intravenously injected contrast mammography and eventually tomosynthesis. The various approaches and applications of spectral mammography are discussed. Digital breast tomosynthesis relies on the mechanical movement of the x-ray tube to acquire a number of projections in a predefined arc, typically from 9 to 25 projections over a scan angle of +/−7.5 to 25 degrees depending on the particular system. The mechanical x-ray tube motion requires relatively long acquisition time, typically between 3.7 to 25 seconds depending on the system. Moreover, mechanical scanning may have an effect on the spatial resolution due to internal x-ray filament or external mechanical vibrations. New x-ray source arrays have been developed and they are aimed at replacing the scanned x-ray tube for improved acquisition time and potentially for higher spatial resolution. The potential advantages and challenges of this approach are described. Combination of digital mammography and tomosynthesis in a single system places increased demands on certain functional aspects of the detector and overall performance, particularly in the tomosynthesis

Dual Energy Tomosynthesis breast phantom imaging

Science.gov (United States)

Koukou, V.; Martini, N.; Fountos, G.; Messaris, G.; Michail, C.; Kandarakis, I.; Nikiforidis, G.

2017-12-01

Dual energy (DE) imaging technique has been applied to many theoretical and experimental studies. The aim of the current study is to evaluate dual energy in breast tomosynthesis using commercial tomosynthesis system in terms of its potential to better visualize microcalcifications (μCs). The system uses a tungsten target X-ray tube and a selenium direct conversion detector. Low-energy (LE) images were acquired at different tube voltages (28, 30, 32 kV), while high-energy images at 49 kV. Fifteen projections, for the low- and high-energy respectively, were acquired without grid while tube scanned continuously. Log-subtraction algorithm was used in order to obtain the DE images with the weighting factor, w, derived empirically. The subtraction was applied to each pair of LE and HE slices after reconstruction. The TORMAM phantom was imaged with the different settings. Four regions-of-interest including μCs were identified in the inhomogeneous part of the phantom. The μCs in DE images were more clearly visible compared to the low-energy images. Initial results showed that DE tomosynthesis imaging is a promising modality, however more work is required.

High-speed large angle mammography tomosynthesis system

Science.gov (United States)

Eberhard, Jeffrey W.; Staudinger, Paul; Smolenski, Joe; Ding, Jason; Schmitz, Andrea; McCoy, Julie; Rumsey, Michael; Al-Khalidy, Abdulrahman; Ross, William; Landberg, Cynthia E.; Claus, Bernhard E. H.; Carson, Paul; Goodsitt, Mitchell; Chan, Heang-Ping; Roubidoux, Marilyn; Thomas, Jerry A.; Osland, Jacqueline

2006-03-01

A new mammography tomosynthesis prototype system that acquires 21 projection images over a 60 degree angular range in approximately 8 seconds has been developed and characterized. Fast imaging sequences are facilitated by a high power tube and generator for faster delivery of the x-ray exposure and a high speed detector read-out. An enhanced a-Si/CsI flat panel digital detector provides greater DQE at low exposure, enabling tomo image sequence acquisitions at total patient dose levels between 150% and 200% of the dose of a standard mammographic view. For clinical scenarios where a single MLO tomographic acquisition per breast may replace the standard CC and MLO views, total tomosynthesis breast dose is comparable to or below the dose in standard mammography. The system supports co-registered acquisition of x-ray tomosynthesis and 3-D ultrasound data sets by incorporating an ultrasound transducer scanning system that flips into position above the compression paddle for the ultrasound exam. Initial images acquired with the system are presented.

Primary breast osteosarcoma mimicking calcified fibroadenoma on screening digital breast tomosynthesis mammogram

Directory of Open Access Journals (Sweden)

Debbie Lee Bennett, MD

2017-12-01

Full Text Available Primary breast osteosarcoma is a rare malignancy, with mostly case reports in the literature. The appearance of breast osteosarcoma on digital breast tomosynthesis imaging has not yet been described. A 69-year-old woman presents for routine screening mammography and is found to have a calcified mass in her right breast. Pattern of calcification appeared “sunburst” on digital breast tomosynthesis images. This mass was larger than on the previous year's mammogram, at which time it had been interpreted as a benign calcified fibroadenoma. The subsequent workup demonstrated the mass to reflect primary breast osteosarcoma. The patient's workup and treatment are detailed in this case. Primary breast osteosarcoma, although rare, should be included as a diagnostic consideration for breast masses with a sunburst pattern of calcifications, particularly when the mammographic appearance has changed.

Breast cancer screening using tomosynthesis in combination with digital mammography.

Science.gov (United States)

Friedewald, Sarah M; Rafferty, Elizabeth A; Rose, Stephen L; Durand, Melissa A; Plecha, Donna M; Greenberg, Julianne S; Hayes, Mary K; Copit, Debra S; Carlson, Kara L; Cink, Thomas M; Barke, Lora D; Greer, Linda N; Miller, Dave P; Conant, Emily F

2014-06-25

Mammography plays a key role in early breast cancer detection. Single-institution studies have shown that adding tomosynthesis to mammography increases cancer detection and reduces false-positive results. To determine if mammography combined with tomosynthesis is associated with better performance of breast screening programs in the United States. Retrospective analysis of screening performance metrics from 13 academic and nonacademic breast centers using mixed models adjusting for site as a random effect. Period 1: digital mammography screening examinations 1 year before tomosynthesis implementation (start dates ranged from March 2010 to October 2011 through the date of tomosynthesis implementation); period 2: digital mammography plus tomosynthesis examinations from initiation of tomosynthesis screening (March 2011 to October 2012) through December 31, 2012. Recall rate for additional imaging, cancer detection rate, and positive predictive values for recall and for biopsy. A total of 454,850 examinations (n=281,187 digital mammography; n=173,663 digital mammography + tomosynthesis) were evaluated. With digital mammography, 29,726 patients were recalled and 5056 biopsies resulted in cancer diagnosis in 1207 patients (n=815 invasive; n=392 in situ). With digital mammography + tomosynthesis, 15,541 patients were recalled and 3285 biopsies resulted in cancer diagnosis in 950 patients (n=707 invasive; n=243 in situ). Model-adjusted rates per 1000 screens were as follows: for recall rate, 107 (95% CI, 89-124) with digital mammography vs 91 (95% CI, 73-108) with digital mammography + tomosynthesis; difference, -16 (95% CI, -18 to -14; P tomosynthesis; difference, 1.3 (95% CI, 0.4-2.1; P = .004); for cancer detection, 4.2 (95% CI, 3.8-4.7) with digital mammography vs 5.4 (95% CI, 4.9-6.0) with digital mammography + tomosynthesis; difference, 1.2 (95% CI, 0.8-1.6; P tomosynthesis; difference, 1.2 (95% CI, 0.8-1.6; P tomosynthesis was associated with an increase

Digital Breast Tomosynthesis versus Supplemental Diagnostic Mammographic Views for Evaluation of Noncalcified Breast Lesions

Science.gov (United States)

Bandos, Andriy I.; Ganott, Marie A.; Sumkin, Jules H.; Kelly, Amy E.; Catullo, Victor J.; Rathfon, Grace Y.; Lu, Amy H.; Gur, David

2013-01-01

Purpose: To compare the diagnostic performance of breast tomosynthesis versus supplemental mammography views in classification of masses, distortions, and asymmetries. Materials and Methods: Eight radiologists who specialized in breast imaging retrospectively reviewed 217 consecutively accrued lesions by using protocols that were HIPAA compliant and institutional review board approved in 182 patients aged 31–60 years (mean, 50 years) who underwent diagnostic mammography and tomosynthesis. The lesions in the cohort included 33% (72 of 217) cancers and 67% (145 of 217) benign lesions. Eighty-four percent (182 of 217) of the lesions were masses, 11% (25 of 217) were asymmetries, and 5% (10 of 217) were distortions that were initially detected at clinical examination in 8% (17 of 217), at mammography in 80% (173 of 217), at ultrasonography (US) in 11% (25 of 217), or at magnetic resonance imaging in 1% (2 of 217). Histopathologic examination established truth in 191 lesions, US revealed a cyst in 12 lesions, and 14 lesions had a normal follow-up. Each lesion was interpreted once with tomosynthesis and once with supplemental mammographic views; both modes included the mediolateral oblique and craniocaudal views in a fully crossed and balanced design by using a five-category Breast Imaging Reporting and Data System (BI-RADS) assessment and a probability-of-malignancy score. Differences between modes were analyzed with a generalized linear mixed model for BI-RADS–based sensitivity and specificity and with modified Obuchowski-Rockette approach for probability-of-malignancy–based area under the receiver operating characteristic (ROC) curve. Results: Average probability-of-malignancy–based area under the ROC curve was 0.87 for tomosynthesis versus 0.83 for supplemental views (P tomosynthesis, the false-positive rate decreased from 85% (989 of 1160) to 74% (864 of 1160) (P tomosynthesis, more cancers were classified as BI-RADS category 5 (39% [226 of 576] vs 33% [188

Accuracy and reading time for six strategies using digital breast tomosynthesis in women with mammographically negative dense breasts.

Science.gov (United States)

Tagliafico, Alberto Stefano; Calabrese, Massimo; Bignotti, Bianca; Signori, Alessio; Fisci, Erica; Rossi, Federica; Valdora, Francesca; Houssami, Nehmat

2017-12-01

To compare six strategies using digital breast tomosynthesis in women with mammographically negative dense breasts. This is a substudy of the 'ASTOUND' trial. 163 women who underwent tomosynthesis with synthetically reconstructed projection images (S-2D) inclusive of 13 (7.9%) cases diagnosed with breast cancer at histopathology after surgery were evaluated. Accuracy measures and screen-reading time of six reading strategies were assessed: (A) Single reading of S-2D alone, (B) single reading of tomosynthesis alone, (C) single reading of joint interpretation of tomosynthesis + S-2D, (D) double-reading of S-2D alone, (E) double reading of tomosynthesis alone, (F) double reading of joint interpretation of tomosynthesis + S-2D. The median age of the patients was 53 years (range, 36-88 years). The highest global accuracy was obtained with double reading of tomosynthesis + S2D (F) with an AUC of 0.979 (ptomosynthesis+ S2D had the best accuracy of six screen-reading strategies although it had the longest reading time. • Tomosynthesis acquisitions are progressively implemented with reconstructed synthesized 2D images • Double reading using S-2D plus tomosynthesis had the highest global accuracy (ptomosynthesis increased reading time.

Tubular Carcinoma of the Breast: Advantages and Limitations of Breast Tomosynthesis

Directory of Open Access Journals (Sweden)

Filipa Vilaverde

2016-01-01

Full Text Available Tubular carcinoma of the breast is a rare variant of invasive ductal carcinoma. We report a case of 42-year-old asymptomatic female with a histopathological proven multifocal tubular carcinoma, studied by mammography, Tomosynthesis, Ultrasound, and Magnetic Resonance. Herein, we discuss the advantages and limitations of Tomosynthesis, an emerging imaging technique, in this particular case.

Tubular Carcinoma of the Breast: Advantages and Limitations of Breast Tomosynthesis

Science.gov (United States)

Rocha, Ana; Reis, Alcinda

2016-01-01

Tubular carcinoma of the breast is a rare variant of invasive ductal carcinoma. We report a case of 42-year-old asymptomatic female with a histopathological proven multifocal tubular carcinoma, studied by mammography, Tomosynthesis, Ultrasound, and Magnetic Resonance. Herein, we discuss the advantages and limitations of Tomosynthesis, an emerging imaging technique, in this particular case. PMID:28116205

An adaptive toolkit for image quality evaluation in system performance test of digital breast tomosynthesis

Science.gov (United States)

Zhang, Guozhi; Petrov, Dimitar; Marshall, Nicholas; Bosmans, Hilde

2017-03-01

Digital breast tomosynthesis (DBT) is a relatively new diagnostic imaging modality for women. Currently, various models of DBT systems are available on the market and the number of installations is rapidly increasing. EUREF, the European Reference Organization for Quality Assured Breast Screening and Diagnostic Services, has proposed a preliminary Guideline - protocol for the quality control of the physical and technical aspects of digital breast tomosynthesis systems, with an ultimate aim of providing limiting values guaranteeing proper performance for different applications of DBT. In this work, we introduce an adaptive toolkit developed in accordance with this guideline to facilitate the process of image quality evaluation in DBT performance test. This toolkit implements robust algorithms to quantify various technical parameters of DBT images and provides a convenient user interface in practice. Each test is built into a separate module with configurations set corresponding to the European guideline, which can be easily adapted to different settings and extended with additional tests. This toolkit largely improves the efficiency for image quality evaluation of DBT. It is also going to evolve with the development of protocols in quality control of DBT systems.

Preliminary Clinical Experience with a Combined Automated Breast Ultrasound and Digital Breast Tomosynthesis System.

Science.gov (United States)

Larson, Eric D; Lee, Won-Mean; Roubidoux, Marilyn A; Goodsitt, Mitchell M; Lashbrook, Chris; Davis, Cynthia E; Kripfgans, Oliver D; Carson, Paul L

2018-03-01

We analyzed the performance of a mammographically configured, automated breast ultrasound (McABUS) scanner combined with a digital breast tomosynthesis (DBT) system. The GE Invenia ultrasound system was modified for integration with GE DBT systems. Ultrasound and DBT imaging were performed in the same mammographic compression. Our small preliminary study included 13 cases, six of whom had contained invasive cancers. From analysis of these cases, current limitations and corresponding potential improvements of the system were determined. A registration analysis was performed to compare the ease of McABUS to DBT registration for this system with that of two systems designed previously. It was observed that in comparison to data from an earlier study, the McABUS-to-DBT registration alignment errors for both this system and a previously built combined system were smaller than those for a previously built standalone McABUS system. Copyright © 2018 World Federation for Ultrasound in Medicine and Biology. Published by Elsevier Inc. All rights reserved.

Development of a stationary digital breast tomosynthesis system for clinical applications

Science.gov (United States)

Tucker, Andrew Wallace

Digital breast tomosynthesis (DBT) has been shown to be a very beneficial tool in the fight against breast cancer. However, current DBT systems have poor spatial resolution compared to full field digital mammography (FFDM), the current gold standard for screening mammography. The poor spatial resolution of DBT systems is a result of the single X-ray source design. In DBT systems a single X-ray source is rotated over an angular span in order to acquire the images needed for 3D reconstruction. The rotation of the X-ray source degrades the spatial resolution of the images. DBT systems which are approved for use in the United States for screening mammography are required to also take a full field digital mammogram with every DBT acquisition in order to compensate for the poor spatial resolution. This double exposure essentially doubles the radiation dose to patients. Over the past few years our research group has developed a carbon nanotube (CNT) based X-ray source technology. The unique nature of CNT X-ray sources allows for multiple X-ray focal spots in a single X-ray source. Using this technology we have recently developed a stationary DBT system (s-DBT) system which is capable of producing a full tomosynthesis image dataset with zero motion of the X-ray source. This system has been shown to have increased spatial resolution over other DBT systems in a laboratory setting. The goal of this thesis work was to optimize the s-DBT system, demonstrate its usefulness over other systems, and finally implement it into the clinic for a clinical trial. The s-DBT system was optimized using different image quality measurements. The optimized system was then used in a breast specimen imaging trial which compared s-DBT to magnified 2D mammography and a conventional single source DBT system. Readers preferred s-DBT to magnified 2D mammography for specimen margin delineation and mass detection, these results were not significant. Using physical measures for spatial resolution the s

Task-based assessment of breast tomosynthesis: Effect of acquisition parameters and quantum noise1

OpenAIRE

Reiser, I.; Nishikawa, R. M.

2010-01-01

Purpose: Tomosynthesis is a promising modality for breast imaging. The appearance of the tomosynthesis reconstructed image is greatly affected by the choice of acquisition and reconstruction parameters. The purpose of this study was to investigate the limitations of tomosynthesis breast imaging due to scan parameters and quantum noise. Tomosynthesis image quality was assessed based on performance of a mathematical observer model in a signal-known exactly (SKE) detection task.

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.

Science.gov (United States)

Chan, Heang-Ping; Goodsitt, Mitchell M; Helvie, Mark A; Zelakiewicz, Scott; Schmitz, Andrea; Noroozian, Mitra; Paramagul, Chintana; Roubidoux, Marilyn A; Nees, Alexis V; Neal, Colleen H; Carson, Paul; Lu, Yao; Hadjiiski, Lubomir; Wei, Jun

2014-12-01

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 ). 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. 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 .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 tomosynthesis provided higher sensitivity and conspicuity than wide-angle DBT digital breast tomosynthesis for subtle microcalcification clusters. © RSNA, 2014.

Comparison of tomosynthesis plus digital mammography and digital mammography alone for breast cancer screening.

Science.gov (United States)

Haas, Brian M; Kalra, Vivek; Geisel, Jaime; Raghu, Madhavi; Durand, Melissa; Philpotts, Liane E

2013-12-01

To compare screening recall rates and cancer detection rates of tomosynthesis plus conventional digital mammography to those of conventional digital mammography alone. All patients presenting for screening mammography between October 1, 2011, and September 30, 2012, at four clinical sites were reviewed in this HIPAA-compliant retrospective study, for which the institutional review board granted approval and waived the requirement for informed consent. Patients at sites with digital tomosynthesis were offered screening with digital mammography plus tomosynthesis. Patients at sites without tomosynthesis underwent conventional digital mammography. Recall rates were calculated and stratified according to breast density and patient age. Cancer detection rates were calculated and stratified according to the presence of a risk factor for breast cancer. The Fisher exact test was used to compare the two groups. Multivariate logistic regression was used to assess the effect of screening method, breast density, patient age, and cancer risk on the odds of recall from screening. A total of 13 158 patients presented for screening mammography; 6100 received tomosynthesis. The overall recall rate was 8.4% for patients in the tomosynthesis group and 12.0% for those in the conventional mammography group (P tomosynthesis reduced recall rates for all breast density and patient age groups, with significant differences (P tomosynthesis versus 5.2 per 1000 in patients receiving conventional mammography alone (P = .70). Patients undergoing tomosynthesis plus digital mammography had significantly lower screening recall rates. The greatest reductions were for those younger than 50 years and those with dense breasts. A nonsignificant 9.5% increase in cancer detection was observed in the tomosynthesis group. © RSNA, 2013.

Digital breast tomosynthesis (3D-mammography) screening: A pictorial review of screen-detected cancers and false recalls attributed to tomosynthesis in prospective screening trials.

Science.gov (United States)

Houssami, Nehmat; Lång, Kristina; Bernardi, Daniela; Tagliafico, Alberto; Zackrisson, Sophia; Skaane, Per

2016-04-01

This pictorial review highlights cancers detected only at tomosynthesis screening and screens falsely recalled in the course of breast tomosynthesis screening, illustrating both true-positive (TP) and false-positive (FP) detection attributed to tomosynthesis. Images and descriptive data were used to characterise cases of screen-detection with tomosynthesis, sourced from prospective screening trials that performed standard (2D) digital mammography (DM) and tomosynthesis (3D-mammography) in the same screening participants. Exemplar cases from four trials highlight common themes of relevance to screening practice including: the type of lesions frequently made more conspicuous or perceptible by tomosynthesis (spiculated masses, and architectural distortions); the histologic findings (both TP and FP) of tomosynthesis-only detection; and the need to extend breast work-up protocols (additional imaging including ultrasound and MRI, and tomosynthesis-guided biopsy) if tomosynthesis is adopted for primary screening. Copyright © 2016 Elsevier Ltd. All rights reserved.

A software-based x-ray scatter correction method for breast tomosynthesis

OpenAIRE

Jia Feng, Steve Si; Sechopoulos, Ioannis

2011-01-01

Purpose: To develop a software-based scatter correction method for digital breast tomosynthesis (DBT) imaging and investigate its impact on the image quality of tomosynthesis reconstructions of both phantoms and patients.

Can Breast Compression Be Reduced in Digital Mammography and Breast Tomosynthesis?

NARCIS (Netherlands)

Agasthya, G.A.; D'Orsi, E.; Kim, Y. J.; Handa, P.; Ho, C.P.; D'Orsi, C.J.; Sechopoulos, I.

2017-01-01

OBJECTIVE: The objective of this study was to investigate the impact of decreasing breast compression during digital mammography and breast tomosynthesis (DBT) on perceived pain and image quality. MATERIALS AND METHODS: In this two-part study, two groups of women with prior mammograms were

Evaluation of the technical performance of three different commercial digital breast tomosynthesis systems in the clinical environment

NARCIS (Netherlands)

Rodriguez Ruiz, A.; Castillo, M.; Garayoa, J.; Chevalier, M.

2016-01-01

The aim of this work was to research and evaluate the performance of three different digital breast tomosynthesis (DBT) systems in the clinical environment (Siemens Mammomat Inspiration, Hologic Selenia Dimensions, and Fujifilm Amulet Innovality). The characterization included the study of the

Added value of one-view breast tomosynthesis combined with digital mammography according to reader experience

International Nuclear Information System (INIS)

Thomassin-Naggara, Isabelle; Perrot, Nicolas; Dechoux, Sophie; Ribeiro, Carine; Chopier, Jocelyne; Bazelaire, Cedric de

2015-01-01

Highlights: • Breast tomosynthesis improves diagnostic performance especially for radiologists with lower experience in mammography. • Adding only one-view digital breast tomosynthesis to mammography improves the cancer detection rate. • Breast tomosynthesis is mainly useful for helping radiologists to detect architectural distortion. - Abstract: Purpose: To retrospectively evaluate the added value of one-view breast tomosynthesis in adjunct with mammography to characterize breast lesions. Materials and methods: Our institutional ethics committees approved the study and granted a waiver of informed consent. One hundred fifty-five women (mean age, 51.3 years, range: 24–92 years) who systematically underwent mammography and breast tomosynthesis with subsequent percutaneous biopsy were analyzed. Four radiologists (two seniors, R1 and R2, and two juniors, R3 and R4 with 30, 10, 3 and 1 years of experience in breast imaging, respectively) independently reviewed exams in two steps: mammography alone and tomosynthesis in adjunct with mammography. The lesions in the cohort included 39.3% (61/155) cancers, 2.5% (4/155) high-risk lesions and 58.1% (90/155) benign lesions. A receiver operating characteristic (ROC) curve analysis was performed to compare the results of the two readings. Results: There was almost perfect agreement irrespective of reader experience for the reading of the mammography in adjunct with tomosynthesis, whereas agreement was poor between junior and senior readers for the reading of mammography alone. Area under the ROC (Az) values for the tomosynthesis in adjunct with mammography were significantly better than Az values for mammography alone for all readers except the most experienced, for whom only a tendency was noted. The proportion of cancers undiagnosed by mammography alone that were well diagnosed by tomosynthesis in adjunct with mammography was 6.5% (4/61), 13.1% (8/61), 27.8% (17/61) and 26.2% (16/61) for Readers 1, 2, 3 and 4

Added value of one-view breast tomosynthesis combined with digital mammography according to reader experience

Energy Technology Data Exchange (ETDEWEB)

Thomassin-Naggara, Isabelle, E-mail: isabelle.thomassin@tnn.aphp.fr [Sorbonne Universités, UPMC Univ Paris 06, IUC, 75005 Paris (France); INSERM, UMR970, Equipe 2, Imagerie de l’angiogenèse, 75005 Paris (France); AP-HP, Hôpital Tenon, Department of Radiology, 4 rue de la Chine, 75020 Paris (France); Perrot, Nicolas [AP-HP, Hôpital Tenon, Department of Radiology, 4 rue de la Chine, 75020 Paris (France); Centre Pyramides, Paris (France); Dechoux, Sophie [Sorbonne Universités, UPMC Univ Paris 06, IUC, 75005 Paris (France); AP-HP, Hôpital Tenon, Department of Radiology, 4 rue de la Chine, 75020 Paris (France); Ribeiro, Carine [Centre Pyramides, Paris (France); Chopier, Jocelyne [AP-HP, Hôpital Tenon, Department of Radiology, 4 rue de la Chine, 75020 Paris (France); Bazelaire, Cedric de [APHP, Department of Radiology, Hôpital Saint Louis, 75010 Paris (France)

2015-02-15

Highlights: • Breast tomosynthesis improves diagnostic performance especially for radiologists with lower experience in mammography. • Adding only one-view digital breast tomosynthesis to mammography improves the cancer detection rate. • Breast tomosynthesis is mainly useful for helping radiologists to detect architectural distortion. - Abstract: Purpose: To retrospectively evaluate the added value of one-view breast tomosynthesis in adjunct with mammography to characterize breast lesions. Materials and methods: Our institutional ethics committees approved the study and granted a waiver of informed consent. One hundred fifty-five women (mean age, 51.3 years, range: 24–92 years) who systematically underwent mammography and breast tomosynthesis with subsequent percutaneous biopsy were analyzed. Four radiologists (two seniors, R1 and R2, and two juniors, R3 and R4 with 30, 10, 3 and 1 years of experience in breast imaging, respectively) independently reviewed exams in two steps: mammography alone and tomosynthesis in adjunct with mammography. The lesions in the cohort included 39.3% (61/155) cancers, 2.5% (4/155) high-risk lesions and 58.1% (90/155) benign lesions. A receiver operating characteristic (ROC) curve analysis was performed to compare the results of the two readings. Results: There was almost perfect agreement irrespective of reader experience for the reading of the mammography in adjunct with tomosynthesis, whereas agreement was poor between junior and senior readers for the reading of mammography alone. Area under the ROC (Az) values for the tomosynthesis in adjunct with mammography were significantly better than Az values for mammography alone for all readers except the most experienced, for whom only a tendency was noted. The proportion of cancers undiagnosed by mammography alone that were well diagnosed by tomosynthesis in adjunct with mammography was 6.5% (4/61), 13.1% (8/61), 27.8% (17/61) and 26.2% (16/61) for Readers 1, 2, 3 and 4

Ultra-Fast Image Reconstruction of Tomosynthesis Mammography Using GPU.

Science.gov (United States)

Arefan, D; Talebpour, A; Ahmadinejhad, N; Kamali Asl, A

2015-06-01

Digital Breast Tomosynthesis (DBT) is a technology that creates three dimensional (3D) images of breast tissue. Tomosynthesis mammography detects lesions that are not detectable with other imaging systems. If image reconstruction time is in the order of seconds, we can use Tomosynthesis systems to perform Tomosynthesis-guided Interventional procedures. This research has been designed to study ultra-fast image reconstruction technique for Tomosynthesis Mammography systems using Graphics Processing Unit (GPU). At first, projections of Tomosynthesis mammography have been simulated. In order to produce Tomosynthesis projections, it has been designed a 3D breast phantom from empirical data. It is based on MRI data in its natural form. Then, projections have been created from 3D breast phantom. The image reconstruction algorithm based on FBP was programmed with C++ language in two methods using central processing unit (CPU) card and the Graphics Processing Unit (GPU). It calculated the time of image reconstruction in two kinds of programming (using CPU and GPU).

Ultra-Fast Image Reconstruction of Tomosynthesis Mammography Using GPU

Directory of Open Access Journals (Sweden)

Arefan D

2015-06-01

Full Text Available Digital Breast Tomosynthesis (DBT is a technology that creates three dimensional (3D images of breast tissue. Tomosynthesis mammography detects lesions that are not detectable with other imaging systems. If image reconstruction time is in the order of seconds, we can use Tomosynthesis systems to perform Tomosynthesis-guided Interventional procedures. This research has been designed to study ultra-fast image reconstruction technique for Tomosynthesis Mammography systems using Graphics Processing Unit (GPU. At first, projections of Tomosynthesis mammography have been simulated. In order to produce Tomosynthesis projections, it has been designed a 3D breast phantom from empirical data. It is based on MRI data in its natural form. Then, projections have been created from 3D breast phantom. The image reconstruction algorithm based on FBP was programmed with C++ language in two methods using central processing unit (CPU card and the Graphics Processing Unit (GPU. It calculated the time of image reconstruction in two kinds of programming (using CPU and GPU.

Power spectrum analysis of the x-ray scatter signal in mammography and breast tomosynthesis projections.

Science.gov (United States)

Sechopoulos, Ioannis; Bliznakova, Kristina; Fei, Baowei

2013-10-01

To analyze the frequency domain characteristics of the signal in mammography images and breast tomosynthesis projections with patient tissue texture due to detected scattered x-rays. Acquisitions of x-ray projection images of 19 different patient breasts were simulated using previously acquired volumetric patient images. Acquisition of these images was performed with a dedicated breast CT prototype system, and the images were classified into voxels representing skin, adipose, and glandular tissue with a previously validated automated algorithm. The classified three dimensional images then underwent simulated mechanical compression representing that which is performed during acquisition of mammography and breast tomosynthesis images. The acquisition of projection images of each patient breast was simulated using Monte Carlo methods with each simulation resulting in two images: one of the primary (non-scattered) signal and one of the scatter signal. To analyze the scatter signal for both mammography and breast tomosynthesis, two projections images of each patient breast were simulated, one with the x-ray source positioned at 0° (mammography and central tomosynthesis projection) and at 30° (wide tomosynthesis projection). The noise power spectra (NPS) for both the scatter signal alone and the total signal (primary + scatter) for all images were obtained and the combined results of all patients analyzed. The total NPS was fit to the expected power-law relationship NPS(f) = k/f β and the results were compared with those previously published on the power spectrum characteristics of mammographic texture. The scatter signal alone was analyzed qualitatively and a power-law fit was also performed. The mammography and tomosynthesis projections of three patient breasts were too small to analyze, so a total of 16 patient breasts were analyzed. The values of β for the total signal of the 0° projections agreed well with previously published results. As expected, the scatter

Comparison of Sonography versus Digital Breast Tomosynthesis to Locate Intramammary Marker Clips.

Science.gov (United States)

Schulz-Wendtland, R; Dankerl, P; Dilbat, G; Bani, M; Fasching, P A; Heusinger, K; Lux, M P; Loehberg, C R; Jud, S M; Rauh, C; Bayer, C M; Beckmann, M W; Wachter, D L; Uder, M; Meier-Meitinger, M; Brehm, B

2015-01-01

Introduction: This study aimed to compare the accuracy of sonography versus digital breast tomosynthesis to locate intramammary marker clips placed under ultrasound guidance. Patients and Methods: Fifty patients with suspicion of breast cancer (lesion diameter less than 2 cm [cT1]) had ultrasound-guided core needle biopsy with placement of a marker clip in the center of the tumor. Intramammary marker clips were subsequently located with both sonography and digital breast tomosynthesis. Results: Sonography detected no dislocation of intrammammary marker clips in 42 of 50 patients (84 %); dislocation was reported in 8 patients (16 %) with a maximum dislocation of 7 mm along the x-, y- or z-axis. Digital breast tomosynthesis showed accurate placement without dislocation of the intramammary marker clip in 48 patients (96 %); 2 patients (4 %) had a maximum clip dislocation of 3 mm along the x-, y- or z-axis (p tomosynthesis could improve the accuracy when locating intramammary marker clips compared to sonography and could, in future, be used to complement or even completely replace sonography.

The compressed breast during mammography and breast tomosynthesis: in vivo shape characterization and modeling

NARCIS (Netherlands)

Rodriguez Ruiz, A.; Agasthya, G.A.; Sechopoulos, I.

2017-01-01

To characterize and develop a patient-based 3D model of the compressed breast undergoing mammography and breast tomosynthesis. During this IRB-approved, HIPAA-compliant study, 50 women were recruited to undergo 3D breast surface imaging with structured light (SL) during breast compression, along

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

Science.gov (United States)

Sechopoulos, Ioannis

2013-01-01

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. PMID:23298127

System geometry optimization for molecular breast tomosynthesis with focusing multi-pinhole collimators

Science.gov (United States)

van Roosmalen, Jarno; Beekman, Freek J.; Goorden, Marlies C.

2018-01-01

Imaging of 99mTc-labelled tracers is gaining popularity for detecting breast tumours. Recently, we proposed a novel design for molecular breast tomosynthesis (MBT) based on two sliding focusing multi-pinhole collimators that scan a modestly compressed breast. Simulation studies indicate that MBT has the potential to improve the tumour-to-background contrast-to-noise ratio significantly over state-of-the-art planar molecular breast imaging. The aim of the present paper is to optimize the collimator-detector geometry of MBT. Using analytical models, we first optimized sensitivity at different fixed system resolutions (ranging from 5 to 12 mm) by tuning the pinhole diameters and the distance between breast and detector for a whole series of automatically generated multi-pinhole designs. We evaluated both MBT with a conventional continuous crystal detector with 3.2 mm intrinsic resolution and with a pixelated detector with 1.6 mm pixels. Subsequently, full system simulations of a breast phantom containing several lesions were performed for the optimized geometry at each system resolution for both types of detector. From these simulations, we found that tumour-to-background contrast-to-noise ratio was highest for systems in the 7 mm-10 mm system resolution range over which it hardly varied. No significant differences between the two detector types were found.

X-ray phase-contrast tomosynthesis for improved breast tissue discrimination

International Nuclear Information System (INIS)

Schleede, Simone; Bech, Martin; Grandl, Susanne; Sztrókay, Aniko; Herzen, Julia; Mayr, Doris; Stockmar, Marco; Potdevin, Guillaume

2014-01-01

Purpose: Attenuation-based tomosynthesis has proven to successfully resolve the glandular tissue overlap present in mammography. However, the ability of tomosynthesis to differentiate tumorous and glandular tissue remains limited, due to the small differences in X-ray attenuation in breast tissue. One possibility to overcome this limitation and to further increase the diagnostic value of tomosynthesis exams, is the application of recently developed grating-based phase-contrast methods, which provide complementary information on the phase shift and the local scattering power of the sample. In this study, we report on first phase-contrast breast tomosynthesis results of a mastectomy sample slice with an invasive ductal carcinoma. Material and methods: A slice of a mastectomy sample with histologically proven invasive ductal cancer was imaged at the synchrotron radiation source ESRF (Grenoble, France). We used a two-grating interferometer setup at the ninth fractional Talbot distance and with an X-ray energy of 23 keV. In grating interferometry absorption, differential phase, and scattering images are recorded simultaneously. The tomosynthesis scan comprises 61 projections. Multimodal tomosynthesis results were reconstructed using a standard filtered back-projection approach. Our findings are supported by a comparison of tomographic views to histopathology. Results: Phase-contrast tomosynthesis combines the advantage of improved soft-tissue discrimination in phase-contrast imaging with the ability of tomosynthesis to provide a third dimension so that improved feature visibility is not hampered by superposition artifacts. Our results indicate superior diagnostic value due to the depth resolution supplied in tomosynthesis imaging; a region of necrotic tissue that is obscured in a projection image can clearly be depicted in one single tomosynthesis slice. Compared to absorption tomosynthesis alone, soft tissue contrast is significantly enhanced in phase

X-ray phase-contrast tomosynthesis for improved breast tissue discrimination.

Science.gov (United States)

Schleede, Simone; Bech, Martin; Grandl, Susanne; Sztrókay, Aniko; Herzen, Julia; Mayr, Doris; Stockmar, Marco; Potdevin, Guillaume; Zanette, Irene; Rack, Alexander; Weitkamp, Timm; Pfeiffer, Franz

2014-03-01

Attenuation-based tomosynthesis has proven to successfully resolve the glandular tissue overlap present in mammography. However, the ability of tomosynthesis to differentiate tumorous and glandular tissue remains limited, due to the small differences in X-ray attenuation in breast tissue. One possibility to overcome this limitation and to further increase the diagnostic value of tomosynthesis exams, is the application of recently developed grating-based phase-contrast methods, which provide complementary information on the phase shift and the local scattering power of the sample. In this study, we report on first phase-contrast breast tomosynthesis results of a mastectomy sample slice with an invasive ductal carcinoma. A slice of a mastectomy sample with histologically proven invasive ductal cancer was imaged at the synchrotron radiation source ESRF (Grenoble, France). We used a two-grating interferometer setup at the ninth fractional Talbot distance and with an X-ray energy of 23 keV. In grating interferometry absorption, differential phase, and scattering images are recorded simultaneously. The tomosynthesis scan comprises 61 projections. Multimodal tomosynthesis results were reconstructed using a standard filtered back-projection approach. Our findings are supported by a comparison of tomographic views to histopathology. Phase-contrast tomosynthesis combines the advantage of improved soft-tissue discrimination in phase-contrast imaging with the ability of tomosynthesis to provide a third dimension so that improved feature visibility is not hampered by superposition artifacts. Our results indicate superior diagnostic value due to the depth resolution supplied in tomosynthesis imaging; a region of necrotic tissue that is obscured in a projection image can clearly be depicted in one single tomosynthesis slice. Compared to absorption tomosynthesis alone, soft tissue contrast is significantly enhanced in phase-contrast tomosynthesis views, where fibrous structures

Digital Breast Tomosynthesis: State of the Art

Science.gov (United States)

Vedantham, Srinivasan; Vijayaraghavan, Gopal R.; Kopans, Daniel B.

2015-01-01

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 PMID:26599926

Comparative effectiveness of combined digital mammography and tomosynthesis screening for women with dense breasts.

Science.gov (United States)

Lee, Christoph I; Cevik, Mucahit; Alagoz, Oguzhan; Sprague, Brian L; Tosteson, Anna N A; Miglioretti, Diana L; Kerlikowske, Karla; Stout, Natasha K; Jarvik, Jeffrey G; Ramsey, Scott D; Lehman, Constance D

2015-03-01

To evaluate the effectiveness of combined biennial digital mammography and tomosynthesis screening, compared with biennial digital mammography screening alone, among women with dense breasts. An established, discrete-event breast cancer simulation model was used to estimate the comparative clinical effectiveness and cost-effectiveness of biennial screening with both digital mammography and tomosynthesis versus digital mammography alone among U.S. women aged 50-74 years with dense breasts from a federal payer perspective and a lifetime horizon. Input values were estimated for test performance, costs, and health state utilities from the National Cancer Institute Breast Cancer Surveillance Consortium, Medicare reimbursement rates, and medical literature. Sensitivity analyses were performed to determine the implications of varying key model parameters, including combined screening sensitivity and specificity, transient utility decrement of diagnostic work-up, and additional cost of tomosynthesis. For the base-case analysis, the incremental cost per quality-adjusted life year gained by adding tomosynthesis to digital mammography screening was $53 893. An additional 0.5 deaths were averted and 405 false-positive findings avoided per 1000 women after 12 rounds of screening. Combined screening remained cost-effective (less than $100 000 per quality-adjusted life year gained) over a wide range of incremental improvements in test performance. Overall, cost-effectiveness was most sensitive to the additional cost of tomosynthesis. Biennial combined digital mammography and tomosynthesis screening for U.S. women aged 50-74 years with dense breasts is likely to be cost-effective if priced appropriately (up to $226 for combined examinations vs $139 for digital mammography alone) and if reported interpretive performance metrics of improved specificity with tomosynthesis are met in routine practice.

Dual-energy contrast-enhanced breast tomosynthesis: optimization of beam quality for dose and image quality

International Nuclear Information System (INIS)

Samei, Ehsan; Saunders, Robert S Jr

2011-01-01

Dual-energy contrast-enhanced breast tomosynthesis is a promising technique to obtain three-dimensional functional information from the breast with high resolution and speed. To optimize this new method, this study searched for the beam quality that maximized image quality in terms of mass detection performance. A digital tomosynthesis system was modeled using a fast ray-tracing algorithm, which created simulated projection images by tracking photons through a voxelized anatomical breast phantom containing iodinated lesions. The single-energy images were combined into dual-energy images through a weighted log subtraction process. The weighting factor was optimized to minimize anatomical noise, while the dose distribution was chosen to minimize quantum noise. The dual-energy images were analyzed for the signal difference to noise ratio (SdNR) of iodinated masses. The fast ray-tracing explored 523 776 dual-energy combinations to identify which yields optimum mass SdNR. The ray-tracing results were verified using a Monte Carlo model for a breast tomosynthesis system with a selenium-based flat-panel detector. The projection images from our voxelized breast phantom were obtained at a constant total glandular dose. The projections were combined using weighted log subtraction and reconstructed using commercial reconstruction software. The lesion SdNR was measured in the central reconstructed slice. The SdNR performance varied markedly across the kVp and filtration space. Ray-tracing results indicated that the mass SdNR was maximized with a high-energy tungsten beam at 49 kVp with 92.5 μm of copper filtration and a low-energy tungsten beam at 49 kVp with 95 μm of tin filtration. This result was consistent with Monte Carlo findings. This mammographic technique led to a mass SdNR of 0.92 ± 0.03 in the projections and 3.68 ± 0.19 in the reconstructed slices. These values were markedly higher than those for non-optimized techniques. Our findings indicate that dual

The compressed breast during mammography and breast tomosynthesis: in vivo shape characterization and modeling

Science.gov (United States)

Rodríguez-Ruiz, Alejandro; Agasthya, Greeshma A.; Sechopoulos, Ioannis

2017-09-01

To characterize and develop a patient-based 3D model of the compressed breast undergoing mammography and breast tomosynthesis. During this IRB-approved, HIPAA-compliant study, 50 women were recruited to undergo 3D breast surface imaging with structured light (SL) during breast compression, along with simultaneous acquisition of a tomosynthesis image. A pair of SL systems were used to acquire 3D surface images by projecting 24 different patterns onto the compressed breast and capturing their reflection off the breast surface in approximately 12-16 s. The 3D surface was characterized and modeled via principal component analysis. The resulting surface model was combined with a previously developed 2D model of projected compressed breast shapes to generate a full 3D model. Data from ten patients were discarded due to technical problems during image acquisition. The maximum breast thickness (found at the chest-wall) had an average value of 56 mm, and decreased 13% towards the nipple (breast tilt angle of 5.2°). The portion of the breast not in contact with the compression paddle or the support table extended on average 17 mm, 18% of the chest-wall to nipple distance. The outermost point along the breast surface lies below the midline of the total thickness. A complete 3D model of compressed breast shapes was created and implemented as a software application available for download, capable of generating new random realistic 3D shapes of breasts undergoing compression. Accurate characterization and modeling of the breast curvature and shape was achieved and will be used for various image processing and clinical tasks.

MO-DE-209-04: Radiation Dosimetry in Breast Tomosynthesis

International Nuclear Information System (INIS)

Sechopoulos, I.

2016-01-01

Digital Breast Tomosynthesis (DBT) is rapidly replacing mammography as the standard of care in breast cancer screening and diagnosis. DBT is a form of computed tomography, in which a limited set of projection images are acquired over a small angular range and reconstructed into tomographic data. The angular range varies from 15° to 50° and the number of projections varies between 9 and 25 projections, as determined by the equipment manufacturer. It is equally valid to treat DBT as the digital analog of classical tomography – that is, linear tomography. In fact, the name “tomosynthesis” stands for “synthetic tomography.” DBT shares many common features with classical tomography, including the radiographic appearance, dose, and image quality considerations. As such, both the science and practical physics of DBT systems is a hybrid between computed tomography and classical tomographic methods. In this lecture, we will explore the continuum from radiography to computed tomography to illustrate the characteristics of DBT. This lecture will consist of four presentations that will provide a complete overview of DBT, including a review of the fundamentals of DBT acquisition, a discussion of DBT reconstruction methods, an overview of dosimetry for DBT systems, and summary of the underlying image theory of DBT thereby relating image quality and dose. Learning Objectives: To understand the fundamental principles behind tomosynthesis image acquisition. To understand the fundamentals of tomosynthesis image reconstruction. To learn the determinants of image quality and dose in DBT, including measurement techniques. To learn the image theory underlying tomosynthesis, and the relationship between dose and image quality. ADM is a consultant to, and holds stock in, Real Time Tomography, LLC. ADM receives research support from Hologic Inc., Analogic Inc., and Barco NV.; ADM is a member of the Scientific Advisory Board for Gamma Medica Inc.; A. Maidment, Research Support

MO-DE-209-04: Radiation Dosimetry in Breast Tomosynthesis

Energy Technology Data Exchange (ETDEWEB)

Sechopoulos, I. [Radboud University Medical Centre (Netherlands)

2016-06-15

Digital Breast Tomosynthesis (DBT) is rapidly replacing mammography as the standard of care in breast cancer screening and diagnosis. DBT is a form of computed tomography, in which a limited set of projection images are acquired over a small angular range and reconstructed into tomographic data. The angular range varies from 15° to 50° and the number of projections varies between 9 and 25 projections, as determined by the equipment manufacturer. It is equally valid to treat DBT as the digital analog of classical tomography – that is, linear tomography. In fact, the name “tomosynthesis” stands for “synthetic tomography.” DBT shares many common features with classical tomography, including the radiographic appearance, dose, and image quality considerations. As such, both the science and practical physics of DBT systems is a hybrid between computed tomography and classical tomographic methods. In this lecture, we will explore the continuum from radiography to computed tomography to illustrate the characteristics of DBT. This lecture will consist of four presentations that will provide a complete overview of DBT, including a review of the fundamentals of DBT acquisition, a discussion of DBT reconstruction methods, an overview of dosimetry for DBT systems, and summary of the underlying image theory of DBT thereby relating image quality and dose. Learning Objectives: To understand the fundamental principles behind tomosynthesis image acquisition. To understand the fundamentals of tomosynthesis image reconstruction. To learn the determinants of image quality and dose in DBT, including measurement techniques. To learn the image theory underlying tomosynthesis, and the relationship between dose and image quality. ADM is a consultant to, and holds stock in, Real Time Tomography, LLC. ADM receives research support from Hologic Inc., Analogic Inc., and Barco NV.; ADM is a member of the Scientific Advisory Board for Gamma Medica Inc.; A. Maidment, Research Support

Comparative study between breast tomosynthesis and classic digital mammography in the evaluation of different breast lesions

Directory of Open Access Journals (Sweden)

Sahar Mansour

2014-09-01

Conclusion: Three-dimensional tomosynthesis significantly enhanced the detection and characterization of breast lesions on digital mammography especially in the context of dense breast parenchyma (ACR 3&4.

Added value of one-view breast tomosynthesis combined with digital mammography according to reader experience.

Science.gov (United States)

Thomassin-Naggara, Isabelle; Perrot, Nicolas; Dechoux, Sophie; Ribeiro, Carine; Chopier, Jocelyne; de Bazelaire, Cedric

2015-02-01

To retrospectively evaluate the added value of one-view breast tomosynthesis in adjunct with mammography to characterize breast lesions. Our institutional ethics committees approved the study and granted a waiver of informed consent. One hundred fifty-five women (mean age, 51.3 years, range: 24-92 years) who systematically underwent mammography and breast tomosynthesis with subsequent percutaneous biopsy were analyzed. Four radiologists (two seniors, R1 and R2, and two juniors, R3 and R4 with 30, 10, 3 and 1 years of experience in breast imaging, respectively) independently reviewed exams in two steps: mammography alone and tomosynthesis in adjunct with mammography. The lesions in the cohort included 39.3% (61/155) cancers, 2.5% (4/155) high-risk lesions and 58.1% (90/155) benign lesions. A receiver operating characteristic (ROC) curve analysis was performed to compare the results of the two readings. There was almost perfect agreement irrespective of reader experience for the reading of the mammography in adjunct with tomosynthesis, whereas agreement was poor between junior and senior readers for the reading of mammography alone. Area under the ROC (Az) values for the tomosynthesis in adjunct with mammography were significantly better than Az values for mammography alone for all readers except the most experienced, for whom only a tendency was noted. The proportion of cancers undiagnosed by mammography alone that were well diagnosed by tomosynthesis in adjunct with mammography was 6.5% (4/61), 13.1% (8/61), 27.8% (17/61) and 26.2% (16/61) for Readers 1, 2, 3 and 4, respectively. The proportion of false positive cases induced by the addition of breast tomosynthesis to mammography was 2.1% (2/94), 2.1% (2/94), 9.5% (9/94) and 12.7% (12/94) for Readers 1, 2, 3 and 4, respectively. Adding breast tomosynthesis to mammography improved sensitivity and negative predictive value for all readers except for the most experienced one, in whom only a tendency for improvement

Digital breast tomosynthesis versus digital mammography: a clinical performance study

International Nuclear Information System (INIS)

Gennaro, Gisella; Baldan, Enrica; Bezzon, Elisabetta; Polico, Ilaria; Proietti, Alessandro; Toffoli, Aida; Toledano, Alicia; Di Maggio, Cosimo; La Grassa, Manuela; Pescarini, Luigi; Muzzio, Pier Carlo

2010-01-01

To compare the clinical performance of digital breast tomosynthesis (DBT) with that of full-field digital mammography (FFDM) in a diagnostic population. The study enrolled 200 consenting women who had at least one breast lesion discovered by mammography and/or ultrasound classified as doubtful or suspicious or probably malignant. They underwent tomosynthesis in one view [mediolateral oblique (MLO)] of both breasts at a dose comparable to that of standard screen-film mammography in two views [craniocaudal (CC) and MLO]. Images were rated by six breast radiologists using the BIRADS score. Ratings were compared with the truth established according to the standard of care and a multiple-reader multiple-case (MRMC) receiver-operating characteristic (ROC) analysis was performed. Clinical performance of DBT compared with that of FFDM was evaluated in terms of the difference between areas under ROC curves (AUCs) for BIRADS scores. Overall clinical performance with DBT and FFDM for malignant versus all other cases was not significantly different (AUCs 0.851 vs 0.836, p = 0.645). The lower limit of the 95% CI or the difference between DBT and FFDM AUCs was -4.9%. Clinical performance of tomosynthesis in one view at the same total dose as standard screen-film mammography is not inferior to digital mammography in two views. (orig.)

Computer Aided Detection of Breast Masses in Digital Tomosynthesis

National Research Council Canada - National Science Library

Singh, Swatee; Lo, Joseph

2008-01-01

The purpose of this study was to investigate feasibility of computer-aided detection of masses and calcification clusters in breast tomosynthesis images and obtain reliable estimates of sensitivity...

Technical Note: Robust measurement of the slice-sensitivity profile in breast tomosynthesis

Energy Technology Data Exchange (ETDEWEB)

Maki, Aili K., E-mail: aili.maki@sri.utoronto.ca; Mainprize, James G. [Physical Sciences Platform, Sunnybrook Research Institute, 2075 Bayview Avenue, Toronto, Ontario M4N 3M5 (Canada); Yaffe, Martin J. [Departments of Medical Imaging and Medical Biophysics, University of Toronto, 2075 Bayview Avenue, Toronto, Ontario M4N 3M5, Canada and Physical Sciences Platform, Sunnybrook Research Institute, 2075 Bayview Avenue, Toronto, Ontario M4N 3M5 (Canada)

2016-08-15

Purpose: The purpose of this work is to improve the repeatability of the measurement of the slice-sensitivity profile (SSP) in reconstructed breast tomosynthesis volumes. Methods: A grid of aluminum ball-bearings (BBs) within a PMMA phantom was imaged on breast tomosynthesis systems from three different manufacturers. The full-width half-maximum (FWHM) values were measured for the SSPs of the BBs in the reconstructed volumes. The effect of transforming the volumes from a Cartesian coordinate system (CCS) to a cone-beam coordinate system (CBCS) on the variability in the FWHM values was assessed. Results: Transforming the volumes from a CCS to a CBCS before measuring the SSPs reduced the coefficient of variation (COV) in the measurements of FWHM in repeated measurements by 56% and reduced the dependence of the FWHM values on the location of the BBs within the reconstructed volume by 76%. Conclusions: Measuring the SSP in the volumes in a CBCS improves the robustness of the measurement.

Adjunct Screening With Tomosynthesis or Ultrasound in Women With Mammography-Negative Dense Breasts: Interim Report of a Prospective Comparative Trial.

Science.gov (United States)

Tagliafico, Alberto S; Calabrese, Massimo; Mariscotti, Giovanna; Durando, Manuela; Tosto, Simona; Monetti, Francesco; Airaldi, Sonia; Bignotti, Bianca; Nori, Jacopo; Bagni, Antonella; Signori, Alessio; Sormani, Maria Pia; Houssami, Nehmat

2016-03-09

Debate on adjunct screening in women with dense breasts has followed legislation requiring that women be informed about their mammographic density and related adjunct imaging. Ultrasound or tomosynthesis can detect breast cancer (BC) in mammography-negative dense breasts, but these modalities have not been directly compared in prospective trials. We conducted a trial of adjunct screening to compare, within the same participants, incremental BC detection by tomosynthesis and ultrasound in mammography-negative dense breasts. Adjunct Screening With Tomosynthesis or Ultrasound in Women With Mammography-Negative Dense Breasts is a prospective multicenter study recruiting asymptomatic women with mammography-negative screens and dense breasts. Eligible women had tomosynthesis and physician-performed ultrasound with independent interpretation of adjunct imaging. Outcome measures included cancer detection rate (CDR), number of false-positive (FP) recalls, and incremental CDR for each modality; these were compared using McNemar's test for paired binary data in a preplanned interim analysis. Among 3,231 mammography-negative screening participants (median age, 51 years; interquartile range, 44 to 78 years) with dense breasts, 24 additional BCs were detected (23 invasive): 13 tomosynthesis-detected BCs (incremental CDR, 4.0 per 1,000 screens; 95% CI, 1.8 to 6.2) versus 23 ultrasound-detected BCs (incremental CDR, 7.1 per 1,000 screens; 95% CI, 4.2 to 10.0), P = .006. Incremental FP recall occurred in 107 participants (3.33%; 95% CI, 2.72% to 3.96%). FP recall (any testing) did not differ between tomosynthesis (FP = 53) and ultrasound (FP = 65), P = .26; FP recall (biopsy) also did not differ between tomosynthesis (FP = 22) and ultrasound (FP = 24), P = .86. The Adjunct Screening With Tomosynthesis or Ultrasound in Women With Mammography-Negative Dense Breasts' interim analysis shows that ultrasound has better incremental BC detection than tomosynthesis in mammography

The simulation of 3D mass models in 2D digital mammography and breast tomosynthesis

Energy Technology Data Exchange (ETDEWEB)

Shaheen, Eman, E-mail: eman.shaheen@uzleuven.be; De Keyzer, Frederik; Bosmans, Hilde; Ongeval, Chantal Van [Department of Radiology, University Hospitals Leuven, Herestraat 49, 3000 Leuven (Belgium); Dance, David R.; Young, Kenneth C. [National Coordinating Centre for the Physics of Mammography, Royal Surrey County Hospital, Guildford GU2 7XX, United Kingdom and Department of Physics, Faculty of Engineering and Physical Sciences, University of Surrey, Guildford GU2 7XH (United Kingdom)

2014-08-15

Purpose: This work proposes a new method of building 3D breast mass models with different morphological shapes and describes the validation of the realism of their appearance after simulation into 2D digital mammograms and breast tomosynthesis images. Methods: Twenty-five contrast enhanced MRI breast lesions were collected and each mass was manually segmented in the three orthogonal views: sagittal, coronal, and transversal. The segmented models were combined, resampled to have isotropic voxel sizes, triangularly meshed, and scaled to different sizes. These masses were referred to as nonspiculated masses and were then used as nuclei onto which spicules were grown with an iterative branching algorithm forming a total of 30 spiculated masses. These 55 mass models were projected into 2D projection images to obtain mammograms after image processing and into tomographic sequences of projection images, which were then reconstructed to form 3D tomosynthesis datasets. The realism of the appearance of these mass models was assessed by five radiologists via receiver operating characteristic (ROC) analysis when compared to 54 real masses. All lesions were also given a breast imaging reporting and data system (BIRADS) score. The data sets of 2D mammography and tomosynthesis were read separately. The Kendall's coefficient of concordance was used for the interrater observer agreement assessment for the BIRADS scores per modality. Further paired analysis, using the Wilcoxon signed rank test, of the BIRADS assessment between 2D and tomosynthesis was separately performed for the real masses and for the simulated masses. Results: The area under the ROC curves, averaged over all observers, was 0.54 (95% confidence interval [0.50, 0.66]) for the 2D study, and 0.67 (95% confidence interval [0.55, 0.79]) for the tomosynthesis study. According to the BIRADS scores, the nonspiculated and the spiculated masses varied in their degrees of malignancy from normal (BIRADS 1) to highly

The simulation of 3D mass models in 2D digital mammography and breast tomosynthesis

International Nuclear Information System (INIS)

Shaheen, Eman; De Keyzer, Frederik; Bosmans, Hilde; Ongeval, Chantal Van; Dance, David R.; Young, Kenneth C.

2014-01-01

Purpose: This work proposes a new method of building 3D breast mass models with different morphological shapes and describes the validation of the realism of their appearance after simulation into 2D digital mammograms and breast tomosynthesis images. Methods: Twenty-five contrast enhanced MRI breast lesions were collected and each mass was manually segmented in the three orthogonal views: sagittal, coronal, and transversal. The segmented models were combined, resampled to have isotropic voxel sizes, triangularly meshed, and scaled to different sizes. These masses were referred to as nonspiculated masses and were then used as nuclei onto which spicules were grown with an iterative branching algorithm forming a total of 30 spiculated masses. These 55 mass models were projected into 2D projection images to obtain mammograms after image processing and into tomographic sequences of projection images, which were then reconstructed to form 3D tomosynthesis datasets. The realism of the appearance of these mass models was assessed by five radiologists via receiver operating characteristic (ROC) analysis when compared to 54 real masses. All lesions were also given a breast imaging reporting and data system (BIRADS) score. The data sets of 2D mammography and tomosynthesis were read separately. The Kendall's coefficient of concordance was used for the interrater observer agreement assessment for the BIRADS scores per modality. Further paired analysis, using the Wilcoxon signed rank test, of the BIRADS assessment between 2D and tomosynthesis was separately performed for the real masses and for the simulated masses. Results: The area under the ROC curves, averaged over all observers, was 0.54 (95% confidence interval [0.50, 0.66]) for the 2D study, and 0.67 (95% confidence interval [0.55, 0.79]) for the tomosynthesis study. According to the BIRADS scores, the nonspiculated and the spiculated masses varied in their degrees of malignancy from normal (BIRADS 1) to highly

The simulation of 3D mass models in 2D digital mammography and breast tomosynthesis.

Science.gov (United States)

Shaheen, Eman; De Keyzer, Frederik; Bosmans, Hilde; Dance, David R; Young, Kenneth C; Van Ongeval, Chantal

2014-08-01

This work proposes a new method of building 3D breast mass models with different morphological shapes and describes the validation of the realism of their appearance after simulation into 2D digital mammograms and breast tomosynthesis images. Twenty-five contrast enhanced MRI breast lesions were collected and each mass was manually segmented in the three orthogonal views: sagittal, coronal, and transversal. The segmented models were combined, resampled to have isotropic voxel sizes, triangularly meshed, and scaled to different sizes. These masses were referred to as nonspiculated masses and were then used as nuclei onto which spicules were grown with an iterative branching algorithm forming a total of 30 spiculated masses. These 55 mass models were projected into 2D projection images to obtain mammograms after image processing and into tomographic sequences of projection images, which were then reconstructed to form 3D tomosynthesis datasets. The realism of the appearance of these mass models was assessed by five radiologists via receiver operating characteristic (ROC) analysis when compared to 54 real masses. All lesions were also given a breast imaging reporting and data system (BIRADS) score. The data sets of 2D mammography and tomosynthesis were read separately. The Kendall's coefficient of concordance was used for the interrater observer agreement assessment for the BIRADS scores per modality. Further paired analysis, using the Wilcoxon signed rank test, of the BIRADS assessment between 2D and tomosynthesis was separately performed for the real masses and for the simulated masses. The area under the ROC curves, averaged over all observers, was 0.54 (95% confidence interval [0.50, 0.66]) for the 2D study, and 0.67 (95% confidence interval [0.55, 0.79]) for the tomosynthesis study. According to the BIRADS scores, the nonspiculated and the spiculated masses varied in their degrees of malignancy from normal (BIRADS 1) to highly suggestive for malignancy (BIRADS 5

TU-AB-207-00: Digital Tomosynthesis

Energy Technology Data Exchange (ETDEWEB)

NONE

2015-06-15

Digital Tomosynthesis (DT) is becoming increasingly common in breast imaging and many other applications. DT is a form of computed tomography in which a limited set of projection images are acquired over a small angular range and reconstructed into a tomographic data set. The angular range and number of projections is determined both by the imaging task and equipment manufacturer. For example, in breast imaging between 9 and 25 projections are acquired over a range of 15° to 60°. It is equally valid to treat DT as the digital analog of classical tomography - for example, linear tomography. In fact, the name “tomosynthesis” is an acronym for “synthetic tomography”. DT shares many common features with classical tomography, including the radiographic appearance, dose, and image quality considerations. As such, both the science and practical physics of DT systems is a hybrid between CT and classical tomographic methods. This lecture will consist of three presentations that will provide a complete overview of DT, including a review of the fundamentals of DT, a discussion of testing methods for DT systems, and a description of the clinical applications of DT. While digital breast tomosynthesis will be emphasized, analogies will be drawn to body imaging to illustrate and compare tomosynthesis methods. Learning Objectives: To understand the fundamental principles behind tomosynthesis, including the determinants of image quality and dose. To learn how to test the performance of tomosynthesis imaging systems. To appreciate the uses of tomosynthesis in the clinic and the future applications of tomosynthesis.

TU-AB-207-00: Digital Tomosynthesis

International Nuclear Information System (INIS)

2015-01-01

Digital Tomosynthesis (DT) is becoming increasingly common in breast imaging and many other applications. DT is a form of computed tomography in which a limited set of projection images are acquired over a small angular range and reconstructed into a tomographic data set. The angular range and number of projections is determined both by the imaging task and equipment manufacturer. For example, in breast imaging between 9 and 25 projections are acquired over a range of 15° to 60°. It is equally valid to treat DT as the digital analog of classical tomography - for example, linear tomography. In fact, the name “tomosynthesis” is an acronym for “synthetic tomography”. DT shares many common features with classical tomography, including the radiographic appearance, dose, and image quality considerations. As such, both the science and practical physics of DT systems is a hybrid between CT and classical tomographic methods. This lecture will consist of three presentations that will provide a complete overview of DT, including a review of the fundamentals of DT, a discussion of testing methods for DT systems, and a description of the clinical applications of DT. While digital breast tomosynthesis will be emphasized, analogies will be drawn to body imaging to illustrate and compare tomosynthesis methods. Learning Objectives: To understand the fundamental principles behind tomosynthesis, including the determinants of image quality and dose. To learn how to test the performance of tomosynthesis imaging systems. To appreciate the uses of tomosynthesis in the clinic and the future applications of tomosynthesis

Clinical experience of photon counting breast tomosynthesis: comparison with traditional mammography

International Nuclear Information System (INIS)

Svane, Gunilla; Azavedo, Edward; Lindman, Karin; Urech, Mattias; Nilsson, Jonas; Weber, Niclas; Lindqvist, Lars; Ullberg, Christer

2011-01-01

Background: In two-dimensional mammography, a well-known problem is over- and underlying tissue which can either obstruct a lesion or create a false-positive result. Tomosynthesis, with an ability to layer the tissue in the image, has the potential to resolve these issues. Purpose: To compare the diagnostic quality, sensitivity and specificity of a single tomosynthesis mammography image and a traditional two-view set of two-dimensional mammograms and to assess the comfort of the two techniques. Material and Methods: One hundred and forty-four women, mainly chosen because of suspicious features on standard mammograms (76 malignant), had a single tomosynthesis image taken of one breast using a novel photon counting system. On average, the dose of the tomosynthesis images was 0.63 times that of the two-view images and the compression force during the procedure was halved. The resulting images were viewed by two radiologists and assessed both individually and comparing the two techniques. Results: In 56% of the cases the radiologists rated the diagnostic quality of the lesion details higher in the tomosynthesis images than in the conventional images (and in 91% equal or higher), which means there is a statistically significant preference for the tomosynthesis technique. This included the calcifications which were rated as having better quality in 41% of the cases. While sensitivity was slightly higher for traditional mammography the specificity was higher for tomosynthesis. However, neither of these two differences was large enough to be statistically significant. Conclusion: The overall accuracy of the two techniques was virtually equal despite the radiologist's very limited experience with tomosynthesis images and vast experience with two-dimensional mammography. As the diagnostic quality of the lesion details in the tomosynthesis images was valued considerably higher this factor should improve with experience. The patients also favored the tomosynthesis examination

Radiation dose with digital breast tomosynthesis compared to digital mammography: per-view analysis.

Science.gov (United States)

Gennaro, Gisella; Bernardi, D; Houssami, N

2018-02-01

To compare radiation dose delivered by digital mammography (FFDM) and breast tomosynthesis (DBT) for a single view. 4,780 FFDM and 4,798 DBT images from 1,208 women enrolled in a screening trial were used to ground dose comparison. Raw images were processed by an automatic software to determine volumetric breast density (VBD) and were used together with exposure data to compute the mean glandular dose (MGD) according to Dance's model. DBT and FFDM were compared in terms of operation of the automatic exposure control (AEC) and MGD level. Statistically significant differences were found between FFDM and DBT MGDs for all views (CC: MGD FFDM =1.366 mGy, MGD DBT =1.858 mGy; ptomosynthesis compared to FFDM. Given the emerging role of DBT, its use in conjunction with synthetic 2D images should not be deterred by concerns regarding radiation burden, and should draw on evidence of potential clinical benefit. • Most studies compared tomosynthesis in combination with mammography vs. mammography alone. • There is some concern about the dose increase with tomosynthesis. • Clinical data show a small increase in radiation dose with tomosynthesis. • Synthetic 2D images from tomosynthesis at zero dose reduce potential harm. • The small dose increase should not be a barrier to use of tomosynthesis.

Diagnostic value of the stand-alone synthetic image in digital breast tomosynthesis examinations.

Science.gov (United States)

Garayoa, Julia; Chevalier, Margarita; Castillo, Maria; Mahillo-Fernández, Ignacio; Amallal El Ouahabi, Najim; Estrada, Carmen; Tejerina, Alejandro; Benitez, Olivia; Valverde, Julio

2018-02-01

To demonstrate the non-inferiority of synthetic image (SI) mammography versus full-field digital mammography (FFDM) in breast tomosynthesis (DBT) examinations. An observational, retrospective, single-centre, multireader blinded study was performed, using 2384 images to directly compare SI and FFDM based on Breast Imaging Reporting and Data System (BIRADS) categorisation and visibility of radiological findings. Readers had no access to digital breast tomosynthesis slices. Multiple reader, multiple case (MRMC) receiver operating characteristic (ROC) methodology was used to compare the diagnostic performance of SI and FFDM images. The kappa statistic was used to estimate the inter-reader and intra-reader reliability. The area under the ROC curves (AUC) reveals the non-inferiority of SI versus FFDM based on BIRADS categorisation [difference between AUC (ΔAUC), -0.014] and lesion visibility (ΔAUC, -0.001) but the differences were not statistically significant (p=0.282 for BIRADS; p=0.961 for lesion visibility). On average, 77.4% of malignant lesions were detected with SI versus 76.5% with FFDM. Sensitivity and specificity of SI are superior to FFDM for malignant lesions scored as BIRADS 5 and breasts categorised as BIRADS 1. SI is not inferior to FFDM when DBT slices are not available during image reading. SI can replace FFDM, reducing the dose by 45%. • Stand-alone SI demonstrated performance not inferior for lesion visibility as compared to FFDM. • Stand-alone SI demonstrated performance not inferior for lesion BIRADS categorisation as compared to FFDM. • Synthetic images provide important dose savings in breast tomosynthesis examinations.

Phantoms for quality control procedures in digital breast tomosynthesis: dose assessment

NARCIS (Netherlands)

Bouwman, R. W.; Diaz, O.; van Engen, R. E.; Young, K. C.; den Heeten, G. J.; Broeders, M. J. M.; Veldkamp, W. J. H.; Dance, D. R.

2013-01-01

The recent introduction of digital breast tomosynthesis into clinical practice requires quality control procedures. In this study we have investigated whether the assessment of the average glandular dose for modelled standard breasts can be performed using a combination of polymethyl methacrylate

Metal and calcification artifact reduction for digital breast tomosynthesis

Science.gov (United States)

Wicklein, Julia; Jerebko, Anna; Ritschl, Ludwig; Mertelmeier, Thomas

2017-03-01

Tomosynthesis images of the breast suffer from artifacts caused by the presence of highly absorbing materials. These can be either induced by metal objects like needles or clips inserted during biopsy devices, or larger calcifications inside the examined breast. Mainly two different kinds of artifacts appear after the filtered backprojection procedure. The first type is undershooting artifacts near edges of high-contrast objects caused by the filtering step. The second type is out-of-plane (ripple) artifacts that appear even in slices where the metal object or macrocalcifications does not exist. Due to the limited angular range of tomosynthesis systems, overlapping structures have high influence on neighboring regions. To overcome these problems, a segmentation of artifact introducing objects is performed on the projection images. Both projection versions, with and without high-contrast objects are filtered independently to avoid undershootings. During backprojection a decision is made for each reconstructed voxel, if it is artifact or high-contrast object. This is based on a mask image, gained from the segmentation of high-contrast objects. This procedure avoids undershooting artifacts and additionally reduces out-of-plane ripple. Results are demonstrated for different kinds of artifact inducing objects and calcifications.

Breast Radiation Dose With CESM Compared With 2D FFDM and 3D Tomosynthesis Mammography.

Science.gov (United States)

James, Judy R; Pavlicek, William; Hanson, James A; Boltz, Thomas F; Patel, Bhavika K

2017-02-01

We aimed to compare radiation dose received during contrast-enhanced spectral mammography (CESM) using high- and low-energy projections with radiation dose received during 2D full field digital mammography (FFDM) and 3D tomosynthesis on phantoms and patients with varying breast thickness and density. A single left craniocaudal projection was chosen to determine the doses for 6214 patients who underwent 2D FFDM, 3662 patients who underwent 3D tomosynthesis, and 173 patients who underwent CESM in this retrospective study. Dose measurements were also collected in phantoms with composition mimicking nondense and dense breast tissue. Average glandular dose (AGD) ± SD was 3.0 ± 1.1 mGy for CESM exposures at a mean breast thickness of 63 mm. At this thickness, the dose was 2.1 mGy from 2D FFDM and 2.5 mGy from 3D tomosynthesis. The nondense phantom had a mean AGD of 1.0 mGy with 2D FFDM, 1.3 mGy with 3D tomosynthesis, and 1.6 mGy with CESM. The dense breast phantom had a mean AGD of 1.3 mGy with 2D FFDM, 1.4 mGy with 3D tomosynthesis, and 2.1 mGy with CESM. At a compressed thickness of 4.5 cm, radiation exposure from CESM was approximately 25% higher in dense breast phantoms than in nondense breast phantoms. The dose in the dense phantom at a compressed thickness of 6 cm was approximately 42% higher than the dose in the nondense phantom at a compressed thickness of 4.5 cm. CESM was found to increase AGD at a mean breast thickness of 63 mm by approximately 0.9 mGy and 0.5 mGy compared with 2D FFDM and 3D tomosynthesis, respectively. Of note, CESM provides a standard image (similar to 2D FFDM) that is obtained using the low-energy projection. Overall, the AGD from CESM falls below the dose limit of 3 mGy set by Mammography Quality Standards Act regulations.

Issues to consider before implementing digital breast tomosynthesis into a breast imaging practice.

Science.gov (United States)

Hardesty, Lara A

2015-03-01

OBJECTIVE. The purpose of this article is to discuss issues surrounding the implementation of digital breast tomosynthesis (DBT) into a clinical breast imaging practice and assist radiologists, technologists, and administrators who are considering the addition of this new technology to their practices. CONCLUSION. When appropriate attention is given to image acquisition, interpretation, storage, technologist and radiologist training, patient selection, billing, radiation dose, and marketing, implementation of DBT into a breast imaging practice can be successful.

Digital breast tomosynthesis (DBT): initial experience in a clinical setting

International Nuclear Information System (INIS)

Skaane, Per; Gullien, Randi; Eben, Ellen B.; Haakenaasen, Unni; Naess Jebsen, Ingvild; Krager, Mona; Bjoerndal, Hilde; Ekseth, Ulrika; Jahr, Gunnar

2012-01-01

Background: Digital breast tomosynthesis (DBT) is a promising new technology. Some experimental clinical studies have shown positive results, but the future role and indications of this new technique, whether in a screening or clinical setting, need to be evaluated. Purpose: To compare digital mammography and DBT in a side-by-side feature analysis for cancer conspicuity, and to assess whether there is a potential additional value of DBT to standard state-of-the-art conventional imaging work-up with respect to detection of additional malignancies. Material and Methods: The study had ethics committee approval. A total of 129 women underwent 2D digital mammography including supplementary cone-down and magnification views and breast ultrasonography if indicated, as well as digital breast tomosynthesis. The indication for conventional imaging in the clinical setting included a palpable lump in 30 (23%), abnormal mammographic screening findings in 54 (42%), and surveillance in 45 (35%) of the women. The women were examined according to present guidelines, including spot-magnification views, ultrasonography, and needle biopsies, if indicated. The DBT examinations were interpreted several weeks after the conventional imaging without knowledge of the conventional imaging findings. In a later session, three radiologists performed a side-by-side feature analysis for cancer conspicuity in a sample of 50 cases. Results: State-of-the-art conventional imaging resulted in needle biopsy of 45 breasts, of which 20 lesions were benign and a total of 25 cancers were diagnosed. The remaining 84 women were dismissed with a normal/definitely benign finding and without indication for needle biopsy. The subsequent DBT interpretation found suspicious findings in four of these 84 women, and these four women had to be called back for repeated work-up with knowledge of the tomosynthesis findings. These delayed work-ups resulted in two cancers (increasing the cancer detection by 8%) and two

Tomo-synthesis. Bibliographic study report

International Nuclear Information System (INIS)

2016-01-01

Tomo-synthesis is a recent technique for breast imaging. This technique, qualified as 'pseudo-3D', draws the attention of health professionals. Indeed, this technique could offer a gain in sensibility and in specificity in the detection of breast cancers compared to 2D mammography, thanks to the reduction of the tissues' overlapping in particular. Although its place and its clinical indication are not still clearly defined, tomo-synthesis is already used in France. The introduction of this technique within the national breast cancer screening program, seems to be foreseen by the authorities in the coming years. IRSN, in the scope of its mission of evaluation of the dose impact of innovative techniques, is closely interested in this technique and has proceeded in 2015 to a bibliographical review of the state of the art in tomo-synthesis. This review paid specific attention to the following points: conception of the installations, dose, image quality and quality control. it has highlighted several points of attention, which incite IRSN to formulate certain recommendations to accompany the spreading of this new technique in France. Most of the clinical trials validating the use of tomo-synthesis were realized on systems of a single manufacturer. However, manufacturers' strategies of design are heterogeneous. There is no unique technique of tomo-synthesis but several, of which equivalence in terms of technical and clinical performances is not demonstrated. Due to the heterogeneity of the different models available on the French market, IRSN recommends not to extrapolate the results of clinical studies obtained on a specific system but to consolidate them for all the available systems. In many imaging departments, tomo-synthesis is already implemented in addition or in substitution of 2D mammography without any regulatory quality control and periodic technical checks. The European reference standard for quality control of these devices is not yet

The role of tomosynthesis in breast cancer staging in 75 patients.

Science.gov (United States)

Mercier, J; Kwiatkowski, F; Abrial, C; Boussion, V; Dieu-de Fraissinette, V; Marraoui, W; Petitcolin-Bidet, V; Lemery, S

2015-01-01

Compare tomosynthesis to mammography, ultrasound, MRI, and histology for the detection and staging of BI-RADS 4-5 anomalies, as a function of breast composition, lesion location, size, and histology. Seventy-five patients underwent mammography, tomosynthesis, ultrasound, and MRI. The diagnostic accuracy of the different examinations was compared. The sensitivities for detection were as follows: 92.5% with MRI, 79% for ultrasound, 75% for tomosynthesis, and 59.5% for mammography. Tomosynthesis improves the sensitivity of mammography (P=0.00013), but not the specificity. The detection of multifocality and multicentricity was improved, but not significantly. Tomosynthesis identified more lesions than mammography in 10% of cases and improved lesion staging irrespective of the density, but was still inferior to MRI. The detection of ductal neoplasia was superior with tomosynthesis than with mammography (P=0.016), but this was not the case with lobular cancer. The visualization of masses was improved with tomosynthesis (P=0.00012), but not microcalcifications. Tomosynthesis was capable of differentiating lesions of all sizes, but the smaller lesions were easier to see. Lesion sizes measured with tomosynthesis, excluding the spicules, concurred with histological dimensions. Spicules lead to an overestimation of the size. In our series, tomosynthesis found more lesions than mammography in 10% of patients, resulting in an adaption of the surgical plan. Copyright © 2014 Éditions françaises de radiologie. Published by Elsevier Masson SAS. All rights reserved.

Tomosynthesis Impact on Breast Cancer Screening in Patients Younger Than 50 Years Old.

Science.gov (United States)

Rose, Stephen L; Shisler, Julie L

2018-04-09

The question of benefits versus harms of breast cancer screening for women younger than 50 years old has been the subject of debate. We investigate if the addition of tomosynthesis to mammography improves screening performance outcomes for women in this age group. Screening performance for 59,921 patients (41,542 digital mammography and 18,379 tomosynthesis) younger than 50 years old was collected from a community-based screening network from January 1, 2015, to December 31, 2015. Patients were offered tomosynthesis if it was available. Parameters including recall, biopsy, and cancer detection rates were compared. Mixed effects regression analysis was used to estimate rates with screening modality, age, and density as fixed effects and screening site as a random effect. Rates for patients with dense breast tissue were also evaluated. Model adjusted rates per 1000 screenings with digital mammography were compared with digital mammography plus tomosynthesis, respectively: recall rate decreased from 117 to 108 (difference, -8.3; p = 0.003); biopsy rate increased from 13.5 to 16.6 (difference, 3.1; p = 0.003); and cancer detection rate increased from 1.9 to 2.6 (difference, 0.8; p = 0.060). Model adjusted rates for patients with dense breast tissue were: recall rate decreased from 135 to 132 (difference, -3.2; p = 0.44); biopsy rate increased from 16.0 to 20.5 (difference, 4.5; p = 0.004); and cancer detection rate increased from 2.1 to 3.5 (difference, 1.3; p = 0.03). Tomosynthesis in a community setting resulted in decreased recall rates for patients younger than 50 years old. For the subgroup of women with dense breast tissue, cancer detection rates also increased.

Digital breast tomosynthesis versus mammography and breast ultrasound: a multireader performance study

International Nuclear Information System (INIS)

Thibault, Fabienne; Malhaire, Caroline; Tardivon, Anne; Dromain, Clarisse; Balleyguier, Corinne S.; Breucq, Catherine; Steyaert, Luc; Baldan, Enrica; Drevon, Harir

2013-01-01

To compare the diagnostic performance of single-view breast tomosynthesis (BT) with that of dual-view mammography (MX); to assess the benefit of adding the craniocaudal (CC) mammographic view to BT, and of adding BT to MX plus breast ultrasound, considered to be the reference work-up. One hundred and fifty-five consenting patients with unresolved mammographic and/or ultrasound findings or breast symptoms underwent conventional work-up plus mediolateral oblique-view BT of the affected breast. The final study set in 130 patients resulted in 55 malignant and 76 benign and normal cases. Seven breast radiologists rated the cases through five sequential techniques using a BIRADS-based scale: MX, MX + ultrasound, MX + ultrasound + BT, BT, BT + MX(CC). Multireader, multicase receiver operating characteristic (ROC) analysis was performed and performance of the techniques was assessed from the areas under ROC curves. The performance of BT and of BT + MX(CC) was tested versus MX; the performance of MX + ultrasound + BT tested versus MX + ultrasound. Tomosynthesis was found to be non-inferior to mammography. BT + MX(CC) did not appear to be superior to MX, and MX + ultrasound + BT not superior to MX + ultrasound. Overall, none of the five techniques tested outperformed the others. Further clinical studies are needed to clarify the role of BT as a substitute for traditional work-up in the diagnostic environment. (orig.)

Generalized Filtered Back-Projection for Digital Breast Tomosynthesis Reconstruction

NARCIS (Netherlands)

Erhard, K.; Grass, M.; Hitziger, S.; Iske, A.; Nielsen, T.

2012-01-01

Filtered back-projection (FBP) has been commonly used as an efficient and robust reconstruction technique in tomographic X-ray imagingduring the last decades. For limited angle tomography acquisitions such as digital breast tomosynthesis, however, standard FBP reconstruction algorithms provide poor

TU-AB-207-03: Tomosynthesis: Clinical Applications

Energy Technology Data Exchange (ETDEWEB)

Maidment, A. [Univ Pennsylvania (United States)

2015-06-15

Digital Tomosynthesis (DT) is becoming increasingly common in breast imaging and many other applications. DT is a form of computed tomography in which a limited set of projection images are acquired over a small angular range and reconstructed into a tomographic data set. The angular range and number of projections is determined both by the imaging task and equipment manufacturer. For example, in breast imaging between 9 and 25 projections are acquired over a range of 15° to 60°. It is equally valid to treat DT as the digital analog of classical tomography - for example, linear tomography. In fact, the name “tomosynthesis” is an acronym for “synthetic tomography”. DT shares many common features with classical tomography, including the radiographic appearance, dose, and image quality considerations. As such, both the science and practical physics of DT systems is a hybrid between CT and classical tomographic methods. This lecture will consist of three presentations that will provide a complete overview of DT, including a review of the fundamentals of DT, a discussion of testing methods for DT systems, and a description of the clinical applications of DT. While digital breast tomosynthesis will be emphasized, analogies will be drawn to body imaging to illustrate and compare tomosynthesis methods. Learning Objectives: To understand the fundamental principles behind tomosynthesis, including the determinants of image quality and dose. To learn how to test the performance of tomosynthesis imaging systems. To appreciate the uses of tomosynthesis in the clinic and the future applications of tomosynthesis.

TU-AB-207-01: Introduction to Tomosynthesis

Energy Technology Data Exchange (ETDEWEB)

Sechopoulos, I. [Emory University (United States)

2015-06-15

Digital Tomosynthesis (DT) is becoming increasingly common in breast imaging and many other applications. DT is a form of computed tomography in which a limited set of projection images are acquired over a small angular range and reconstructed into a tomographic data set. The angular range and number of projections is determined both by the imaging task and equipment manufacturer. For example, in breast imaging between 9 and 25 projections are acquired over a range of 15° to 60°. It is equally valid to treat DT as the digital analog of classical tomography - for example, linear tomography. In fact, the name “tomosynthesis” is an acronym for “synthetic tomography”. DT shares many common features with classical tomography, including the radiographic appearance, dose, and image quality considerations. As such, both the science and practical physics of DT systems is a hybrid between CT and classical tomographic methods. This lecture will consist of three presentations that will provide a complete overview of DT, including a review of the fundamentals of DT, a discussion of testing methods for DT systems, and a description of the clinical applications of DT. While digital breast tomosynthesis will be emphasized, analogies will be drawn to body imaging to illustrate and compare tomosynthesis methods. Learning Objectives: To understand the fundamental principles behind tomosynthesis, including the determinants of image quality and dose. To learn how to test the performance of tomosynthesis imaging systems. To appreciate the uses of tomosynthesis in the clinic and the future applications of tomosynthesis.

TU-AB-207-01: Introduction to Tomosynthesis

International Nuclear Information System (INIS)

Sechopoulos, I.

2015-01-01

Digital Tomosynthesis (DT) is becoming increasingly common in breast imaging and many other applications. DT is a form of computed tomography in which a limited set of projection images are acquired over a small angular range and reconstructed into a tomographic data set. The angular range and number of projections is determined both by the imaging task and equipment manufacturer. For example, in breast imaging between 9 and 25 projections are acquired over a range of 15° to 60°. It is equally valid to treat DT as the digital analog of classical tomography - for example, linear tomography. In fact, the name “tomosynthesis” is an acronym for “synthetic tomography”. DT shares many common features with classical tomography, including the radiographic appearance, dose, and image quality considerations. As such, both the science and practical physics of DT systems is a hybrid between CT and classical tomographic methods. This lecture will consist of three presentations that will provide a complete overview of DT, including a review of the fundamentals of DT, a discussion of testing methods for DT systems, and a description of the clinical applications of DT. While digital breast tomosynthesis will be emphasized, analogies will be drawn to body imaging to illustrate and compare tomosynthesis methods. Learning Objectives: To understand the fundamental principles behind tomosynthesis, including the determinants of image quality and dose. To learn how to test the performance of tomosynthesis imaging systems. To appreciate the uses of tomosynthesis in the clinic and the future applications of tomosynthesis

TU-AB-207-03: Tomosynthesis: Clinical Applications

International Nuclear Information System (INIS)

Maidment, A.

2015-01-01

Digital Tomosynthesis (DT) is becoming increasingly common in breast imaging and many other applications. DT is a form of computed tomography in which a limited set of projection images are acquired over a small angular range and reconstructed into a tomographic data set. The angular range and number of projections is determined both by the imaging task and equipment manufacturer. For example, in breast imaging between 9 and 25 projections are acquired over a range of 15° to 60°. It is equally valid to treat DT as the digital analog of classical tomography - for example, linear tomography. In fact, the name “tomosynthesis” is an acronym for “synthetic tomography”. DT shares many common features with classical tomography, including the radiographic appearance, dose, and image quality considerations. As such, both the science and practical physics of DT systems is a hybrid between CT and classical tomographic methods. This lecture will consist of three presentations that will provide a complete overview of DT, including a review of the fundamentals of DT, a discussion of testing methods for DT systems, and a description of the clinical applications of DT. While digital breast tomosynthesis will be emphasized, analogies will be drawn to body imaging to illustrate and compare tomosynthesis methods. Learning Objectives: To understand the fundamental principles behind tomosynthesis, including the determinants of image quality and dose. To learn how to test the performance of tomosynthesis imaging systems. To appreciate the uses of tomosynthesis in the clinic and the future applications of tomosynthesis

The simulation of 3D microcalcification clusters in 2D digital mammography and breast tomosynthesis

International Nuclear Information System (INIS)

Shaheen, Eman; Van Ongeval, Chantal; Zanca, Federica; Cockmartin, Lesley; Marshall, Nicholas; Jacobs, Jurgen; Young, Kenneth C.; Dance, David R.; Bosmans, Hilde

2011-01-01

Purpose: This work proposes a new method of building 3D models of microcalcification clusters and describes the validation of their realistic appearance when simulated into 2D digital mammograms and into breast tomosynthesis images. Methods: A micro-CT unit was used to scan 23 breast biopsy specimens of microcalcification clusters with malignant and benign characteristics and their 3D reconstructed datasets were segmented to obtain 3D models of microcalcification clusters. These models were then adjusted for the x-ray spectrum used and for the system resolution and simulated into 2D projection images to obtain mammograms after image processing and into tomographic sequences of projection images, which were then reconstructed to form 3D tomosynthesis datasets. Six radiologists were asked to distinguish between 40 real and 40 simulated clusters of microcalcifications in two separate studies on 2D mammography and tomosynthesis datasets. Receiver operating characteristic (ROC) analysis was used to test the ability of each observer to distinguish between simulated and real microcalcification clusters. The kappa statistic was applied to assess how often the individual simulated and real microcalcification clusters had received similar scores (''agreement'') on their realistic appearance in both modalities. This analysis was performed for all readers and for the real and the simulated group of microcalcification clusters separately. ''Poor'' agreement would reflect radiologists' confusion between simulated and real clusters, i.e., lesions not systematically evaluated in both modalities as either simulated or real, and would therefore be interpreted as a success of the present models. Results: The area under the ROC curve, averaged over the observers, was 0.55 (95% confidence interval [0.44, 0.66]) for the 2D study, and 0.46 (95% confidence interval [0.29, 0.64]) for the tomosynthesis study, indicating no statistically significant difference between real and simulated

Digital breast tomosynthesis for breast cancer screening and diagnosis in women with dense breasts - a systematic review and meta-analysis

NARCIS (Netherlands)

Phi, Xuan-Anh; Tagliafico, Alberto; Houssami, Nehmat; Greuter, Marcel J. W.; de Bock, Geertruida H.

2018-01-01

Background: This study aimed to systematically review and to meta-analyse the accuracy of digital breast tomosynthesis (DBT) versus digital mammography (DM) in women with mammographically dense breasts in screening and diagnosis. Methods: Two independent reviewers identified screening or diagnostic

Digital breast tomosynthesis for breast cancer screening and diagnosis in women with dense breasts - a systematic review and meta-analysis

NARCIS (Netherlands)

Phi, Xuan-Anh; Tagliafico, Alberto; Houssami, Nehmat; Greuter, Marcel J W; de Bock, Geertruida H

2018-01-01

BACKGROUND: This study aimed to systematically review and to meta-analyse the accuracy of digital breast tomosynthesis (DBT) versus digital mammography (DM) in women with mammographically dense breasts in screening and diagnosis. METHODS: Two independent reviewers identified screening or diagnostic

Quantification of resolution in multiplanar reconstructions for digital breast tomosynthesis

Science.gov (United States)

Vent, Trevor L.; Acciavatti, Raymond J.; Kwon, Young Joon; Maidment, Andrew D. A.

2016-03-01

Multiplanar reconstruction (MPR) in digital breast tomosynthesis (DBT) allows tomographic images to be portrayed in various orientations. We have conducted research to determine the resolution of tomosynthesis MPR. We built a phantom that houses a star test pattern to measure resolution. This phantom provides three rotational degrees of freedom. The design consists of two hemispheres with longitudinal and latitudinal grooves that reference angular increments. When joined together, the hemispheres form a dome that sits inside a cylindrical encasement. The cylindrical encasement contains reference notches to match the longitudinal and latitudinal grooves that guide the phantom's rotations. With this design, any orientation of the star-pattern can be analyzed. Images of the star-pattern were acquired using a DBT mammography system at the Hospital of the University of Pennsylvania. Images taken were reconstructed and analyzed by two different methods. First, the maximum visible frequency (in line pairs per millimeter) of the star test pattern was measured. Then, the contrast was calculated at a fixed spatial frequency. These analyses confirm that resolution decreases with tilt relative to the breast support. They also confirm that resolution in tomosynthesis MPR is dependent on object orientation. Current results verify that the existence of super-resolution depends on the orientation of the frequency; the direction parallel to x-ray tube motion shows super-resolution. In conclusion, this study demonstrates that the direction of the spatial frequency relative to the motion of the x-ray tube is a determinant of resolution in MPR for DBT.

Abbreviated Breast MRI and Digital Tomosynthesis Mammography in Screening Women With Dense Breasts | Division of Cancer Prevention

Science.gov (United States)

This randomized phase II trial studies how well abbreviated breast magnetic resonance imaging (MRI) and digital tomosynthesis mammography work in detecting cancer in women with dense breasts. Abbreviated breast MRI is a low cost procedure in which radio waves and a powerful magnet linked to a computer and used to create detailed pictures of the breast in less than 10 minutes.

Digital Mammography Tomosynthesis

International Nuclear Information System (INIS)

Gergov, I.; Alexov, G.; Rusonov, K.

2017-01-01

Siemens MAMMOMAT Inspiration with Tomosynthesis enhances the diagnostic precision in mammographic screening. The apparatus has a wide-angle tomosynthesis up to 50 degrees. The Siemens breast augmentation algorithm reconstructs multiple two-dimensional breast images into three-dimensional images at the lowest doses to help detect tumors hidden from the overlapping chest tissue, allowing for a more accurate diagnosis than standard 2-dimensional digital mammography, and reducing the number of false positive results. 3D digital tomosynthesis improves the precision of detecting and diagnosing a larger number of expansive lesions, ensures better morphological mass analysis and architectural distortion, and detecting calcifications by adding digital breast tomosynthesis to the traditional two-dimensional digital mammogram of the patient. In this way, it solves the problem of overlapping parenchyma, reduces the number of unnecessary biopsies from questionable sonomammographic findings, and the need for stressful repeating procedures, which usually contributes to both better patient outcomes and cost saving. [bg

Temporal Subtraction of Digital Breast Tomosynthesis Images for Improved Mass Detection

National Research Council Canada - National Science Library

Li, Christina M

2007-01-01

Digital breast tomosynthesis (DBT) strives to overcome the obstacles presented in conventional 2D mammography by taking multiple projections over a fixed angle and reconstructing volumetric data isolates overlying anatomy...

Correlating locations in ipsilateral breast tomosynthesis views using an analytical hemispherical compression model

NARCIS (Netherlands)

Schie, G. van; Tanner, C.; Snoeren, P.R.; Samulski, M.; Leifland, K.; Wallis, M.G.; Karssemeijer, N.

2011-01-01

To improve cancer detection in mammography, breast examinations usually consist of two views per breast. In order to combine information from both views, corresponding regions in the views need to be matched. In 3D digital breast tomosynthesis (DBT), this may be a difficult and time-consuming task

Quality control in breast tomosynthesis; Controle de qualidade em tomossintese mamaria

Energy Technology Data Exchange (ETDEWEB)

Jakubiak, Rosangela Requi; Messias, Pricila Cordeiro; Santos, Marilia Fernanda, E-mail: requi@gmail.com [Universidade Tecnologica Federal do Parana (UTFPR), Curitiba, PR (Brazil); Urban, Linei Augusta B.D., E-mail: ineiurban@hotmail.com [Diagnostico Avancado por Imagem (DAPI), Curitiba, PR (Brazil)

2014-07-01

In Brazil breast cancer is the most common and the leading cause of death among women, with estimated 57,000 new cases in 2014. The mammography (2D) plays an important role in the early detection of breast cancer, but in some cases can be difficult to detect malignant lesions due overlap of breast tissues. The Breast Digital Tomosynthesis (BDT: 3D) reduces the effects of overlap, providing improved characterization of mammographic findings. However, the dose may double as compared to the mammography. This study presents results of Contrast Ratio Noise tests (CRN) and quality image on a Siemens mammography equipment Mammomat Inspiration with tomosynthesis. The CRN was determined with plates Polymethylmethacrylate (PMMA) of 20 to 70 mm thickness and an aluminum plate of 10 mm{sup 2} and 0.2 mm thickness. Image quality was assessed with the ACR Breast Simulator. In assessment of image quality, the detectability of fibers and masses was identical in 2D and 3D systems. Were visualized 4.5 fibers and 4 mass in both modes. In 2D mode groups have been identified 3.5 microcalcifications, and 3D were 3 groups. The Mean Glandular Dose for the simulator in 2D mode was 1.17 mGy and 2.35 mGy for the 3D mode. The result reinforces the importance of quality control in the process of obtaining the images and obtained in accordance CRN values, ensuring image quality and dose compatible in 2D and 3D processes.

Characterizing X-ray detectors for prototype digital breast tomosynthesis systems

International Nuclear Information System (INIS)

Kim, Y.-S.; Park, H.-S.; Park, S.-J.; Choi, S.; Lee, H.; Kim, H.-J.; Lee, D.; Choi, Y.-W.

2016-01-01

The digital breast tomosynthesis (DBT) system is a newly developed 3-D imaging technique that overcomes the tissue superposition problems of conventional mammography. Therefore, it produces fewer false positives. In DBT system, several parameters are involved in image acquisition, including geometric components. A series of projections should be acquired at low exposure. This makes the system strongly dependent on the detector's characteristic performance. This study compares two types of x-ray detectors developed by the Korea Electrotechnology Research Institute (KERI). The first prototype DBT system has a CsI (Tl) scintillator/CMOS based flat panel digital detector (2923 MAM, Dexela Ltd.), with a pixel size of 0.0748 mm. The second uses a-Se based direct conversion full field detector (AXS 2430, analogic) with a pixel size of 0.085 mm. The geometry of both systems is same, with a focal spot 665.8 mm from the detector, and a center of rotation 33 mm above the detector surface. The systems were compared with regard to modulation transfer function (MTF), normalized noise power spectrum (NNPS), detective quantum efficiency (DQE) and a new metric, the relative object detectability (ROD). The ROD quantifies the relative performance of each detector at detecting specified objects. The system response function demonstrated excellent linearity (R 2 >0.99). The CMOS-based detector had a high sensitivity, while the Anrad detector had a large dynamic range. The higher MTF and noise power spectrum (NPS) values were measured using an Anrad detector. The maximum DQE value of the Dexela detector was higher than that of the Anrad detector with a low exposure level, considering one projection exposure for tomosynthesis. Overall, the Dexela detector performed better than did the Anrad detector with regard to the simulated Al wires, spheres, test objects of ROD with low exposure level. In this study, we compared the newly developed prototype DBT system with two different types

A second pass correction method for calcification artifacts in digital breast tomosynthesis

NARCIS (Netherlands)

Erhard, K.; Grass, M.; Nielsen, T.

2011-01-01

Digital breast tomosynthesis (DBT) aims for improving the diagnosis of breast cancer and reducing the false positive rates by going from 2D projection mammography to 3D volume information. With the acquisition of a series of projection images, taken over a limited angular range, DBT allows for

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

Science.gov (United States)

Ikejimba, Lynda; Kiarashi, Nooshin; Lin, Yuan; Chen, Baiyu; Ghate, Sujata V.; Zerhouni, Moustafa; Samei, Ehsan; Lo, Joseph Y.

2012-03-01

Digital breast tomosynthesis (DBT) is a novel x-ray imaging technique that provides 3D structural information of the breast. In contrast to 2D mammography, DBT minimizes tissue overlap potentially improving cancer detection and reducing number of unnecessary recalls. The addition of a contrast agent to DBT and mammography for lesion enhancement has the benefit of providing functional information of a lesion, as lesion contrast uptake and washout patterns may help differentiate between benign and malignant tumors. This study used a task-based method to determine the optimal imaging approach by analyzing six imaging paradigms in terms of their ability to resolve iodine at a given dose: contrast enhanced mammography and tomosynthesis, temporal subtraction mammography and tomosynthesis, and dual energy subtraction mammography and tomosynthesis. Imaging performance was characterized using a detectability index d', derived from the system task transfer function (TTF), an imaging task, iodine contrast, and the noise power spectrum (NPS). The task modeled a 5 mm 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. In general, higher dose gave higher d', but for the lowest iodine concentration and lowest dose, dual energy subtraction tomosynthesis and temporal subtraction tomosynthesis demonstrated the highest performance.

Comparison of digital mammography and digital breast tomosynthesis in the detection of architectural distortion.

Science.gov (United States)

Dibble, Elizabeth H; Lourenco, Ana P; Baird, Grayson L; Ward, Robert C; Maynard, A Stanley; Mainiero, Martha B

2018-01-01

To compare interobserver variability (IOV), reader confidence, and sensitivity/specificity in detecting architectural distortion (AD) on digital mammography (DM) versus digital breast tomosynthesis (DBT). This IRB-approved, HIPAA-compliant reader study used a counterbalanced experimental design. We searched radiology reports for AD on screening mammograms from 5 March 2012-27 November 2013. Cases were consensus-reviewed. Controls were selected from demographically matched non-AD examinations. Two radiologists and two fellows blinded to outcomes independently reviewed images from two patient groups in two sessions. Readers recorded presence/absence of AD and confidence level. Agreement and differences in confidence and sensitivity/specificity between DBT versus DM and attendings versus fellows were examined using weighted Kappa and generalised mixed modeling, respectively. There were 59 AD patients and 59 controls for 1,888 observations (59 × 2 (cases and controls) × 2 breasts × 2 imaging techniques × 4 readers). For all readers, agreement improved with DBT versus DM (0.61 vs. 0.37). Confidence was higher with DBT, p = .001. DBT achieved higher sensitivity (.59 vs. .32), p .90). DBT achieved higher positive likelihood ratio values, smaller negative likelihood ratio values, and larger ROC values. DBT decreases IOV, increases confidence, and improves sensitivity while maintaining high specificity in detecting AD. • Digital breast tomosynthesis decreases interobserver variability in the detection of architectural distortion. • Digital breast tomosynthesis increases reader confidence in the detection of architectural distortion. • Digital breast tomosynthesis improves sensitivity in the detection of architectural distortion.

Second generation stationary digital breast tomosynthesis system with faster scan time and wider angular span.

Science.gov (United States)

Calliste, Jabari; Wu, Gongting; Laganis, Philip E; Spronk, Derrek; Jafari, Houman; Olson, Kyle; Gao, Bo; Lee, Yueh Z; Zhou, Otto; Lu, Jianping

2017-09-01

The aim of this study was to characterize a new generation stationary digital breast tomosynthesis system with higher tube flux and increased angular span over a first generation system. The linear CNT x-ray source was designed, built, and evaluated to determine its performance parameters. The second generation system was then constructed using the CNT x-ray source and a Hologic gantry. Upon construction, test objects and phantoms were used to characterize system resolution as measured by the modulation transfer function (MTF), and artifact spread function (ASF). The results indicated that the linear CNT x-ray source was capable of stable operation at a tube potential of 49 kVp, and measured focal spot sizes showed source-to-source consistency with a nominal focal spot size of 1.1 mm. After construction, the second generation (Gen 2) system exhibited entrance surface air kerma rates two times greater the previous s-DBT system. System in-plane resolution as measured by the MTF is 7.7 cycles/mm, compared to 6.7 cycles/mm for the Gen 1 system. As expected, an increase in the z-axis depth resolution was observed, with a decrease in the ASF from 4.30 mm to 2.35 mm moving from the Gen 1 system to the Gen 2 system as result of an increased angular span. The results indicate that the Gen 2 stationary digital breast tomosynthesis system, which has a larger angular span, increased entrance surface air kerma, and faster image acquisition time over the Gen 1 s-DBT system, results in higher resolution images. With the detector operating at full resolution, the Gen 2 s-DBT system can achieve an in-plane resolution of 7.7 cycles per mm, which is better than the current commercial DBT systems today, and may potentially result in better patient diagnosis. © 2017 American Association of Physicists in Medicine.

Multimodal breast cancer imaging using coregistered dynamic diffuse optical tomography and digital breast tomosynthesis

Science.gov (United States)

Zimmermann, Bernhard B.; Deng, Bin; Singh, Bhawana; Martino, Mark; Selb, Juliette; Fang, Qianqian; Sajjadi, Amir Y.; Cormier, Jayne; Moore, Richard H.; Kopans, Daniel B.; Boas, David A.; Saksena, Mansi A.; Carp, Stefan A.

2017-04-01

Diffuse optical tomography (DOT) is emerging as a noninvasive functional imaging method for breast cancer diagnosis and neoadjuvant chemotherapy monitoring. In particular, the multimodal approach of combining DOT with x-ray digital breast tomosynthesis (DBT) is especially synergistic as DBT prior information can be used to enhance the DOT reconstruction. DOT, in turn, provides a functional information overlay onto the mammographic images, increasing sensitivity and specificity to cancer pathology. We describe a dynamic DOT apparatus designed for tight integration with commercial DBT scanners and providing a fast (up to 1 Hz) image acquisition rate to enable tracking hemodynamic changes induced by the mammographic breast compression. The system integrates 96 continuous-wave and 24 frequency-domain source locations as well as 32 continuous wave and 20 frequency-domain detection locations into low-profile plastic plates that can easily mate to the DBT compression paddle and x-ray detector cover, respectively. We demonstrate system performance using static and dynamic tissue-like phantoms as well as in vivo images acquired from the pool of patients recalled for breast biopsies at the Massachusetts General Hospital Breast Imaging Division.

Breast mass detection in mammography and tomosynthesis via fully convolutional network-based heatmap regression

Science.gov (United States)

Zhang, Jun; Cain, Elizabeth Hope; Saha, Ashirbani; Zhu, Zhe; Mazurowski, Maciej A.

2018-02-01

Breast mass detection in mammography and digital breast tomosynthesis (DBT) is an essential step in computerized breast cancer analysis. Deep learning-based methods incorporate feature extraction and model learning into a unified framework and have achieved impressive performance in various medical applications (e.g., disease diagnosis, tumor detection, and landmark detection). However, these methods require large-scale accurately annotated data. Unfortunately, it is challenging to get precise annotations of breast masses. To address this issue, we propose a fully convolutional network (FCN) based heatmap regression method for breast mass detection, using only weakly annotated mass regions in mammography images. Specifically, we first generate heat maps of masses based on human-annotated rough regions for breast masses. We then develop an FCN model for end-to-end heatmap regression with an F-score loss function, where the mammography images are regarded as the input and heatmaps for breast masses are used as the output. Finally, the probability map of mass locations can be estimated with the trained model. Experimental results on a mammography dataset with 439 subjects demonstrate the effectiveness of our method. Furthermore, we evaluate whether we can use mammography data to improve detection models for DBT, since mammography shares similar structure with tomosynthesis. We propose a transfer learning strategy by fine-tuning the learned FCN model from mammography images. We test this approach on a small tomosynthesis dataset with only 40 subjects, and we show an improvement in the detection performance as compared to training the model from scratch.

Interval breast cancers in the 'screening with tomosynthesis or standard mammography' (STORM) population-based trial.

Science.gov (United States)

Houssami, Nehmat; Bernardi, Daniela; Caumo, Francesca; Brunelli, Silvia; Fantò, Carmine; Valentini, Marvi; Romanucci, Giovanna; Gentilini, Maria A; Zorzi, Manuel; Macaskill, Petra

2018-04-01

The prospective 'screening with tomosynthesis or standard mammography' (STORM) trial recruited women participating in biennial breast screening in Italy (2011-2012), and compared sequential screen-readings based on 2D-mammography alone or based on tomosynthesis (integrated 2D/3D-mammography). The STORM trial showed that tomosynthesis screen-reading significantly increased breast cancer detection compared to 2D-mammography alone. The present study completes reporting of the trial by examining interval breast cancers ascertained at two year follow-up. 9 interval breast cancers were identified; the estimated interval cancer rate was 1.23/1000 screens [9/7292] (95%CI 0.56 to 2.34) or 1.24/1000 negative screens [9/7235] (95%CI 0.57 to 2.36). In concurrently screened women who attended the same screening services and received 2D-mammography, interval cancer rate was 1.60/1000 screens [40/25,058] (95% CI 1.14 to 2.17) or 1.61/1000 negative screens [40/24,922] (95% CI 1.15 to 2.18). Estimated screening sensitivity for the STORM trial was 85.5% [59/69] (95%CI 75.0%-92.8%), and that for 2D-mammography screening was 77.3% [136/176] (95%CI 70.4%-83.2%). Interval breast cancer rate amongst screening participants in the STORM trial was marginally lower (and screening sensitivity higher) than estimates amongst 2D-screened women; these findings should be interpreted with caution given the small number of interval cases and the sample size of the trial. Much larger screening studies, or pooled analyses, are required to examine interval cancer rates arising after breast tomosynthesis screening versus digital mammography screening. Copyright © 2018 Elsevier Ltd. All rights reserved.

Comparative study of patient doses calculated with two methods for breast digital tomosynthesis

International Nuclear Information System (INIS)

Castillo, M.; Chevalier, M.; Calzado, A.; Garayo, J.; Valverde, J.

2015-01-01

In this study, the average glandular doses (DG) delivered in breast tomosynthesis examinations were estimated over a sample of 150 patients using two different methods. In method 1, the conversion factors air-kerma to DG used were those tabulated by Dance et al. and in method 2 were the ones from Feng et al. The protocol for the examination followed in the unit of this study consists in two views per breast, each view composed by a 2D acquisition and a tomosynthesis scan (3D). The resulting DG values from both methods present statistically significant differences (p=0.02) for the 2D modality and were similar for the 3D scan (p=0.22). The estimated median value of DG for the most frequent breasts (thicknesses between 50 and 60 mm) delivered in a single 3D acquisition is 1.7 mGy (36% and 17% higher than the value for the 2D mode estimated with each method) which lies far below the tolerances established by the Spanish Protocol Quality Control in Radiodiagnostic (2011). The total DG for a tomosynthesis examination (6.0 mGy) is a factor 2.4 higher than the dose delivered in a 2D examination with two views (method 1). (Author)

Optimization of Tomosynthesis Imaging for Improved Mass and Microcalcification Detection in the Breast

National Research Council Canada - National Science Library

Xia, Dan

2008-01-01

The goal of this research is to obtain systematic understandings of the effects of various physical factors that are important in breast tomosynthesis imaging and to develop techniques for effectively...

Can the synthetic C view images be used in isolation for diagnosing breast malignancy without reviewing the entire digital breast tomosynthesis data set?

Science.gov (United States)

Murphy, Mark C; Coffey, Louise; O'Neill, Ailbhe C; Quinn, Cecily; Prichard, Ruth; McNally, Sorcha

2018-02-09

The aim of this study was to determine if the synthetic C view acquired at digital breast tomosynthesis (DBT) would give adequate information to confirm a malignancy and could obviate the need to review all the tomosynthesis image data set. All patients with biopsy-proven breast cancer recalled from screening mammograms between May and September 2016 were included for review. For each patient, the screening 2D mammogram, the synthetic C view, and the DBT images were reviewed by three breast radiologists and each assigned a BIRADS code. Any discrepancies were reviewed and resolved by consensus. A total of 92 patients were diagnosed with breast cancer in this time period. Fourteen were excluded because they did not have DBT performed. Five women were recalled for evaluation of two lesions. In total, 83 lesions were assessed. In 27 cases, the BIRADS code remained unchanged in the three modalities. In 16 cases, the lesions appeared more concerning on C view and DBT that on the original mammogram but were not definitive for malignancy (BIRADS 4). In 29 cases, a BIRADS 5 code was assigned on C view and tomosynthesis but not on 2D. For 11 lesions, a BIRADS 5 code was assigned only on DBT. Four women had BIRADS 5 lesions seen on both the C view and DBT that were not seen on the screening 2D mammogram. One was multifocal. While the synthetic C view gives additional information when compared to a screening 2D mammogram, the full DBT tomosynthesis data set needs to be reviewed to diagnose a breast malignancy.

Potential impact of tomosynthesis on the detection and diagnosis of breast lesi

Directory of Open Access Journals (Sweden)

Tamer F. Taha Ali

2016-03-01

Conclusion: Breast tomosynthesis is a promising technology that offers improved diagnostic and screening accuracy, fewer recalls as well as 3D lesion localization. Lesion conspicuity is improved using DBT compared with FFDM with a more confidence in making clinical decisions.

Tomosynthesis imaging: At a translational crossroads

International Nuclear Information System (INIS)

Dobbins, James T. III

2009-01-01

Tomosynthesis is a decades-old technique for section imaging that has seen a recent upsurge in interest due to its promise to provide three-dimensional information at lower dose and potentially lower cost than CT in certain clinical imaging situations. This renewed interest in tomosynthesis began in the late 1990s as a new generation of flat-panel detectors became available; these detectors were the one missing piece of the picture that had kept tomosynthesis from enjoying significant utilization earlier. In the past decade, tomosynthesis imaging has been investigated in a variety of clinical imaging situations, but the two most prominent have been in breast and chest imaging. Tomosynthesis has the potential to substantially change the way in which breast cancer and pulmonary nodules are detected and managed. Commercial tomosynthesis devices are now available or on the horizon. Many of the remaining research activities with tomosynthesis will be translational in nature and will involve physicist and clinician alike. This overview article provides a forward-looking assessment of the translational questions facing tomosynthesis imaging and anticipates some of the likely research and clinical activities in the next five years.

Tomosynthesis imaging: At a translational crossroads

Science.gov (United States)

Dobbins, James T.

2009-01-01

Tomosynthesis is a decades-old technique for section imaging that has seen a recent upsurge in interest due to its promise to provide three-dimensional information at lower dose and potentially lower cost than CT in certain clinical imaging situations. This renewed interest in tomosynthesis began in the late 1990s as a new generation of flat-panel detectors became available; these detectors were the one missing piece of the picture that had kept tomosynthesis from enjoying significant utilization earlier. In the past decade, tomosynthesis imaging has been investigated in a variety of clinical imaging situations, but the two most prominent have been in breast and chest imaging. Tomosynthesis has the potential to substantially change the way in which breast cancer and pulmonary nodules are detected and managed. Commercial tomosynthesis devices are now available or on the horizon. Many of the remaining research activities with tomosynthesis will be translational in nature and will involve physicist and clinician alike. This overview article provides a forward-looking assessment of the translational questions facing tomosynthesis imaging and anticipates some of the likely research and clinical activities in the next five years. PMID:19610284

Effect of age on breast cancer screening using tomosynthesis in combination with digital mammography.

Science.gov (United States)

Rafferty, Elizabeth A; Rose, Stephen L; Miller, Dave P; Durand, Melissa A; Conant, Emily F; Copit, Debra S; Friedewald, Sarah M; Plecha, Donna M; Ott, Ingrid L; Hayes, Mary K; Carlson, Kara L; Cink, Thomas M; Barke, Lora D; Greer, Linda N; Niklason, Loren T

2017-08-01

To determine the effect of tomosynthesis imaging as a function of age for breast cancer screening. Screening performance metrics from 13 institutions were examined for 12 months prior to introduction of tomosynthesis (period 1) and compared to those after introduction of tomosynthesis (period 2, range 3-22 months). Screening metrics for women ages 40-49, 50-59, 60-69, and 70+ , included rates per 1000 screens for recalls, biopsies, cancers, and invasive cancers detected. Performance parameters were compared for women screened with digital mammography alone (n = 278,908) and digital mammography + tomosynthesis (n = 173,414). Addition of tomosynthesis to digital mammography produced significant reductions in recall rates for all age groups and significant increases in cancer detection rates for women 40-69. Largest recall rate reduction with tomosynthesis was for women 40-49, decreasing from 137 (95% CI 117-156) to 115 (95% CI 95-135); difference, -22 (95% CI -26 to -18; P cancer detection rate for women 40-49 from 1.6 (95% CI 1.2-1.9) to 2.7 (95% CI 2.2-3.1) with tomosynthesis (difference, 1.1; 95% CI 0.6-1.6; P cancer detection rates for women 40-69 and decreased recall rates for all age groups with largest performance gains seen in women 40-49. The similar performance seen with tomosynthesis screening for women in their 40s compared to digital mammography for women in their 50s argues strongly for commencement of mammography screening at age 40 using tomosynthesis.

Image quality of microcalcifications in digital breast tomosynthesis: Effects of projection-view distributions

OpenAIRE

Lu, Yao; Chan, Heang-Ping; Wei, Jun; Goodsitt, Mitch; Carson, Paul L.; Hadjiiski, Lubomir; Schmitz, Andrea; Eberhard, Jeffrey W.; Claus, Bernhard E. H.

2011-01-01

Purpose: To analyze the effects of projection-view (PV) distribution on the contrast and spatial blurring of microcalcifications on the tomosynthesized slices (X-Y plane) and along the depth (Z) direction for the same radiation dose in digital breast tomosynthesis (DBT).Methods: A GE GEN2 prototype DBT system was used for acquisition of DBT scans. The system acquires PV images from 21 angles in 3° increments over a ±30° range. From these acquired PV images, the authors selected six subsets of...

A software-based x-ray scatter correction method for breast tomosynthesis

International Nuclear Information System (INIS)

Jia Feng, Steve Si; Sechopoulos, Ioannis

2011-01-01

Purpose: To develop a software-based scatter correction method for digital breast tomosynthesis (DBT) imaging and investigate its impact on the image quality of tomosynthesis reconstructions of both phantoms and patients. Methods: A Monte Carlo (MC) simulation of x-ray scatter, with geometry matching that of the cranio-caudal (CC) view of a DBT clinical prototype, was developed using the Geant4 toolkit and used to generate maps of the scatter-to-primary ratio (SPR) of a number of homogeneous standard-shaped breasts of varying sizes. Dimension-matched SPR maps were then deformed and registered to DBT acquisition projections, allowing for the estimation of the primary x-ray signal acquired by the imaging system. Noise filtering of the estimated projections was then performed to reduce the impact of the quantum noise of the x-ray scatter. Three dimensional (3D) reconstruction was then performed using the maximum likelihood-expectation maximization (MLEM) method. This process was tested on acquisitions of a heterogeneous 50/50 adipose/glandular tomosynthesis phantom with embedded masses, fibers, and microcalcifications and on acquisitions of patients. The image quality of the reconstructions of the scatter-corrected and uncorrected projections was analyzed by studying the signal-difference-to-noise ratio (SDNR), the integral of the signal in each mass lesion (integrated mass signal, IMS), and the modulation transfer function (MTF). Results: The reconstructions of the scatter-corrected projections demonstrated superior image quality. The SDNR of masses embedded in a 5 cm thick tomosynthesis phantom improved 60%-66%, while the SDNR of the smallest mass in an 8 cm thick phantom improved by 59% (p < 0.01). The IMS of the masses in the 5 cm thick phantom also improved by 15%-29%, while the IMS of the masses in the 8 cm thick phantom improved by 26%-62% (p < 0.01). Some embedded microcalcifications in the tomosynthesis phantoms were visible only in the scatter

Comparison study of reconstruction algorithms for prototype digital breast tomosynthesis using various breast phantoms.

Science.gov (United States)

Kim, Ye-seul; Park, Hye-suk; Lee, Haeng-Hwa; Choi, Young-Wook; Choi, Jae-Gu; Kim, Hak Hee; Kim, Hee-Joung

2016-02-01

Digital breast tomosynthesis (DBT) is a recently developed system for three-dimensional imaging that offers the potential to reduce the false positives of mammography by preventing tissue overlap. Many qualitative evaluations of digital breast tomosynthesis were previously performed by using a phantom with an unrealistic model and with heterogeneous background and noise, which is not representative of real breasts. The purpose of the present work was to compare reconstruction algorithms for DBT by using various breast phantoms; validation was also performed by using patient images. DBT was performed by using a prototype unit that was optimized for very low exposures and rapid readout. Three algorithms were compared: a back-projection (BP) algorithm, a filtered BP (FBP) algorithm, and an iterative expectation maximization (EM) algorithm. To compare the algorithms, three types of breast phantoms (homogeneous background phantom, heterogeneous background phantom, and anthropomorphic breast phantom) were evaluated, and clinical images were also reconstructed by using the different reconstruction algorithms. The in-plane image quality was evaluated based on the line profile and the contrast-to-noise ratio (CNR), and out-of-plane artifacts were evaluated by means of the artifact spread function (ASF). Parenchymal texture features of contrast and homogeneity were computed based on reconstructed images of an anthropomorphic breast phantom. The clinical images were studied to validate the effect of reconstruction algorithms. The results showed that the CNRs of masses reconstructed by using the EM algorithm were slightly higher than those obtained by using the BP algorithm, whereas the FBP algorithm yielded much lower CNR due to its high fluctuations of background noise. The FBP algorithm provides the best conspicuity for larger calcifications by enhancing their contrast and sharpness more than the other algorithms; however, in the case of small-size and low

Average glandular dose in digital mammography and digital breast tomosynthesis: comparison of phantom and patient data

NARCIS (Netherlands)

Bouwman, R. W.; van Engen, R. E.; Young, K. C.; den Heeten, G. J.; Broeders, M. J. M.; Schopphoven, S.; Jeukens, C. R. L. P. N.; Veldkamp, W. J. H.; Dance, D. R.

2015-01-01

For the evaluation of the average glandular dose (AGD) in digital mammography (DM) and digital breast tomosynthesis (DBT) phantoms simulating standard model breasts are used. These phantoms consist of slabs of polymethyl methacrylate (PMMA) or a combination of PMMA and polyethylene (PE). In the last

Individualised calculation of tissue imparted energy in breast tomosynthesis

International Nuclear Information System (INIS)

Geeraert, N.; Klausz, R.; Muller, S.; Bosmans, H.; Bloch, I.

2016-01-01

The imparted energy to the glandular tissue in the breast (glandular imparted energy, GIE) is proposed for an improved assessment of the individual radiation-induced risk resulting from X-ray breast imaging. GIE is computed from an estimation of the quantity and localisation of glandular tissue in the breast. After a digital breast tomosynthesis (DBT) acquisition, the volumetric glandular content (volumetric breast density, VBD) is computed from the central X-ray projection. The glandular tissue distribution is determined by labelling the DBT voxels to ensure the conservation of the VBD. Finally, the GIE is calculated by Monte Carlo computation on the resulting tissue-labelled DBT volume. For verification, the method was applied to 10 breast-shaped digital phantoms made of different glandular spheres in an adipose background, and to a digital anthropomorphic phantom. Results were compared to direct GIE computations on the phantoms considered as 'ground-truth'. The major limitations in accuracy are those of DBT, in particular the limited z-resolution. However, for most phantoms, the results can be considered as acceptable. (authors)

Clinical evaluation of contrast-enhanced digital mammography and contrast enhanced tomosynthesis--Comparison to contrast-enhanced breast MRI.

Science.gov (United States)

Chou, Chen-Pin; Lewin, John M; Chiang, Chia-Ling; Hung, Bao-Hui; Yang, Tsung-Lung; Huang, Jer-Shyung; Liao, Jia-Bin; Pan, Huay-Ben

2015-12-01

To compare the diagnostic accuracy of contrast-enhanced digital mammography (CEDM) and contrast-enhanced tomosynthesis (CET) to dynamic contrast enhanced breast MRI (DCE-MRI) using a multireader-multicase study. Institutional review board approval and informed consents were obtained. Total 185 patients (mean age 51.3) with BI-RADS 4 or 5 lesions were evaluated before biopsy with mammography, tomosynthesis, CEDM, CET and DCE-MRI. Mediolateral-oblique and cranio-caudal views of the target breast CEDM and CET were acquired at 2 and 4 min after contrast agent injection. A mediolateral-oblique view of the non-target breast was taken at 6 min. Each lesion was scored with forced BI-RADS categories by three readers. Each reader interpreted lesions in the following order: mammography, tomosynthesis, CEDM, CET, and DCE-MRI during a single reading session. Histology showed 81 cancers and 144 benign lesions in the study. Of the 81 malignant lesions, 44% (36/81) were invasive and 56% (45/81) were non-invasive. Areas under the ROC curve, averaged for the 3 readers, were as follows: 0.897 for DCE-MRI, 0.892 for CET, 0.878 for CEDM, 0.784 for tomosynthesis and 0.740 for mammography. Significant differences in AUC were found between the group of contrast enhanced modalities (CEDM, CET, DCE-MRI) and the unenhanced modalities (all p0.05). CET and CEDM may be considered as an alternative modality to MRI for following up women with abnormal mammography. All three contrast modalities were superior in accuracy to conventional digital mammography with or without tomosynthesis. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

The Adjunctive Digital Breast Tomosynthesis in Diagnosis of Breast Cancer

Directory of Open Access Journals (Sweden)

Tsung-Lung Yang

2013-01-01

Full Text Available Purpose. To compare the diagnostic performance of digital breast tomosynthesis (DBT and digital mammography (DM for breast cancers. Materials and Methods. Fifty-seven female patients with pathologically proved breast cancer were enrolled. Three readers gave a subjective assessment superiority of the index lesions (mass, focal asymmetry, architectural distortion, or calcifications and a forced BIRADS score, based on DM reading alone and with additional DBT information. The relevance between BIRADS category and index lesions of breast cancer was compared by chi-square test. Result. A total of 59 breast cancers were reviewed, including 17 (28.8% mass lesions, 12 (20.3% focal asymmetry/density, 6 (10.2% architecture distortion, 23 (39.0% calcifications, and 1 (1.7% intracystic tumor. Combo DBT was perceived to be more informative in 58.8% mass lesions, 83.3% density, 94.4% architecture distortion, and only 11.6% calcifications. As to the forced BIRADS score, 84.4% BIRADS 0 on DM was upgraded to BIRADS 4 or 5 on DBT, whereas only 27.3% BIRADS 4A on DM was upgraded on DBT, as BIRADS 4A lesions were mostly calcifications. A significant P value (<0.001 between the BIRADS category and index lesions was noted. Conclusion. Adjunctive DBT gives exquisite information for mass lesion, focal asymmetry, and/or architecture distortion to improve the diagnostic performance in mammography.

Design and evaluation of a grid reciprocation scheme for use in digital breast tomosynthesis

Science.gov (United States)

Patel, Tushita; Sporkin, Helen; Peppard, Heather; Williams, Mark B.

2016-03-01

This work describes a methodology for efficient removal of scatter radiation during digital breast tomosynthesis (DBT). The goal of this approach is to enable grid image obscuration without a large increase in radiation dose by minimizing misalignment of the grid focal point (GFP) and x-ray focal spot (XFS) during grid reciprocation. Hardware for the motion scheme was built and tested on the dual modality breast tomosynthesis (DMT) scanner, which combines DBT and molecular breast tomosynthesis (MBT) on a single gantry. The DMT scanner uses fully isocentric rotation of tube and x-ray detector for maintaining a fixed tube-detector alignment during DBT imaging. A cellular focused copper prototype grid with 80 cm focal length, 3.85 mm height, 0.1 mm thick lamellae, and 1.1 mm hole pitch was tested. Primary transmission of the grid at 28 kV tube voltage was on average 74% with the grid stationary and aligned for maximum transmission. It fell to 72% during grid reciprocation by the proposed method. Residual grid line artifacts (GLAs) in projection views and reconstructed DBT images are characterized and methods for reducing the visibility of GLAs in the reconstructed volume through projection image flat-field correction and spatial frequency-based filtering of the DBT slices are described and evaluated. The software correction methods reduce the visibility of these artifacts in the reconstructed volume, making them imperceptible both in the reconstructed DBT images and their Fourier transforms.

Near-infrared spectral tomography integrated with digital breast tomosynthesis: Effects of tissue scattering on optical data acquisition design

Energy Technology Data Exchange (ETDEWEB)

Michaelsen, Kelly; Krishnaswamy, Venkat; Pogue, Brian W.; Poplack, Steven P.; Paulsen, Keith D. [Thayer School of Engineering, Dartmouth College, Hanover, New Hampshire 03755 (United States); Department of Diagnostic Radiology, Dartmouth Medical School, Lebanon, New Hampshire 03756 (United States); Thayer School of Engineering, Dartmouth College, Hanover, New Hampshire 03755 and Department of Diagnostic Radiology, Dartmouth Medical School, Lebanon, New Hampshire 03756 (United States)

2012-07-15

Purpose: Design optimization and phantom validation of an integrated digital breast tomosynthesis (DBT) and near-infrared spectral tomography (NIRST) system targeting improvement in sensitivity and specificity of breast cancer detection is presented. Factors affecting instrumentation design include minimization of cost, complexity, and examination time while maintaining high fidelity NIRST measurements with sufficient information to recover accurate optical property maps. Methods: Reconstructed DBT slices from eight patients with abnormal mammograms provided anatomical information for the NIRST simulations. A limited frequency domain (FD) and extensive continuous wave (CW) NIRST system was modeled. The FD components provided tissue scattering estimations used in the reconstruction of the CW data. Scattering estimates were perturbed to study the effects on hemoglobin recovery. Breast mimicking agar phantoms with inclusions were imaged using the combined DBT/NIRST system for comparison with simulation results. Results: Patient simulations derived from DBT images show successful reconstruction of both normal and malignant lesions in the breast. They also demonstrate the importance of accurately quantifying tissue scattering. Specifically, 20% errors in optical scattering resulted in 22.6% or 35.1% error in quantification of total hemoglobin concentrations, depending on whether scattering was over- or underestimated, respectively. Limited frequency-domain optical signal sampling provided two regions scattering estimates (for fat and fibroglandular tissues) that led to hemoglobin concentrations that reduced the error in the tumor region by 31% relative to when a single estimate of optical scattering was used throughout the breast volume of interest. Acquiring frequency-domain data with six wavelengths instead of three did not significantly improve the hemoglobin concentration estimates. Simulation results were confirmed through experiments in two-region breast mimicking

Near-infrared spectral tomography integrated with digital breast tomosynthesis: Effects of tissue scattering on optical data acquisition design

International Nuclear Information System (INIS)

Michaelsen, Kelly; Krishnaswamy, Venkat; Pogue, Brian W.; Poplack, Steven P.; Paulsen, Keith D.

2012-01-01

Purpose: Design optimization and phantom validation of an integrated digital breast tomosynthesis (DBT) and near-infrared spectral tomography (NIRST) system targeting improvement in sensitivity and specificity of breast cancer detection is presented. Factors affecting instrumentation design include minimization of cost, complexity, and examination time while maintaining high fidelity NIRST measurements with sufficient information to recover accurate optical property maps. Methods: Reconstructed DBT slices from eight patients with abnormal mammograms provided anatomical information for the NIRST simulations. A limited frequency domain (FD) and extensive continuous wave (CW) NIRST system was modeled. The FD components provided tissue scattering estimations used in the reconstruction of the CW data. Scattering estimates were perturbed to study the effects on hemoglobin recovery. Breast mimicking agar phantoms with inclusions were imaged using the combined DBT/NIRST system for comparison with simulation results. Results: Patient simulations derived from DBT images show successful reconstruction of both normal and malignant lesions in the breast. They also demonstrate the importance of accurately quantifying tissue scattering. Specifically, 20% errors in optical scattering resulted in 22.6% or 35.1% error in quantification of total hemoglobin concentrations, depending on whether scattering was over- or underestimated, respectively. Limited frequency-domain optical signal sampling provided two regions scattering estimates (for fat and fibroglandular tissues) that led to hemoglobin concentrations that reduced the error in the tumor region by 31% relative to when a single estimate of optical scattering was used throughout the breast volume of interest. Acquiring frequency-domain data with six wavelengths instead of three did not significantly improve the hemoglobin concentration estimates. Simulation results were confirmed through experiments in two-region breast mimicking

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

Science.gov (United States)

Ikejimba, Lynda C.; Kiarashi, Nooshin; Ghate, Sujata V.; Samei, Ehsan; Lo, Joseph Y.

2014-01-01

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

Segmentation methods for breast vasculature in dual-energy contrast-enhanced digital breast tomosynthesis

Science.gov (United States)

Lau, Kristen C.; Lee, Hyo Min; Singh, Tanushriya; Maidment, Andrew D. A.

2015-03-01

Dual-energy contrast-enhanced digital breast tomosynthesis (DE CE-DBT) uses an iodinated contrast agent to image the three-dimensional breast vasculature. The University of Pennsylvania has an ongoing DE CE-DBT clinical study in patients with known breast cancers. The breast is compressed continuously and imaged at four time points (1 pre-contrast; 3 post-contrast). DE images are obtained by a weighted logarithmic subtraction of the high-energy (HE) and low-energy (LE) image pairs. Temporal subtraction of the post-contrast DE images from the pre-contrast DE image is performed to analyze iodine uptake. Our previous work investigated image registration methods to correct for patient motion, enhancing the evaluation of vascular kinetics. In this project we investigate a segmentation algorithm which identifies blood vessels in the breast from our temporal DE subtraction images. Anisotropic diffusion filtering, Gabor filtering, and morphological filtering are used for the enhancement of vessel features. Vessel labeling methods are then used to distinguish vessel and background features successfully. Statistical and clinical evaluations of segmentation accuracy in DE-CBT images are ongoing.

Statistical iterative reconstruction to improve image quality for digital breast tomosynthesis

International Nuclear Information System (INIS)

Xu, Shiyu; Chen, Ying; Lu, Jianping; Zhou, Otto

2015-01-01

Purpose: Digital breast tomosynthesis (DBT) is a novel modality with the potential to improve early detection of breast cancer by providing three-dimensional (3D) imaging with a low radiation dose. 3D image reconstruction presents some challenges: cone-beam and flat-panel geometry, and highly incomplete sampling. A promising means to overcome these challenges is statistical iterative reconstruction (IR), since it provides the flexibility of accurate physics modeling and a general description of system geometry. The authors’ goal was to develop techniques for applying statistical IR to tomosynthesis imaging data. Methods: These techniques include the following: a physics model with a local voxel-pair based prior with flexible parameters to fine-tune image quality; a precomputed parameter λ in the prior, to remove data dependence and to achieve a uniform resolution property; an effective ray-driven technique to compute the forward and backprojection; and an oversampled, ray-driven method to perform high resolution reconstruction with a practical region-of-interest technique. To assess the performance of these techniques, the authors acquired phantom data on the stationary DBT prototype system. To solve the estimation problem, the authors proposed an optimization-transfer based algorithm framework that potentially allows fewer iterations to achieve an acceptably converged reconstruction. Results: IR improved the detectability of low-contrast and small microcalcifications, reduced cross-plane artifacts, improved spatial resolution, and lowered noise in reconstructed images. Conclusions: Although the computational load remains a significant challenge for practical development, the superior image quality provided by statistical IR, combined with advancing computational techniques, may bring benefits to screening, diagnostics, and intraoperative imaging in clinical applications

Statistical iterative reconstruction to improve image quality for digital breast tomosynthesis

Energy Technology Data Exchange (ETDEWEB)

Xu, Shiyu, E-mail: shiyu.xu@gmail.com; Chen, Ying, E-mail: adachen@siu.edu [Department of Electrical and Computer Engineering, Southern Illinois University Carbondale, Carbondale, Illinois 62901 (United States); Lu, Jianping; Zhou, Otto [Department of Physics and Astronomy and Curriculum in Applied Sciences and Engineering, University of North Carolina Chapel Hill, Chapel Hill, North Carolina 27599 (United States)

2015-09-15

Purpose: Digital breast tomosynthesis (DBT) is a novel modality with the potential to improve early detection of breast cancer by providing three-dimensional (3D) imaging with a low radiation dose. 3D image reconstruction presents some challenges: cone-beam and flat-panel geometry, and highly incomplete sampling. A promising means to overcome these challenges is statistical iterative reconstruction (IR), since it provides the flexibility of accurate physics modeling and a general description of system geometry. The authors’ goal was to develop techniques for applying statistical IR to tomosynthesis imaging data. Methods: These techniques include the following: a physics model with a local voxel-pair based prior with flexible parameters to fine-tune image quality; a precomputed parameter λ in the prior, to remove data dependence and to achieve a uniform resolution property; an effective ray-driven technique to compute the forward and backprojection; and an oversampled, ray-driven method to perform high resolution reconstruction with a practical region-of-interest technique. To assess the performance of these techniques, the authors acquired phantom data on the stationary DBT prototype system. To solve the estimation problem, the authors proposed an optimization-transfer based algorithm framework that potentially allows fewer iterations to achieve an acceptably converged reconstruction. Results: IR improved the detectability of low-contrast and small microcalcifications, reduced cross-plane artifacts, improved spatial resolution, and lowered noise in reconstructed images. Conclusions: Although the computational load remains a significant challenge for practical development, the superior image quality provided by statistical IR, combined with advancing computational techniques, may bring benefits to screening, diagnostics, and intraoperative imaging in clinical applications.

Value analysis of digital breast tomosynthesis for breast cancer screening in a commercially-insured US population

Directory of Open Access Journals (Sweden)

Bonafede MM

2015-01-01

Full Text Available Machaon M Bonafede,1 Vivek B Kalra,2 Jeffrey D Miller,1 Laurie L Fajardo3 1Truven Health Analytics, Cambridge, MA, 2Yale University School of Medicine, New Haven, CT, 3Department of Radiology, University of Iowa College of Medicine, Iowa City, IA, USA Purpose: The objective of this study was to conduct a value analysis of digital breast tomosynthesis (DBT for breast cancer screening among women enrolled in US commercial health insurance plans to assess the potential budget impact associated with the clinical benefits of DBT. Methods: An economic model was developed to estimate the system-wide financial impact of DBT as a breast cancer screening modality within a hypothetical US managed care plan with one million members. Two scenarios were considered for women in the health plan who undergo annual screening mammography, ie, full field digital mammography (FFDM and combined FFDM + DBT. The model focused on two main drivers of DBT value, ie, the capacity for DBT to reduce the number of women recalled for additional follow-up imaging and diagnostic services and the capacity of DBT to facilitate earlier diagnosis of cancer at less invasive stages where treatment costs are lower. Model inputs were derived from published sources and from analyses of the Truven Health MarketScan® Research Databases (2010–2012. Comparative clinical and economic outcomes were simulated for one year following screening and compared on an incremental basis. Results: Base-case analysis results show that 4,523 women in the hypothetical million member health plan who are screened using DBT avoid the use of follow-up services. The overall benefit of DBT was calculated at $78.53 per woman screened. Adjusting for a hypothetical $50 incremental cost of the DBT examination, this translates to $28.53 savings per woman screened, or $0.20 savings per member per month across the plan population and an overall cost savings to the plan of $2.4 million per year. Conclusion: The

A computer simulation study comparing lesion detection accuracy with digital mammography, breast tomosynthesis, and cone-beam CT breast imaging

International Nuclear Information System (INIS)

Gong Xing; Glick, Stephen J.; Liu, Bob; Vedula, Aruna A.; Thacker, Samta

2006-01-01

Although conventional mammography is currently the best modality to detect early breast cancer, it is limited in that the recorded image represents the superposition of a three-dimensional (3D) object onto a 2D plane. Recently, two promising approaches for 3D volumetric breast imaging have been proposed, breast tomosynthesis (BT) and CT breast imaging (CTBI). To investigate possible improvements in lesion detection accuracy with either breast tomosynthesis or CT breast imaging as compared to digital mammography (DM), a computer simulation study was conducted using simulated lesions embedded into a structured 3D breast model. The computer simulation realistically modeled x-ray transport through a breast model, as well as the signal and noise propagation through a CsI based flat-panel imager. Polyenergetic x-ray spectra of Mo/Mo 28 kVp for digital mammography, Mo/Rh 28 kVp for BT, and W/Ce 50 kVp for CTBI were modeled. For the CTBI simulation, the intensity of the x-ray spectra for each projection view was determined so as to provide a total average glandular dose of 4 mGy, which is approximately equivalent to that given in conventional two-view screening mammography. The same total dose was modeled for both the DM and BT simulations. Irregular lesions were simulated by using a stochastic growth algorithm providing lesions with an effective diameter of 5 mm. Breast tissue was simulated by generating an ensemble of backgrounds with a power law spectrum, with the composition of 50% fibroglandular and 50% adipose tissue. To evaluate lesion detection accuracy, a receiver operating characteristic (ROC) study was performed with five observers reading an ensemble of images for each case. The average area under the ROC curves (A z ) was 0.76 for DM, 0.93 for BT, and 0.94 for CTBI. Results indicated that for the same dose, a 5 mm lesion embedded in a structured breast phantom was detected by the two volumetric breast imaging systems, BT and CTBI, with statistically

A comparison of methods to evaluate gray scale response of tomosynthesis systems using a software breast phantom

Science.gov (United States)

Sousa, Maria A. Z.; Bakic, Predrag R.; Schiabel, Homero; Maidment, Andrew D. A.

2017-03-01

Digital breast tomosynthesis (DBT) has been shown to be an effective imaging tool for breast cancer diagnosis as it provides three-dimensional images of the breast with minimal tissue overlap. The quality of the reconstructed image depends on many factors that can be assessed using uniform or realistic phantoms. In this paper, we created four models of phantoms using an anthropomorphic software breast phantom and compared four methods to evaluate the gray scale response in terms of the contrast, noise and detectability of adipose and glandular tissues binarized according to phantom ground truth. For each method, circular regions of interest (ROIs) were selected with various sizes, quantity and positions inside a square area in the phantom. We also estimated the percent density of the simulated breast and the capability of distinguishing both tissues by receiver operating characteristic (ROC) analysis. Results shows a sensitivity of the methods to the ROI size, placement and to the slices considered.

SU-C-209-07: Phantoms for Digital Breast Tomosynthesis Imaging System Evaluation

Energy Technology Data Exchange (ETDEWEB)

Jacobson, D; Liu, Y [Medical College of Wisconsin, Milwaukee, WI (United States)

2016-06-15

Purpose: Digital Breast Tomosynthesis (DBT) is gaining importance in breast imaging. There is a need for phantoms that can be used for image evaluation and comparison. Existing commercially available phantoms for DBT are expensive and may lack clinically relevant test objects. The purpose of this study is to develop phantoms for DBT evaluation. Methods Four phantoms have been designed and constructed to assess the image quality (IQ) of two DBT systems. The first contains a spiral of 0.3 mm SiC beads in gelatin to measure the tomographic slice thickness profile and uniformity of coverage in a series of tomographic planes. The second contains simulated tumors inclined with respect to the phantom base to assess tomographic image quality. The third has a tilted array of discs with varying contrast and diameter. This phantom was imaged alone and in a stack of TE slabs giving 2 to 10 cm thickness. The fourth has a dual wedge of glandular and adipose simulating materials. One wedge contains discs with varying diameter and thickness; the other supports a mass with six simulated spicules of varying size and a cluster of simulated calcifications. The simulated glandular tissue material varies between 35 and 100% of the total thickness (5.5 cm). Results: All phantoms were scanned successfully. The best IQ comparison was achieved with the dual wedge phantom as demonstrated by the spiculated mass and calcifications. Images were evaluated by two radiologists and one physicist. The projection images and corresponding set of tomographic planes were comparable and the synthesized projection images were inferior to the projection images for both systems. Conclusion: Four phantoms were designed, constructed and imaged on two DBT systems. They successfully demonstrated performance differences between two systems, and between true and synthesized projection images. Future work will incorporate these designs into a single phantom.

Voting strategy for artifact reduction in digital breast tomosynthesis

International Nuclear Information System (INIS)

Wu Tao; Moore, Richard H.; Kopans, Daniel B.

2006-01-01

Artifacts are observed in digital breast tomosynthesis (DBT) reconstructions due to the small number of projections and the narrow angular range that are typically employed in tomosynthesis imaging. In this work, we investigate the reconstruction artifacts that are caused by high-attenuation features in breast and develop several artifact reduction methods based on a 'voting strategy'. The voting strategy identifies the projection(s) that would introduce artifacts to a voxel and rejects the projection(s) when reconstructing the voxel. Four approaches to the voting strategy were compared, including projection segmentation, maximum contribution deduction, one-step classification, and iterative classification. The projection segmentation method, based on segmentation of high-attenuation features from the projections, effectively reduces artifacts caused by metal and large calcifications that can be reliably detected and segmented from projections. The other three methods are based on the observation that contributions from artifact-inducing projections have higher value than those from normal projections. These methods attempt to identify the projection(s) that would cause artifacts by comparing contributions from different projections. Among the three methods, the iterative classification method provides the best artifact reduction; however, it can generate many false positive classifications that degrade the image quality. The maximum contribution deduction method and one-step classification method both reduce artifacts well from small calcifications, although the performance of artifact reduction is slightly better with the one-step classification. The combination of one-step classification and projection segmentation removes artifacts from both large and small calcifications

A parameterization method and application in breast tomosynthesis dosimetry

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Li, Xinhua; Zhang, Da; Liu, Bob [Division of Diagnostic Imaging Physics and Webster Center for Advanced Research and Education in Radiation, Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts 02114 (United States)

2013-09-15

Purpose: To present a parameterization method based on singular value decomposition (SVD), and to provide analytical parameterization of the mean glandular dose (MGD) conversion factors from eight references for evaluating breast tomosynthesis dose in the Mammography Quality Standards Act (MQSA) protocol and in the UK, European, and IAEA dosimetry protocols.Methods: MGD conversion factor is usually listed in lookup tables for the factors such as beam quality, breast thickness, breast glandularity, and projection angle. The authors analyzed multiple sets of MGD conversion factors from the Hologic Selenia Dimensions quality control manual and seven previous papers. Each data set was parameterized using a one- to three-dimensional polynomial function of 2–16 terms. Variable substitution was used to improve accuracy. A least-squares fit was conducted using the SVD.Results: The differences between the originally tabulated MGD conversion factors and the results computed using the parameterization algorithms were (a) 0.08%–0.18% on average and 1.31% maximum for the Selenia Dimensions quality control manual, (b) 0.09%–0.66% on average and 2.97% maximum for the published data by Dance et al. [Phys. Med. Biol. 35, 1211–1219 (1990); ibid. 45, 3225–3240 (2000); ibid. 54, 4361–4372 (2009); ibid. 56, 453–471 (2011)], (c) 0.74%–0.99% on average and 3.94% maximum for the published data by Sechopoulos et al. [Med. Phys. 34, 221–232 (2007); J. Appl. Clin. Med. Phys. 9, 161–171 (2008)], and (d) 0.66%–1.33% on average and 2.72% maximum for the published data by Feng and Sechopoulos [Radiology 263, 35–42 (2012)], excluding one sample in (d) that does not follow the trends in the published data table.Conclusions: A flexible parameterization method is presented in this paper, and was applied to breast tomosynthesis dosimetry. The resultant data offer easy and accurate computations of MGD conversion factors for evaluating mean glandular breast dose in the MQSA

Metal artifact reduction using a patch-based reconstruction for digital breast tomosynthesis

Science.gov (United States)

Borges, Lucas R.; Bakic, Predrag R.; Maidment, Andrew D. A.; Vieira, Marcelo A. C.

2017-03-01

Digital breast tomosynthesis (DBT) is rapidly emerging as the main clinical tool for breast cancer screening. Although several reconstruction methods for DBT are described by the literature, one common issue is the interplane artifacts caused by out-of-focus features. For breasts containing highly attenuating features, such as surgical clips and large calcifications, the artifacts are even more apparent and can limit the detection and characterization of lesions by the radiologist. In this work, we propose a novel method of combining backprojected data into tomographic slices using a patch-based approach, commonly used in denoising. Preliminary tests were performed on a geometry phantom and on an anthropomorphic phantom containing metal inserts. The reconstructed images were compared to a commercial reconstruction solution. Qualitative assessment of the reconstructed images provides evidence that the proposed method reduces artifacts while maintaining low noise levels. Objective assessment supports the visual findings. The artifact spread function shows that the proposed method is capable of suppressing artifacts generated by highly attenuating features. The signal difference to noise ratio shows that the noise levels of the proposed and commercial methods are comparable, even though the commercial method applies post-processing filtering steps, which were not implemented on the proposed method. Thus, the proposed method can produce tomosynthesis reconstructions with reduced artifacts and low noise levels.

Validation of mean glandular dose values provided by a digital breast tomosynthesis system in Brazil

International Nuclear Information System (INIS)

Beraldo O, B.; Paixao, L.; Donato da S, S.; Araujo T, M. H.; Nogueira, M. S.

2014-08-01

Digital breast tomosynthesis (DBT) is an emerging imaging modality that provides quasi-three-dimensional structural information of the breast and has strong promise to improve the differentiation of normal tissue and suspicious masses reducing the tissue overlaps. DBT images are reconstructed from a sequence of low-dose X-ray projections of the breast acquired at a small number of angles over a limited angular range. The Ho logic Selen ia Dimensions system is equipped with an amorphous Selenium (a-Se) detector layer of 250 μm thickness and a 70 μm pixel pitch. Studies are needed to determine the radiation dose of patients that are undergoing this emerging procedure to compare with the results obtained in DBT images. The mean glandular dose (D G ) is the dosimetric quantity used in quality control of the mammographic systems. The aim of this work is to validate D G values for different breast thicknesses provided by a Ho logic Selen ia Dimensions system using a DBT mode in comparison with the same results obtained by a calibrated 90 X 5-6M-model Radcal ionization chamber. D G values were derived from the incident air kerma (K i ) measurements and tabulated conversion coefficients that are dependent on the half value layer (HVL) of the X-ray spectrum. Voltage and tube loading values were recorded in irradiations using W/Al anode/filter combination, automatic exposure control mode and polymethyl methacrylate (PMMA) slabs which simulate different breast thicknesses. For K i measurements, the ionization chamber was positioned at 655 mm from the focus and the same radiographic technique values were selected with the manual mode. D G values for a complete procedure ranged from 0.9 ± 0.1 to 3.7 ± 0.4 mGy. The results for different breast thicknesses are in accordance with values obtained by DBT images and with acceptable levels established by the Commission of the European Communities (Cec) and the International Atomic Energy Agency (IAEA). This work contributes to

Validation of mean glandular dose values provided by a digital breast tomosynthesis system in Brazil

Energy Technology Data Exchange (ETDEWEB)

Beraldo O, B.; Paixao, L.; Donato da S, S. [Centro de Desenvolvimento da Tecnologia Nuclear / CNEN, Post-graduation in Sciences and Technology of Radiations Minerals and Materials, Pte. Antonio Carlos 6627, 31270-901 Belo Horizonte (Brazil); Araujo T, M. H. [Dr Maria Helena Araujo Teixeira Clinic, Guajajaras 40, 30180-100 Belo Horizonte (Brazil); Nogueira, M. S., E-mail: bbo@cdtn.br [Centro de Desenvolvimento da Tecnologia Nuclear / CNEN, Pte. Antonio Carlos 6627, 31270-901 Belo Horizonte (Brazil)

2014-08-15

Digital breast tomosynthesis (DBT) is an emerging imaging modality that provides quasi-three-dimensional structural information of the breast and has strong promise to improve the differentiation of normal tissue and suspicious masses reducing the tissue overlaps. DBT images are reconstructed from a sequence of low-dose X-ray projections of the breast acquired at a small number of angles over a limited angular range. The Ho logic Selen ia Dimensions system is equipped with an amorphous Selenium (a-Se) detector layer of 250 μm thickness and a 70 μm pixel pitch. Studies are needed to determine the radiation dose of patients that are undergoing this emerging procedure to compare with the results obtained in DBT images. The mean glandular dose (D{sub G}) is the dosimetric quantity used in quality control of the mammographic systems. The aim of this work is to validate D{sub G} values for different breast thicknesses provided by a Ho logic Selen ia Dimensions system using a DBT mode in comparison with the same results obtained by a calibrated 90 X 5-6M-model Radcal ionization chamber. D{sub G} values were derived from the incident air kerma (K{sub i}) measurements and tabulated conversion coefficients that are dependent on the half value layer (HVL) of the X-ray spectrum. Voltage and tube loading values were recorded in irradiations using W/Al anode/filter combination, automatic exposure control mode and polymethyl methacrylate (PMMA) slabs which simulate different breast thicknesses. For K{sub i} measurements, the ionization chamber was positioned at 655 mm from the focus and the same radiographic technique values were selected with the manual mode. D{sub G} values for a complete procedure ranged from 0.9 ± 0.1 to 3.7 ± 0.4 mGy. The results for different breast thicknesses are in accordance with values obtained by DBT images and with acceptable levels established by the Commission of the European Communities (Cec) and the International Atomic Energy Agency (IAEA

Estimates of Average Glandular Dose with Auto-modes of X-ray Exposures in Digital Breast Tomosynthesis

Directory of Open Access Journals (Sweden)

Izdihar Kamal

2015-05-01

Full Text Available Objectives: The aim of this research was to examine the average glandular dose (AGD of radiation among different breast compositions of glandular and adipose tissue with auto-modes of exposure factor selection in digital breast tomosynthesis. Methods: This experimental study was carried out in the National Cancer Society, Kuala Lumpur, Malaysia, between February 2012 and February 2013 using a tomosynthesis digital mammography X-ray machine. The entrance surface air kerma and the half-value layer were determined using a 100H thermoluminescent dosimeter on 50% glandular and 50% adipose tissue (50/50 and 20% glandular and 80% adipose tissue (20/80 commercially available breast phantoms (Computerized Imaging Reference Systems, Inc., Norfolk, Virginia, USA with auto-time, auto-filter and auto-kilovolt modes. Results: The lowest AGD for the 20/80 phantom with auto-time was 2.28 milliGray (mGy for two dimension (2D and 2.48 mGy for three dimensional (3D images. The lowest AGD for the 50/50 phantom with auto-time was 0.97 mGy for 2D and 1.0 mGy for 3D. Conclusion: The AGD values for both phantoms were lower against a high kilovolt peak and the use of auto-filter mode was more practical for quick acquisition while limiting the probability of operator error.

Significance and Application of Digital Breast Tomosynthesis for the BI-RADS Classification of Breast Cancer.

Science.gov (United States)

Cai, Si-Qing; Yan, Jian-Xiang; Chen, Qing-Shi; Huang, Mei-Ling; Cai, Dong-Lu

2015-01-01

Full-field digital mammography (FFDM) with dense breasts has a high rate of missed diagnosis, and digital breast tomosynthesis (DBT) could reduce organization overlapping and provide more reliable images for BI-RADS classification. This study aims to explore application of COMBO (FFDM+DBT) for effect and significance of BI-RADS classification of breast cancer. In this study, we selected 832 patients who had been treated from May 2013 to November 2013. Classify FFDM and COMBO examination according to BI-RADS separately and compare the differences for glands in the image of the same patient in judgment, mass characteristics display and indirect signs. Employ Paired Wilcoxon rank sum test was used in 79 breast cancer patients to find differences between two examine methods. The results indicated that COMBO pattern is able to observe more details in distribution of glands when estimating content. Paired Wilcoxon rank sum test showed that overall classification level of COMBO is higher significantly compared to FFDM to BI-RADS diagnosis and classification of breast (PBI-RADS classification in breast cancer in clinical.

Effect of the glandular composition on digital breast tomosynthesis image quality and dose optimisation

International Nuclear Information System (INIS)

Marques, T.; Di Maria, S.; Vaz, P.; Ribeiro, A.; Belchior, A.; Cardoso, J.; Matela, N.; Oliveira, N.; Almeida, P.; Janeiro, L.

2015-01-01

In the image quality assessment for digital breast tomosynthesis (DBT), a breast phantom with an average percentage of 50 % glandular tissue is seldom used, which may not be representative of the breast tissue composition of the women undergoing such examination. This work aims at studying the effect of the glandular composition of the breast on the image quality taking into consideration different sizes of lesions. Monte Carlo simulations were performed using the state-of-the-art computer program PENELOPE to validate the image acquisition system of the DBT equipment as well as to calculate the mean glandular dose for each projection image and for different breast compositions. The integrated PENELOPE imaging tool (PenEasy) was used to calculate, in mammography, for each clinical detection task the X-ray energy that maximises the figure of merit. All the 2D cranial-caudal projections for DBT were simulated and then underwent the reconstruction process applying the Simultaneous Algebraic Reconstruction Technique. Finally, through signal-to-noise ratio analysis, the image quality in DBT was assessed. (authors)

Visualization of Breast Microcalcifications on Digital Breast Tomosynthesis and 2-Dimensional Digital Mammography Using Specimens

Directory of Open Access Journals (Sweden)

Jieun Byun

2017-04-01

Full Text Available Purpose: The purpose of this study is to compare the visibility of microcalcifications of digital breast tomosynthesis (DBT and full-field digital mammography (FFDM using breast specimens. Materials And Methods: Thirty-one specimens’ DBT and FFDM were retrospectively reviewed by four readers. Results: The image quality of microcalcifications of DBT was rated as superior or equivalent in 71.0% by reader 1, 67.8% by reader 2, 64.5% by reader 3, and 80.6% by reader 4. The Fleiss kappa statistic for agreement among readers was 0.31. Conclusions: We suggest that image quality of DBT appears to be comparable with or better than FFDM in terms of revealing microcalcifications.

Average glandular dose in digital mammography and breast tomosynthesis

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Olgar, T. [Ankara Univ. (Turkey). Dept. of Engineering Physics; Universitaetsklinikum Leipzig AoeR (Germany). Klinik und Poliklinik fuer Diagnostische und Interventionelle Radiologie; Kahn, T.; Gosch, D. [Universitaetsklinikum Leipzig AoeR (Germany). Klinik und Poliklinik fuer Diagnostische und Interventionelle Radiologie

2012-10-15

Purpose: To determine the average glandular dose (AGD) in digital full-field mammography (2 D imaging mode) and in breast tomosynthesis (3 D imaging mode). Materials and Methods: Using the method described by Boone, the AGD was calculated from the exposure parameters of 2247 conventional 2 D mammograms and 984 mammograms in 3 D imaging mode of 641 patients examined with the digital mammographic system Hologic Selenia Dimensions. The breast glandular tissue content was estimated by the Hologic R2 Quantra automated volumetric breast density measurement tool for each patient from right craniocaudal (RCC) and left craniocaudal (LCC) images in 2 D imaging mode. Results: The mean compressed breast thickness (CBT) was 52.7 mm for craniocaudal (CC) and 56.0 mm for mediolateral oblique (MLO) views. The mean percentage of breast glandular tissue content was 18.0 % and 17.4 % for RCC and LCC projections, respectively. The mean AGD values in 2 D imaging mode per exposure for the standard breast were 1.57 mGy and 1.66 mGy, while the mean AGD values after correction for real breast composition were 1.82 mGy and 1.94 mGy for CC and MLO views, respectively. The mean AGD values in 3 D imaging mode per exposure for the standard breast were 2.19 mGy and 2.29 mGy, while the mean AGD values after correction for the real breast composition were 2.53 mGy and 2.63 mGy for CC and MLO views, respectively. No significant relationship was found between the AGD and CBT in 2 D imaging mode and a good correlation coefficient of 0.98 in 3 D imaging mode. Conclusion: In this study the mean calculated AGD per exposure in 3 D imaging mode was on average 34 % higher than for 2 D imaging mode for patients examined with the same CBT.

Average glandular dose in digital mammography and breast tomosynthesis

International Nuclear Information System (INIS)

Olgar, T.; Universitaetsklinikum Leipzig AoeR; Kahn, T.; Gosch, D.

2012-01-01

Purpose: To determine the average glandular dose (AGD) in digital full-field mammography (2 D imaging mode) and in breast tomosynthesis (3 D imaging mode). Materials and Methods: Using the method described by Boone, the AGD was calculated from the exposure parameters of 2247 conventional 2 D mammograms and 984 mammograms in 3 D imaging mode of 641 patients examined with the digital mammographic system Hologic Selenia Dimensions. The breast glandular tissue content was estimated by the Hologic R2 Quantra automated volumetric breast density measurement tool for each patient from right craniocaudal (RCC) and left craniocaudal (LCC) images in 2 D imaging mode. Results: The mean compressed breast thickness (CBT) was 52.7 mm for craniocaudal (CC) and 56.0 mm for mediolateral oblique (MLO) views. The mean percentage of breast glandular tissue content was 18.0 % and 17.4 % for RCC and LCC projections, respectively. The mean AGD values in 2 D imaging mode per exposure for the standard breast were 1.57 mGy and 1.66 mGy, while the mean AGD values after correction for real breast composition were 1.82 mGy and 1.94 mGy for CC and MLO views, respectively. The mean AGD values in 3 D imaging mode per exposure for the standard breast were 2.19 mGy and 2.29 mGy, while the mean AGD values after correction for the real breast composition were 2.53 mGy and 2.63 mGy for CC and MLO views, respectively. No significant relationship was found between the AGD and CBT in 2 D imaging mode and a good correlation coefficient of 0.98 in 3 D imaging mode. Conclusion: In this study the mean calculated AGD per exposure in 3 D imaging mode was on average 34 % higher than for 2 D imaging mode for patients examined with the same CBT.

Radiation dose with digital breast tomosynthesis compared to digital mammography. Per-view analysis

Energy Technology Data Exchange (ETDEWEB)

Gennaro, Gisella [Veneto Institute of Oncology IOV- IRCCS, Radiology Unit, Padua (Italy); Bernardi, D. [Azienda Provinciale Servizi Sanitari (APSS), U.O. Senologia Clinica e Screening Mammografico, Department of Diagnostics, Trento (Italy); Houssami, N. [University of Sydney, Screening and Test Evaluation Program (STEP), School of Public Health, Sydney Medical School, Sydney (Australia)

2018-02-15

To compare radiation dose delivered by digital mammography (FFDM) and breast tomosynthesis (DBT) for a single view. 4,780 FFDM and 4,798 DBT images from 1,208 women enrolled in a screening trial were used to ground dose comparison. Raw images were processed by an automatic software to determine volumetric breast density (VBD) and were used together with exposure data to compute the mean glandular dose (MGD) according to Dance's model. DBT and FFDM were compared in terms of operation of the automatic exposure control (AEC) and MGD level. Statistically significant differences were found between FFDM and DBT MGDs for all views (CC: MGD{sub FFDM}=1.366 mGy, MGD{sub DBT}=1.858 mGy; p<0.0001; MLO: MGD{sub FFDM}=1.374 mGy, MGD{sub DBT}=1.877 mGy; p<0.0001). Considering the 4,768 paired views, Bland-Altman analysis showed that the average increase of DBT dose compared to FFDM is 38 %, and a range between 0 % and 75 %. Our findings show a modest increase of radiation dose to the breast by tomosynthesis compared to FFDM. Given the emerging role of DBT, its use in conjunction with synthetic 2D images should not be deterred by concerns regarding radiation burden, and should draw on evidence of potential clinical benefit. (orig.)

Image quality and dose assessment in digital breast tomosynthesis: A Monte Carlo study

International Nuclear Information System (INIS)

Baptista, M.; Di Maria, S.; Oliveira, N.; Matela, N.; Janeiro, L.; Almeida, P.; Vaz, P.

2014-01-01

Mammography is considered a standard technique for the early detection of breast cancer. However, its sensitivity is limited essentially due to the issue of the overlapping breast tissue. This limitation can be partially overcome, with a relatively new technique, called digital breast tomosynthesis (DBT). For this technique, optimization of acquisition parameters which maximize image quality, whilst complying with the ALARA principle, continues to be an area of considerable research. The aim of this work was to study the best quantum energies that optimize the image quality with the lowest achievable dose in DBT and compare these results with the digital mammography (DM) ones. Monte Carlo simulations were performed using the state-of-the-art computer program MCNPX 2.7.0 in order to generate several 2D cranio-caudal (CC) projections obtained during an acquisition of a standard DBT examination. Moreover, glandular absorbed doses and photon flux calculations, for each projection image, were performed. A homogeneous breast computational phantom with 50%/50% glandular/adipose tissue composition was used and two compressed breast thicknesses were evaluated: 4 cm and 8 cm. The simulated projection images were afterwards reconstructed with an algebraic reconstruction tool and the signal difference to noise ratio (SDNR) was calculated in order to evaluate the image quality in DBT and DM. Finally, a thorough comparison between the results obtained in terms of SDNR and dose assessment in DBT and DM was performed. - Highlights: • Optimization of the image quality in digital breast tomosynthesis. • Calculation of photon energies that maximize the signal difference to noise ratio. • Projections images and dose calculations through the Monte Carlo (MC) method. • Tumor masses and microcalcifications included in the MC model. • A dose saving of about 30% can be reached if optimal photon energies are used

Effects on image quality of a 2D antiscatter grid in x-ray digital breast tomosynthesis: Initial experience using the dual modality (x-ray and molecular) breast tomosynthesis scanner

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Patel, Tushita, E-mail: tp3rn@virginia.edu [Department of Physics, University of Virginia, Charlottesville, Virginia 22904 (United States); Peppard, Heather [Department of Radiology and Medical Imaging, University of Virginia, Charlottesville, Virginia 22908 (United States); Williams, Mark B. [Department of Physics, University of Virginia, Charlottesville, Virginia 22904 (United States); Department of Radiology and Medical Imaging, University of Virginia, Charlottesville, Virginia 22908 (United States); Department of Biomedical Engineering, University of Virginia, Charlottesville, Virginia 22908 (United States)

2016-04-15

Purpose: Radiation scattered from the breast in digital breast tomosynthesis (DBT) causes image degradation, including loss of contrast between cancerous and background tissue. Unlike in 2-dimensional (2D) mammography, an antiscatter grid cannot readily be used in DBT because changing alignment between the tube and detector during the scan would result in unacceptable loss of primary radiation. However, in the dual modality breast tomosynthesis (DMT) scanner, which combines DBT and molecular breast tomosynthesis, the tube and detector rotate around a common axis, thereby maintaining a fixed tube-detector alignment. This C-arm geometry raises the possibility of using a 2D (cellular) focused antiscatter grid. The purpose of this study is to assess change in image quality when using an antiscatter grid in the DBT portion of a DMT scan under conditions of fixed radiation dose. Methods: Two 2D focused prototype grids with 80 cm focal length were tested, one stack-laminated from copper (Cu) and one cast from a tungsten-polymer (W-poly). They were reciprocated using a motion scheme designed to maximize transmission of primary x-ray photons. Grid-in and grid-out scatter-to-primary ratios (SPRs) were measured for rectangular blocks of material simulating 30%, 50%, and 70% glandular tissue compositions. For assessment of changes in image quality through the addition of a grid, the Computerized Imaging Reference Systems, Inc., phantom Model 011A containing a set of 1 cm thick blocks simulating a range of glandular/adipose ratios from 0/100 to 100/0 was used. To simulate 6.5 and 8.5 cm thick compressed breasts, 1 cm thick slices of PMMA were added to the Model 011A phantom. DBT images were obtained with and without the grid, with exposure parameters fixed for a given compressed thickness. Signal-difference-to-noise ratios (SDNRs), contrast, and voxel value-based attenuation coefficients (μ) were measured for all blocks from reconstructed phantom images. Results: For 4, 6, and

SU-E-I-58: Objective Models of Breast Shape Undergoing Mammography and Tomosynthesis Using Principal Component Analysis.

Science.gov (United States)

Feng, Ssj; Sechopoulos, I

2012-06-01

To develop an objective model of the shape of the compressed breast undergoing mammographic or tomosynthesis acquisition. Automated thresholding and edge detection was performed on 984 anonymized digital mammograms (492 craniocaudal (CC) view mammograms and 492 medial lateral oblique (MLO) view mammograms), to extract the edge of each breast. Principal Component Analysis (PCA) was performed on these edge vectors to identify a limited set of parameters and eigenvectors that. These parameters and eigenvectors comprise a model that can be used to describe the breast shapes present in acquired mammograms and to generate realistic models of breasts undergoing acquisition. Sample breast shapes were then generated from this model and evaluated. The mammograms in the database were previously acquired for a separate study and authorized for use in further research. The PCA successfully identified two principal components and their corresponding eigenvectors, forming the basis for the breast shape model. The simulated breast shapes generated from the model are reasonable approximations of clinically acquired mammograms. Using PCA, we have obtained models of the compressed breast undergoing mammographic or tomosynthesis acquisition based on objective analysis of a large image database. Up to now, the breast in the CC view has been approximated as a semi-circular tube, while there has been no objectively-obtained model for the MLO view breast shape. Such models can be used for various breast imaging research applications, such as x-ray scatter estimation and correction, dosimetry estimates, and computer-aided detection and diagnosis. © 2012 American Association of Physicists in Medicine.

Breast Cancer Risk Estimation Using Parenchymal Texture Analysis in Digital Breast Tomosynthesis

International Nuclear Information System (INIS)

Ikejimba, Lynda C.; Kontos, Despina; Maidment, Andrew D. A.

2010-01-01

Mammographic parenchymal texture has been shown to correlate with genetic markers of developing breast cancer. Digital breast tomosynthesis (DBT) is a novel x-ray imaging technique in which tomographic images of the breast are reconstructed from multiple source projections acquired at different angles of the x-ray tube. Compared to digital mammography (DM), DBT eliminates breast tissue overlap, offering superior parenchymal tissue visualization. We hypothesize that texture analysis in DBT could potentially provide a better assessment of parenchymal texture and ultimately result in more accurate assessment of breast cancer risk. As a first step towards validating this hypothesis, we investigated the association between DBT parenchymal texture and breast percent density (PD), a known breast cancer risk factor, and compared it to DM. Bilateral DBT and DM images from 71 women participating in a breast cancer screening trial were analyzed. Filtered-backprojection was used to reconstruct DBT tomographic planes in 1 mm increments with 0.22 mm in-plane resolution. Corresponding DM images were acquired at 0.1 mm pixel resolution. Retroareolar regions of interest (ROIs) equivalent to 2.5 cm 3 were segmented from the DBT images and corresponding 2.5 cm 2 ROIs were segmented from the DM images. Breast PD was mammographically estimated using the Cumulus scale. Overall, DBT texture features demonstrated a stronger correlation than DM to PD. The Pearson correlation coefficients for DBT were r = 0.40 (p 2 = 0.39) compared to DM (R 2 = 0.33). We attribute these observations to the superior parenchymal tissue visualization in DBT. Our study is the first to perform DBT texture analysis in a screening population of women, showing that DBT could potentially provide better breast cancer risk assessment in the future.

Convolutional encoder-decoder for breast mass segmentation in digital breast tomosynthesis

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Zhang, Jun; Ghate, Sujata V.; Grimm, Lars J.; Saha, Ashirbani; Cain, Elizabeth Hope; Zhu, Zhe; Mazurowski, Maciej A.

2018-02-01

Digital breast tomosynthesis (DBT) is a relatively new modality for breast imaging that can provide detailed assessment of dense tissue within the breast. In the domains of cancer diagnosis, radiogenomics, and resident education, it is important to accurately segment breast masses. However, breast mass segmentation is a very challenging task, since mass regions have low contrast difference between their neighboring tissues. Notably, the task might become more difficult in cases that were assigned BI-RADS 0 category since this category includes many lesions that are of low conspicuity and locations that were deemed to be overlapping normal tissue upon further imaging and were not sent to biopsy. Segmentation of such lesions is of particular importance in the domain of reader performance analysis and education. In this paper, we propose a novel deep learning-based method for segmentation of BI-RADS 0 lesions in DBT. The key components of our framework are an encoding path for local-to-global feature extraction, and a decoding patch to expand the images. To address the issue of limited training data, in the training stage, we propose to sample patches not only in mass regions but also in non-mass regions. We utilize a Dice-like loss function in the proposed network to alleviate the class-imbalance problem. The preliminary results on 40 subjects show promise of our method. In addition to quantitative evaluation of the method, we present a visualization of the results that demonstrate both the performance of the algorithm as well as the difficulty of the task at hand.

Tomosynthesis-detected Architectural Distortion: Management Algorithm with Radiologic-Pathologic Correlation.

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Durand, Melissa A; Wang, Steven; Hooley, Regina J; Raghu, Madhavi; Philpotts, Liane E

2016-01-01

As use of digital breast tomosynthesis becomes increasingly widespread, new management challenges are inevitable because tomosynthesis may reveal suspicious lesions not visible at conventional two-dimensional (2D) full-field digital mammography. Architectural distortion is a mammographic finding associated with a high positive predictive value for malignancy. It is detected more frequently at tomosynthesis than at 2D digital mammography and may even be occult at conventional 2D imaging. Few studies have focused on tomosynthesis-detected architectural distortions to date, and optimal management of these distortions has yet to be well defined. Since implementing tomosynthesis at our institution in 2011, we have learned some practical ways to assess architectural distortion. Because distortions may be subtle, tomosynthesis localization tools plus improved visualization of adjacent landmarks are crucial elements in guiding mammographic identification of elusive distortions. These same tools can guide more focused ultrasonography (US) of the breast, which facilitates detection and permits US-guided tissue sampling. Some distortions may be sonographically occult, in which case magnetic resonance imaging may be a reasonable option, both to increase diagnostic confidence and to provide a means for image-guided biopsy. As an alternative, tomosynthesis-guided biopsy, conventional stereotactic biopsy (when possible), or tomosynthesis-guided needle localization may be used to achieve tissue diagnosis. Practical uses for tomosynthesis in evaluation of architectural distortion are highlighted, potential complications are identified, and a working algorithm for management of tomosynthesis-detected architectural distortion is proposed. (©)RSNA, 2016.

Description and validation of a scoring system for tomosynthesis in pulmonary cystic fibrosis.

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Vult von Steyern, Kristina; Björkman-Burtscher, Isabella M; Höglund, Peter; Bozovic, Gracijela; Wiklund, Marie; Geijer, Mats

2012-12-01

To design and validate a scoring system for tomosynthesis (digital tomography) in pulmonary cystic fibrosis. A scoring system dedicated to tomosynthesis in pulmonary cystic fibrosis was designed. Three radiologists independently scored 88 pairs of radiographs and tomosynthesis examinations of the chest in 60 patients with cystic fibrosis and 7 oncology patients. Radiographs were scored according to the Brasfield scoring system and tomosynthesis examinations were scored using the new scoring system. Observer agreements for the tomosynthesis score were almost perfect for the total score with square-weighted kappa >0.90, and generally substantial to almost perfect for subscores. Correlation between the tomosynthesis score and the Brasfield score was good for the three observers (Kendall's rank correlation tau 0.68, 0.77 and 0.78). Tomosynthesis was generally scored higher as a percentage of the maximum score. Observer agreements for the total score for Brasfield score were almost perfect (square-weighted kappa 0.80, 0.81 and 0.85). The tomosynthesis scoring system seems robust and correlates well with the Brasfield score. Compared with radiography, tomosynthesis is more sensitive to cystic fibrosis changes, especially bronchiectasis and mucus plugging, and the new tomosynthesis scoring system offers the possibility of more detailed and accurate scoring of disease severity. Tomosynthesis is more sensitive than conventional radiography for pulmonary cystic fibrosis changes. The radiation dose from chest tomosynthesis is low compared with computed tomography. Tomosynthesis may become useful in the regular follow-up of patients with cystic fibrosis.

Physical aspects of different tomosynthesis systems

International Nuclear Information System (INIS)

Semturs, F.; Sturm, E.; Gruber, R.; Helbich, T.H.

2010-01-01

Digital breast tomosynthesis (DBT) is a new image processing technique based on digital mammography technology. Image slices of the stationary compressed breast are reconstructed from multiple images taken at different angles of the X-ray tube at the same time. The main goal is to achieve a similar radiation dose exposure as common encountered in traditional digital mammography. One of the key advantages of DBT is that lesions are less likely to be hidden amongst normal tissues as they are in traditional digital mammography. This way the quality of diagnosis can be improved, especially for dense breasts. Current DBT implementations from several manufacturers differ in certain features such as scanning angle, number of projections, scanning time, pixel size, reconstruction methods and type of tube movement. A comparison and description of these different characteristics as well as a discussion on the proposed number of imaging planes and related radiation dose requirements are given. (orig.) [de

Amorphous In-Ga-Zn-O thin-film transistor active pixel sensor x-ray imager for digital breast tomosynthesis.

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Zhao, Chumin; Kanicki, Jerzy

2014-09-01

The breast cancer detection rate for digital breast tomosynthesis (DBT) is limited by the x-ray image quality. The limiting Nyquist frequency for current DBT systems is around 5 lp/mm, while the fine image details contained in the high spatial frequency region (>5 lp/mm) are lost. Also today the tomosynthesis patient dose is high (0.67-3.52 mGy). To address current issues, in this paper, for the first time, a high-resolution low-dose organic photodetector/amorphous In-Ga-Zn-O thin-film transistor (a-IGZO TFT) active pixel sensor (APS) x-ray imager is proposed for next generation DBT systems. The indirect x-ray detector is based on a combination of a novel low-cost organic photodiode (OPD) and a cesium iodide-based (CsI:Tl) scintillator. The proposed APS x-ray imager overcomes the difficulty of weak signal detection, when small pixel size and low exposure conditions are used, by an on-pixel signal amplification with a significant charge gain. The electrical performance of a-IGZO TFT APS pixel circuit is investigated by SPICE simulation using modified Rensselaer Polytechnic Institute amorphous silicon (a-Si:H) TFT model. Finally, the noise, detective quantum efficiency (DQE), and resolvability of the complete system are modeled using the cascaded system formalism. The result demonstrates that a large charge gain of 31-122 is achieved for the proposed high-mobility (5-20 cm2/V s) amorphous metal-oxide TFT APS. The charge gain is sufficient to eliminate the TFT thermal noise, flicker noise as well as the external readout circuit noise. Moreover, the low TFT (sensor imager under 1 mR, indicating good image quality under low dose. A threefold reduction of current tomosynthesis dose is expected if proposed technology is combined with an advanced DBT image reconstruction method. The proposed a-IGZO APS x-ray imager with a pixel pitch6.67 lp/mm) and a low dose (<0.4 mGy) in next generation DBT systems.

Description and validation of a scoring system for tomosynthesis in pulmonary cystic fibrosis

Energy Technology Data Exchange (ETDEWEB)

Vult von Steyern, Kristina; Bjoerkman-Burtscher, Isabella M.; Bozovic, Gracijela; Wiklund, Marie; Geijer, Mats [Skaane University Hospital, Lund University, Centre for Medical Imaging and Physiology, Lund (Sweden); Hoeglund, Peter [Skaane University Hospital, Competence Centre for Clinical Research, Lund (Sweden)

2012-12-15

To design and validate a scoring system for tomosynthesis (digital tomography) in pulmonary cystic fibrosis. A scoring system dedicated to tomosynthesis in pulmonary cystic fibrosis was designed. Three radiologists independently scored 88 pairs of radiographs and tomosynthesis examinations of the chest in 60 patients with cystic fibrosis and 7 oncology patients. Radiographs were scored according to the Brasfield scoring system and tomosynthesis examinations were scored using the new scoring system. Observer agreements for the tomosynthesis score were almost perfect for the total score with square-weighted kappa >0.90, and generally substantial to almost perfect for subscores. Correlation between the tomosynthesis score and the Brasfield score was good for the three observers (Kendall's rank correlation tau 0.68, 0.77 and 0.78). Tomosynthesis was generally scored higher as a percentage of the maximum score. Observer agreements for the total score for Brasfield score were almost perfect (square-weighted kappa 0.80, 0.81 and 0.85). The tomosynthesis scoring system seems robust and correlates well with the Brasfield score. Compared with radiography, tomosynthesis is more sensitive to cystic fibrosis changes, especially bronchiectasis and mucus plugging, and the new tomosynthesis scoring system offers the possibility of more detailed and accurate scoring of disease severity. (orig.)

Description and validation of a scoring system for tomosynthesis in pulmonary cystic fibrosis

International Nuclear Information System (INIS)

Vult von Steyern, Kristina; Bjoerkman-Burtscher, Isabella M.; Bozovic, Gracijela; Wiklund, Marie; Geijer, Mats; Hoeglund, Peter

2012-01-01

To design and validate a scoring system for tomosynthesis (digital tomography) in pulmonary cystic fibrosis. A scoring system dedicated to tomosynthesis in pulmonary cystic fibrosis was designed. Three radiologists independently scored 88 pairs of radiographs and tomosynthesis examinations of the chest in 60 patients with cystic fibrosis and 7 oncology patients. Radiographs were scored according to the Brasfield scoring system and tomosynthesis examinations were scored using the new scoring system. Observer agreements for the tomosynthesis score were almost perfect for the total score with square-weighted kappa >0.90, and generally substantial to almost perfect for subscores. Correlation between the tomosynthesis score and the Brasfield score was good for the three observers (Kendall's rank correlation tau 0.68, 0.77 and 0.78). Tomosynthesis was generally scored higher as a percentage of the maximum score. Observer agreements for the total score for Brasfield score were almost perfect (square-weighted kappa 0.80, 0.81 and 0.85). The tomosynthesis scoring system seems robust and correlates well with the Brasfield score. Compared with radiography, tomosynthesis is more sensitive to cystic fibrosis changes, especially bronchiectasis and mucus plugging, and the new tomosynthesis scoring system offers the possibility of more detailed and accurate scoring of disease severity. (orig.)

Comparison of detectability in step-and-shoot mode and continuous mode digital tomosynthesis systems

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Lee, Changwoo; Han, Minah; Baek, Jongduk

2017-03-01

Digital tomosynthesis system has been widely used in chest, dental, and breast imaging. Since the digital tomosynthesis system provides volumetric images from multiple projection data, structural noise inherent in X-ray radiograph can be reduced, and thus signal detection performance is improved. Currently, tomosynthesis system uses two data acquisition modes: step-and-shoot mode and continuous mode. Several studies have been conducted to compare the system performance of two acquisition modes with respect to spatial resolution and contrast. In this work, we focus on signal detectability in step-and-shoot mode and continuous mode. For evaluation, uniform background is considered, and eight spherical objects with diameters of 0.5, 0.8, 1, 2, 3, 5, 8, 10 mm are used as signals. Projection data with and without spherical objects are acquired in step-and-shoot mode and continuous mode, respectively, and quantum noise are added. Then, noisy projection data are reconstructed by FDK algorithm. To compare the detection performance of two acquisition modes, we calculate task signal-to-noise ratio (SNR) of channelized Hotelling observer with Laguerre-Gauss channels for each spherical object. While the task-SNR values of two acquisition modes are similar for spherical objects larger than 1 mm diameter, step-and-shoot mode yields higher detectability for small signal sizes. The main reason of this behavior is that small signal is more affected by X-ray tube motion blur than large signal. Our results indicate that it is beneficial to use step-and-shoot data acquisition mode to improve the detectability of small signals (i.e., less than 1 mm diameter) in digital tomosynthesis systems.

Experimental investigation for determination of optimal X-ray beam tube voltages in a newly developed digital breast tomosynthesis system

Energy Technology Data Exchange (ETDEWEB)

Park, Hye-Suk, E-mail: radiosugar@yonsei.ac.kr [Department of Radiological Science and Research Institute of Health Science, Yonsei University, Wonju, Gangwon 220-710 (Korea, Republic of); Kim, Ye-Seul, E-mail: radiohesugar@gmail.com [Department of Radiological Science and Research Institute of Health Science, Yonsei University, Wonju, Gangwon 220-710 (Korea, Republic of); Choi, Young-Wook, E-mail: ywchoi@keri.re.kr [Korea Electrotechnology Research Institute (KERI), Ansan, Geongki 426-170 (Korea, Republic of); Choi, JaeGu, E-mail: jgchoi88@paran.com [Korea Electrotechnology Research Institute (KERI), Ansan, Geongki 426-170 (Korea, Republic of); Rhee, Yong-Chun, E-mail: ycrhee@yonsei.ac.kr [Department of Radiological Science and Research Institute of Health Science, Yonsei University, Wonju, Gangwon 220-710 (Korea, Republic of); Kim, Hee-Joung, E-mail: hjk1@yonsei.ac.kr [Department of Radiological Science and Research Institute of Health Science, Yonsei University, Wonju, Gangwon 220-710 (Korea, Republic of)

2014-11-01

Our purpose was to investigate optimal tube voltages (kVp) for a newly developed digital breast tomosynthesis (DBT) process and to determine tube current–exposure time products (mA s) for the average glandular dose (AGD), which is similar to that of the two views in conventional mammography (CM). In addition, the optimal acquisition parameters for this system were compared with those of CM. The analysis was based on the contrast-to-noise ratio (CNR) from the simulated micro-calcifications on homogeneous phantoms, and the figure of merit (FOM) was retrieved from the CNR and AGD at X-ray tube voltages ranging from 24 to 40 kVp at intervals of 2 kV. The optimal kVp increased more than 2 kV with increasing glandularity for thicker (≥50 mm) breast phantoms. The optimal kVp for DBT was found to be 4–7 kV higher than that calculated for CM with breast phantoms thicker than 50 mm. This is likely due to the greater effect of noise and dose reduction by kVp increment when using the lower dose per projection in DBT. It is important to determine optimum acquisition conditions for a maximally effective DBT system. The results of our study provide useful information to further improve DBT for high quality imaging.

Evidence on Synthesized Two-dimensional Mammography Versus Digital Mammography When Using Tomosynthesis (Three-dimensional Mammography) for Population Breast Cancer Screening.

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Houssami, Nehmat

2017-09-28

One limitation of using digital breast tomosynthesis (3-dimensional [3D] mammography) technology with conventional (2-dimensional [2D]) mammography for breast cancer (BC) screening is the increased radiation dose from dual acquisitions. To resolve this problem, synthesized 2D (s2D) reconstruction images similar to 2D mammography were developed using tomosynthesis acquisitions. The present review summarizes the evidence for s2D versus digital mammography (2D) when using tomosynthesis (3D) for BC screening to address whether using s2D instead of 2D (alongside 3D) will yield similar detection measures. Comparative population screening studies have provided consistent evidence that cancer detection rates do not differ between integrated 2D/3D (range, 5.45-8.5/1000 screens) and s2D/3D (range, 5.03-8.8/1000 screens). Also, although the recall measures were relatively heterogeneous across included studies, little difference was found between the 2 modalities. The mean glandular dose for s2D/3D was 55% to 58% of that for 2D/3D. In the context of BC screening, s2D/3D involves substantially less radiation than 2D/3D and provides similar detection measures. Thus, consideration of transitioning to tomosynthesis screening should aim to use s2D/3D to minimize harm. Copyright © 2017 Elsevier Inc. All rights reserved.

Breast tissue classification in digital breast tomosynthesis images using texture features: a feasibility study

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Kontos, Despina; Berger, Rachelle; Bakic, Predrag R.; Maidment, Andrew D. A.

2009-02-01

Mammographic breast density is a known breast cancer risk factor. Studies have shown the potential to automate breast density estimation by using computerized texture-based segmentation of the dense tissue in mammograms. Digital breast tomosynthesis (DBT) is a tomographic x-ray breast imaging modality that could allow volumetric breast density estimation. We evaluated the feasibility of distinguishing between dense and fatty breast regions in DBT using computer-extracted texture features. Our long-term hypothesis is that DBT texture analysis can be used to develop 3D dense tissue segmentation algorithms for estimating volumetric breast density. DBT images from 40 women were analyzed. The dense tissue area was delineated within each central source projection (CSP) image using a thresholding technique (Cumulus, Univ. Toronto). Two (2.5cm)2 ROIs were manually selected: one within the dense tissue region and another within the fatty region. Corresponding (2.5cm)3 ROIs were placed within the reconstructed DBT images. Texture features, previously used for mammographic dense tissue segmentation, were computed. Receiver operating characteristic (ROC) curve analysis was performed to evaluate feature classification performance. Different texture features appeared to perform best in the 3D reconstructed DBT compared to the 2D CSP images. Fractal dimension was superior in DBT (AUC=0.90), while contrast was best in CSP images (AUC=0.92). We attribute these differences to the effects of tissue superimposition in CSP and the volumetric visualization of the breast tissue in DBT. Our results suggest that novel approaches, different than those conventionally used in projection mammography, need to be investigated in order to develop DBT dense tissue segmentation algorithms for estimating volumetric breast density.

Oblique reconstructions in tomosynthesis. II. Super-resolution

International Nuclear Information System (INIS)

Acciavatti, Raymond J.; Maidment, Andrew D. A.

2013-01-01

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

Oblique reconstructions in tomosynthesis. II. Super-resolution

Science.gov (United States)

Acciavatti, Raymond J.; Maidment, Andrew D. A.

2013-01-01

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

Comparing the diagnostic efficacy of full field digital mammography with digital breast tomosynthesis using BIRADS score in a tertiary cancer care hospital.

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Singla, Divya; Chaturvedi, Arvind K; Aggarwal, Abhinav; Rao, S A; Hazarika, Dibyamohan; Mahawar, Vivek

2018-01-01

Breast cancer is one of the leading cancers in females worldwide, and its incidence has been rising at an exponential pace in the last 10 years even in India. Mammography has been the mainstay for detection of breast cancer over decades and has gradually advanced from screen film to full-field digital mammography. Recently, tomosynthesis has evolved as an advanced imaging investigation for early diagnosis of breast lesions in both diagnostic and screening settings. To compare and evaluate the impact of digital breast tomosynthesis (DBT) compared to full-field digital mammography (FFDM) in the interpretation of BIRADS score in both diagnostic and screening settings. A 1-year prospective longitudinal study was conducted in the Department of Radio-diagnosis in our institute using Hologic Selenia Dimensions for mammography as well as tomosynthesis. One hundred women known or suspected (opportunistic screening) for breast cancer were evaluated either with FFDM alone or both FFDM and DBT. Sensitivity, specificity, positive predictive value, negative predictive value, and P value were used to assess the various diagnostic criteria in our study. Addition of DBT to FFDM results in a statistically significant increase in the sensitivity, specificity, and positive predictive value, and a statistically significant decrease in the false positive rates. Similar results were noted in both diagnostic and screening cases. It was observed that, in most cases, i.e. a total of 47, DBT did not change the BIRADS scoring; however, its addition increased the diagnostic confidence. BIRADS was upgraded and downgraded in 14 and 31 cases, respectively, with the addition of DBT to FFDM. New lesions were seen with addition of DBT to FFDM in 8 cases. Addition of DBT to FFDM results in increase in sensitivity, specificity, positive predictive value, and a statistically significant decrease in false positive rates in both diagnostic and screening cases. As addition of tomosynthesis results in a

Comparing the diagnostic efficacy of full field digital mammography with digital breast tomosynthesis using BIRADS score in a tertiary cancer care hospital

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Divya Singla

2018-01-01

Full Text Available Introduction: Breast cancer is one of the leading cancers in females worldwide, and its incidence has been rising at an exponential pace in the last 10 years even in India. Mammography has been the mainstay for detection of breast cancer over decades and has gradually advanced from screen film to full-field digital mammography. Recently, tomosynthesis has evolved as an advanced imaging investigation for early diagnosis of breast lesions in both diagnostic and screening settings. Aim of Study: To compare and evaluate the impact of digital breast tomosynthesis (DBT compared to full-field digital mammography (FFDM in the interpretation of BIRADS score in both diagnostic and screening settings. Settings and Design: A 1-year prospective longitudinal study was conducted in the Department of Radio-diagnosis in our institute using Hologic Selenia Dimensions for mammography as well as tomosynthesis. Materials and Methods: One hundred women known or suspected (opportunistic screening for breast cancer were evaluated either with FFDM alone or both FFDM and DBT. Sensitivity, specificity, positive predictive value, negative predictive value, and P value were used to assess the various diagnostic criteria in our study. Results: Addition of DBT to FFDM results in a statistically significant increase in the sensitivity, specificity, and positive predictive value, and a statistically significant decrease in the false positive rates. Similar results were noted in both diagnostic and screening cases. It was observed that, in most cases, i.e. a total of 47, DBT did not change the BIRADS scoring; however, its addition increased the diagnostic confidence. BIRADS was upgraded and downgraded in 14 and 31 cases, respectively, with the addition of DBT to FFDM. New lesions were seen with addition of DBT to FFDM in 8 cases. Conclusion: Addition of DBT to FFDM results in increase in sensitivity, specificity, positive predictive value, and a statistically significant

Investigation on 3D dose distribution in digital breast tomosynthesis

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Masi, M.

2017-03-01

Monte Carlo calculations for dosimetry in digital breast tomosynthesis (DBT) require experimental validations. We measured the 3D dose distribution in a breast phantom in a DBT scan, using XR-QA2 radiochromic films. We positioned film pieces at the entrance surface, at the bottom surface and at four depths between adjacent slabs in the 5-slabs, 5-cm-thick phantom simulating a compressed breast with 50% glandular fraction. We irradiated the phantom at 40kV (half value layer 1.1mm Al) for three angular tilting of the beam central axis ( {±}25° and 0° normal incidence). We determined the transverse and longitudinal distributions of the average dose in the phantom (in terms of air kerma normalized to the entrance air kerma), showing the angular dependence of the depth-resolved 3D dose distributions. In transverse planes the maximum dose variations were between 5.0% and 14.8% for normal incidence, and by 8.6% from the central to the tilted view. In the direction of the beam axis, the dose decreases up to about 71% from the entrance to the exit value. The extimated backscatter fraction was between 3% and 8%.

Mass detection in digital breast tomosynthesis data using convolutional neural networks and multiple instance learning.

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Yousefi, Mina; Krzyżak, Adam; Suen, Ching Y

2018-05-01

Digital breast tomosynthesis (DBT) was developed in the field of breast cancer screening as a new tomographic technique to minimize the limitations of conventional digital mammography breast screening methods. A computer-aided detection (CAD) framework for mass detection in DBT has been developed and is described in this paper. The proposed framework operates on a set of two-dimensional (2D) slices. With plane-to-plane analysis on corresponding 2D slices from each DBT, it automatically learns complex patterns of 2D slices through a deep convolutional neural network (DCNN). It then applies multiple instance learning (MIL) with a randomized trees approach to classify DBT images based on extracted information from 2D slices. This CAD framework was developed and evaluated using 5040 2D image slices derived from 87 DBT volumes. The empirical results demonstrate that this proposed CAD framework achieves much better performance than CAD systems that use hand-crafted features and deep cardinality-restricted Bolzmann machines to detect masses in DBTs. Copyright © 2018 Elsevier Ltd. All rights reserved.

Automated Breast Density Computation in Digital Mammography and Digital Breast Tomosynthesis: Influence on Mean Glandular Dose and BIRADS Density Categorization.

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Castillo-García, Maria; Chevalier, Margarita; Garayoa, Julia; Rodriguez-Ruiz, Alejandro; García-Pinto, Diego; Valverde, Julio

2017-07-01

The study aimed to compare the breast density estimates from two algorithms on full-field digital mammography (FFDM) and digital breast tomosynthesis (DBT) and to analyze the clinical implications. We selected 561 FFDM and DBT examinations from patients without breast pathologies. Two versions of a commercial software (Quantra 2D and Quantra 3D) calculated the volumetric breast density automatically in FFDM and DBT, respectively. Other parameters such as area breast density and total breast volume were evaluated. We compared the results from both algorithms using the Mann-Whitney U non-parametric test and the Spearman's rank coefficient for data correlation analysis. Mean glandular dose (MGD) was calculated following the methodology proposed by Dance et al. Measurements with both algorithms are well correlated (r ≥ 0.77). However, there are statistically significant differences between the medians (P density median values from FFDM are, respectively, 8% and 77% higher than DBT estimations. Both algorithms classify 35% and 55% of breasts into BIRADS (Breast Imaging-Reporting and Data System) b and c categories, respectively. There are no significant differences between the MGD calculated using the breast density from each algorithm. DBT delivers higher MGD than FFDM, with a lower difference (5%) for breasts in the BIRADS d category. MGD is, on average, 6% higher than values obtained with the breast glandularity proposed by Dance et al. Breast density measurements from both algorithms lead to equivalent BIRADS classification and MGD values, hence showing no difference in clinical outcomes. The median MGD values of FFDM and DBT examinations are similar for dense breasts (BIRADS d category). Published by Elsevier Inc.

Performance of breast cancer screening using digital breast tomosynthesis: results from the prospective population-based Oslo Tomosynthesis Screening Trial.

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Skaane, Per; Sebuødegård, Sofie; Bandos, Andriy I; Gur, David; Østerås, Bjørn Helge; Gullien, Randi; Hofvind, Solveig

2018-02-10

Digital breast tomosynthesis (DBT) has the potential to overcome limitations of conventional mammography. This study investigated the effects of addition of DBT on interval and detected cancers in population-based screening. Oslo Tomosynthesis Screening Trial (OTST) was a prospective, independent double-reading trial inviting women 50-69 years biennially, comparing full-field digital mammography (FFDM) plus DBT with FFDM alone. Performance indicators and characteristics of screen-detected and interval cancers were compared with two previous FFDM rounds. 24,301 consenting women underwent FFDM + DBT screening over a 2-year period. Results were compared with 59,877 FFDM examinations during prior rounds. Addition of DBT resulted in a non-significant increase in sensitivity (76.2%, 378/496, vs. 80.8%, 227/281, p = 0.151) and a significant increase in specificity (96.4%, 57229/59381 vs. 97.5%, 23427/24020, p < .001). Number of recalls per screen-detected cancer decreased from 6.7 (2530/378) to 3.6 (820/227) with DBT (p < .001). Cancer detection per 1000 women screened increased (6.3, 378/59877, vs. 9.3, 227/24301, p < .001). Interval cancer rate per 1000 screens for FFDM + DBT remained similar to previous FFDM rounds (2.1, 51/24301 vs. 2.0, 118/59877, p = 0.734). Interval cancers post-DBT were comparable to prior rounds but significantly different in size, grade, and node status from cancers detected only using DBT. 39.6% (19/48) of interval cancers had positive nodes compared with only 3.9% (2/51) of additional DBT-only-detected cancers. DBT-supplemented screening resulted in significant increases in screen-detected cancers and specificity. However, no significant change was observed in the rate, size, node status, or grade of interval cancers. ClinicalTrials.gov: NCT01248546.

MO-DE-209-02: Tomosynthesis Reconstruction Methods

International Nuclear Information System (INIS)

Mainprize, J.

2016-01-01

Digital Breast Tomosynthesis (DBT) is rapidly replacing mammography as the standard of care in breast cancer screening and diagnosis. DBT is a form of computed tomography, in which a limited set of projection images are acquired over a small angular range and reconstructed into tomographic data. The angular range varies from 15° to 50° and the number of projections varies between 9 and 25 projections, as determined by the equipment manufacturer. It is equally valid to treat DBT as the digital analog of classical tomography – that is, linear tomography. In fact, the name “tomosynthesis” stands for “synthetic tomography.” DBT shares many common features with classical tomography, including the radiographic appearance, dose, and image quality considerations. As such, both the science and practical physics of DBT systems is a hybrid between computed tomography and classical tomographic methods. In this lecture, we will explore the continuum from radiography to computed tomography to illustrate the characteristics of DBT. This lecture will consist of four presentations that will provide a complete overview of DBT, including a review of the fundamentals of DBT acquisition, a discussion of DBT reconstruction methods, an overview of dosimetry for DBT systems, and summary of the underlying image theory of DBT thereby relating image quality and dose. Learning Objectives: To understand the fundamental principles behind tomosynthesis image acquisition. To understand the fundamentals of tomosynthesis image reconstruction. To learn the determinants of image quality and dose in DBT, including measurement techniques. To learn the image theory underlying tomosynthesis, and the relationship between dose and image quality. ADM is a consultant to, and holds stock in, Real Time Tomography, LLC. ADM receives research support from Hologic Inc., Analogic Inc., and Barco NV.; ADM is a member of the Scientific Advisory Board for Gamma Medica Inc.; A. Maidment, Research Support

MO-DE-209-01: Primer On Tomosynthesis

International Nuclear Information System (INIS)

Maidment, A.

2016-01-01

Digital Breast Tomosynthesis (DBT) is rapidly replacing mammography as the standard of care in breast cancer screening and diagnosis. DBT is a form of computed tomography, in which a limited set of projection images are acquired over a small angular range and reconstructed into tomographic data. The angular range varies from 15° to 50° and the number of projections varies between 9 and 25 projections, as determined by the equipment manufacturer. It is equally valid to treat DBT as the digital analog of classical tomography – that is, linear tomography. In fact, the name “tomosynthesis” stands for “synthetic tomography.” DBT shares many common features with classical tomography, including the radiographic appearance, dose, and image quality considerations. As such, both the science and practical physics of DBT systems is a hybrid between computed tomography and classical tomographic methods. In this lecture, we will explore the continuum from radiography to computed tomography to illustrate the characteristics of DBT. This lecture will consist of four presentations that will provide a complete overview of DBT, including a review of the fundamentals of DBT acquisition, a discussion of DBT reconstruction methods, an overview of dosimetry for DBT systems, and summary of the underlying image theory of DBT thereby relating image quality and dose. Learning Objectives: To understand the fundamental principles behind tomosynthesis image acquisition. To understand the fundamentals of tomosynthesis image reconstruction. To learn the determinants of image quality and dose in DBT, including measurement techniques. To learn the image theory underlying tomosynthesis, and the relationship between dose and image quality. ADM is a consultant to, and holds stock in, Real Time Tomography, LLC. ADM receives research support from Hologic Inc., Analogic Inc., and Barco NV.; ADM is a member of the Scientific Advisory Board for Gamma Medica Inc.; A. Maidment, Research Support

MO-DE-209-02: Tomosynthesis Reconstruction Methods

Energy Technology Data Exchange (ETDEWEB)

Mainprize, J. [Sunnybrook Health Sciences Centre, Toronto, ON (Canada)

2016-06-15

Digital Breast Tomosynthesis (DBT) is rapidly replacing mammography as the standard of care in breast cancer screening and diagnosis. DBT is a form of computed tomography, in which a limited set of projection images are acquired over a small angular range and reconstructed into tomographic data. The angular range varies from 15° to 50° and the number of projections varies between 9 and 25 projections, as determined by the equipment manufacturer. It is equally valid to treat DBT as the digital analog of classical tomography – that is, linear tomography. In fact, the name “tomosynthesis” stands for “synthetic tomography.” DBT shares many common features with classical tomography, including the radiographic appearance, dose, and image quality considerations. As such, both the science and practical physics of DBT systems is a hybrid between computed tomography and classical tomographic methods. In this lecture, we will explore the continuum from radiography to computed tomography to illustrate the characteristics of DBT. This lecture will consist of four presentations that will provide a complete overview of DBT, including a review of the fundamentals of DBT acquisition, a discussion of DBT reconstruction methods, an overview of dosimetry for DBT systems, and summary of the underlying image theory of DBT thereby relating image quality and dose. Learning Objectives: To understand the fundamental principles behind tomosynthesis image acquisition. To understand the fundamentals of tomosynthesis image reconstruction. To learn the determinants of image quality and dose in DBT, including measurement techniques. To learn the image theory underlying tomosynthesis, and the relationship between dose and image quality. ADM is a consultant to, and holds stock in, Real Time Tomography, LLC. ADM receives research support from Hologic Inc., Analogic Inc., and Barco NV.; ADM is a member of the Scientific Advisory Board for Gamma Medica Inc.; A. Maidment, Research Support

MO-DE-209-01: Primer On Tomosynthesis

Energy Technology Data Exchange (ETDEWEB)

Maidment, A. [Univ Pennsylvania (United States)

2016-06-15

Digital Breast Tomosynthesis (DBT) is rapidly replacing mammography as the standard of care in breast cancer screening and diagnosis. DBT is a form of computed tomography, in which a limited set of projection images are acquired over a small angular range and reconstructed into tomographic data. The angular range varies from 15° to 50° and the number of projections varies between 9 and 25 projections, as determined by the equipment manufacturer. It is equally valid to treat DBT as the digital analog of classical tomography – that is, linear tomography. In fact, the name “tomosynthesis” stands for “synthetic tomography.” DBT shares many common features with classical tomography, including the radiographic appearance, dose, and image quality considerations. As such, both the science and practical physics of DBT systems is a hybrid between computed tomography and classical tomographic methods. In this lecture, we will explore the continuum from radiography to computed tomography to illustrate the characteristics of DBT. This lecture will consist of four presentations that will provide a complete overview of DBT, including a review of the fundamentals of DBT acquisition, a discussion of DBT reconstruction methods, an overview of dosimetry for DBT systems, and summary of the underlying image theory of DBT thereby relating image quality and dose. Learning Objectives: To understand the fundamental principles behind tomosynthesis image acquisition. To understand the fundamentals of tomosynthesis image reconstruction. To learn the determinants of image quality and dose in DBT, including measurement techniques. To learn the image theory underlying tomosynthesis, and the relationship between dose and image quality. ADM is a consultant to, and holds stock in, Real Time Tomography, LLC. ADM receives research support from Hologic Inc., Analogic Inc., and Barco NV.; ADM is a member of the Scientific Advisory Board for Gamma Medica Inc.; A. Maidment, Research Support

Combination of one-view digital breast tomosynthesis with one-view digital mammography versus standard two-view digital mammography: per lesion analysis

Energy Technology Data Exchange (ETDEWEB)

Gennaro, Gisella; Bezzon, Elisabetta; Pescarini, Luigi; Polico, Ilaria; Proietti, Alessandro; Baldan, Enrica; Pomerri, Fabio; Muzzio, Pier Carlo [Veneto Institute of Oncology (IRCCS), Padua (Italy); Hendrick, R.E. [University of Colorado-Denver, Department of Radiology, School of Medicine, Aurora, CO (United States); Toledano, Alicia [Biostatistics Consulting, LLC, Kensington, MD (United States); Paquelet, Jean R. [Advanced Medical Imaging Consultants, Fort Collins, CO (United States); Breast Imaging, McKee Medical Center, Loveland, CO (United States); Chersevani, Roberta [Private Medical Practice, Gorizia (Italy); Di Maggio, Cosimo [Private Medical Practice, Padua (Italy); La Grassa, Manuela [Department of Radiology, Oncological Reference Center (IRCCS), Aviano (Italy)

2013-08-15

To evaluate the clinical value of combining one-view mammography (cranio-caudal, CC) with the complementary view tomosynthesis (mediolateral-oblique, MLO) in comparison to standard two-view mammography (MX) in terms of both lesion detection and characterization. A free-response receiver operating characteristic (FROC) experiment was conducted independently by six breast radiologists, obtaining data from 463 breasts of 250 patients. Differences in mean lesion detection fraction (LDF) and mean lesion characterization fraction (LCF) were analysed by analysis of variance (ANOVA) to compare clinical performance of the combination of techniques to standard two-view digital mammography. The 463 cases (breasts) reviewed included 258 with one to three lesions each, and 205 with no lesions. The 258 cases with lesions included 77 cancers in 68 breasts and 271 benign lesions to give a total of 348 proven lesions. The combination, DBT{sub (MLO)}+MX{sub (CC)}, was superior to MX (CC+MLO) in both lesion detection (LDF) and lesion characterization (LCF) overall and for benign lesions. DBT{sub (MLO)}+MX{sub (CC)} was non-inferior to two-view MX for malignant lesions. This study shows that readers' capabilities in detecting and characterizing breast lesions are improved by combining single-view digital breast tomosynthesis and single-view mammography compared to two-view digital mammography. (orig.)

Comparison of fan beam, slit-slat and multi-pinhole collimators for molecular breast tomosynthesis.

Science.gov (United States)

van Roosmalen, Jarno; Beekman, Freek J; Goorden, Marlies C

2018-05-16

Recently, we proposed and optimized dedicated multi-pinhole molecular breast tomosynthesis (MBT) that images a lightly compressed breast. As MBT may also be performed with other types of collimators, the aim of this paper is to optimize MBT with fan beam and slit-slat collimators and to compare its performance to that of multi-pinhole MBT to arrive at a truly optimized design. Using analytical expressions, we first optimized fan beam and slit-slat collimator parameters to reach maximum sensitivity at a series of given system resolutions. Additionally, we performed full system simulations of a breast phantom containing several tumours for the optimized designs. We found that at equal system resolution the maximum achievable sensitivity increases from pinhole to slit-slat to fan beam collimation with fan beam and slit-slat MBT having on average a 48% and 20% higher sensitivity than multi-pinhole MBT. Furthermore, by inspecting simulated images and applying a tumour-to-background contrast-to-noise (TB-CNR) analysis, we found that slit-slat collimators underperform with respect to the other collimator types. The fan beam collimators obtained a similar TB-CNR as the pinhole collimators, but the optimum was reached at different system resolutions. For fan beam collimators, a 6-8 mm system resolution was optimal in terms of TB-CNR, while with pinhole collimation highest TB-CNR was reached in the 7-10 mm range.

Radiation dose reduction in digital breast tomosynthesis (DBT) by means of deep-learning-based supervised image processing

Science.gov (United States)

Liu, Junchi; Zarshenas, Amin; Qadir, Ammar; Wei, Zheng; Yang, Limin; Fajardo, Laurie; Suzuki, Kenji

2018-03-01

To reduce cumulative radiation exposure and lifetime risks for radiation-induced cancer from breast cancer screening, we developed a deep-learning-based supervised image-processing technique called neural network convolution (NNC) for radiation dose reduction in DBT. NNC employed patched-based neural network regression in a convolutional manner to convert lower-dose (LD) to higher-dose (HD) tomosynthesis images. We trained our NNC with quarter-dose (25% of the standard dose: 12 mAs at 32 kVp) raw projection images and corresponding "teaching" higher-dose (HD) images (200% of the standard dose: 99 mAs at 32 kVp) of a breast cadaver phantom acquired with a DBT system (Selenia Dimensions, Hologic, CA). Once trained, NNC no longer requires HD images. It converts new LD images to images that look like HD images; thus the term "virtual" HD (VHD) images. We reconstructed tomosynthesis slices on a research DBT system. To determine a dose reduction rate, we acquired 4 studies of another test phantom at 4 different radiation doses (1.35, 2.7, 4.04, and 5.39 mGy entrance dose). Structural SIMilarity (SSIM) index was used to evaluate the image quality. For testing, we collected half-dose (50% of the standard dose: 32+/-14 mAs at 33+/-5 kVp) and full-dose (standard dose: 68+/-23 mAs at 33+/-5 kvp) images of 10 clinical cases with the DBT system at University of Iowa Hospitals and Clinics. NNC converted half-dose DBT images of 10 clinical cases to VHD DBT images that were equivalent to full dose DBT images. Our cadaver phantom experiment demonstrated 79% dose reduction.

With the Advent of Tomosynthesis in the Workup of Mammographic Abnormality, is Spot Compression Mammography Now Obsolete? An Initial Clinical Experience.

Science.gov (United States)

Ni Mhuircheartaigh, Neasa; Coffey, Louise; Fleming, Hannah; O' Doherty, Ann; McNally, Sorcha

2017-09-01

To determine if the routine use of spot compression mammography is now obsolete in the assessment of screen detected masses, asymmetries and architectural distortion since the availability of digital breast tomosynthesis. We introduced breast tomosynthesis in the workup of screen detected abnormalities in our screening center in January 2015. During an initial learning period with tomosynthesis standard spot compression views were also performed. Three consultant breast radiologists retrospectively reviewed all screening mammograms recalled for assessment over the first 6-month period. We assessed retrospectively whether there was any additional diagnostic information obtained from spot compression views not already apparent on tomography. All cases were also reviewed for any additional lesions detected by tomosynthesis, not detected on routine 2-view screening mammography. 548 women screened with standard 2-view digital screening mammography were recalled for assessment in the selected period and a total of 565 lesions were assessed. 341 lesions were assessed by both tomosynthesis and routine spot compression mammography. The spot compression view was considered more helpful than tomosynthesis in only one patient. This was because the breast was inadequately positioned for tomosynthesis and the area in question was not adequately imaged. Apart from this technical error there was no asymmetry, distortion or mass where spot compression provided more diagnostic information than tomosynthesis alone. We detected three additional cancers on tomosynthesis, not detected by routine screening mammography. From our initial experience with tomosynthesis we conclude that spot compression mammography is now obsolete in the assessment of screen detected masses, asymmetries and distortions where tomosynthesis is available. © 2017 Wiley Periodicals, Inc.

Importance of point-by-point back projection correction for isocentric motion in digital breast tomosynthesis: Relevance to morphology of structures such as microcalcifications

International Nuclear Information System (INIS)

Chen Ying; Lo, Joseph Y.; Dobbins, James T. III

2007-01-01

Digital breast tomosynthesis is a three-dimensional imaging technique that provides an arbitrary set of reconstruction planes in the breast from a limited-angle series of projection images acquired while the x-ray tube moves. Traditional shift-and-add (SAA) tomosynthesis reconstruction is a common mathematical method to line up each projection image based on its shifting amount to generate reconstruction slices. With parallel-path geometry of tube motion, the path of the tube lies in a plane parallel to the plane of the detector. The traditional SAA algorithm gives shift amounts for each projection image calculated only along the direction of x-ray tube movement. However, with the partial isocentric motion of the x-ray tube in breast tomosynthesis, small objects such as microcalcifications appear blurred (for instance, about 1-4 pixels in blur for a microcalcification in a human breast) in traditional SAA images in the direction perpendicular to the direction of tube motion. Some digital breast tomosynthesis algorithms reported in the literature utilize a traditional one-dimensional SAA method that is not wholly suitable for isocentric motion. In this paper, a point-by-point back projection (BP) method is described and compared with traditional SAA for the important clinical task of evaluating morphology of small objects such as microcalcifications. Impulse responses at different three-dimensional locations with five different combinations of imaging acquisition parameters were investigated. Reconstruction images of microcalcifications in a human subject were also evaluated. Results showed that with traditional SAA and 45 deg. view angle of tube movement with respect to the detector, at the same height above the detector, the in-plane blur artifacts were obvious for objects farther away from x-ray source. In a human subject, the appearance of calcifications was blurred in the direction orthogonal to the tube motion with traditional SAA. With point-by-point BP, the

Digital breast tomosynthesis (DBT) to characterize MRI-detected additional lesions unidentified at targeted ultrasound in newly diagnosed breast cancer patients

International Nuclear Information System (INIS)

Mariscotti, Giovanna; Durando, Manuela; Regini, Elisa; Fornari, Alberto; Fonio, Paolo; Gandini, Giovanni; Houssami, Nehmat; Campanino, Pier Paolo; Bussone, Riccardo; Castellano, Isabella; Sapino, Anna

2015-01-01

Preoperative breast magnetic resonance (MR) often generates additional suspicious findings needing further investigations. Targeted breast ultrasound (US) is the standard tool to characterize MR additional lesions. The purpose of this study is to evaluate the potential role of digital breast tomosynthesis (DBT) to characterize MR detected additional findings, unidentified at targeted breast US. This prospective study included women who a) had biopsy-proven, newly diagnosed breast cancers detected at conventional 2D mammography and/or US, referred to breast MR for tumour staging; and b) had DBT if additional MR findings were not detected at targeted ('second look') US. In 520 patients, MR identified 164 (in 114 women, 22 %) additional enhancing lesions. Targeted US identified 114/164 (69.5 %) of these, whereas 50/164 (30.5 %) remained unidentified. DBT identified 32/50 of these cases, increasing the overall characterization of MR detected additional findings to 89.0 % (146/164). Using DBT the identified lesions were significantly more likely to be malignant than benign MR-detected additional lesions (p = 0.04). DBT improves the characterization of additional MR findings not identified at targeted breast US in preoperative breast cancer staging. (orig.)

Digital breast tomosynthesis (DBT) to characterize MRI-detected additional lesions unidentified at targeted ultrasound in newly diagnosed breast cancer patients

Energy Technology Data Exchange (ETDEWEB)

Mariscotti, Giovanna; Durando, Manuela; Regini, Elisa; Fornari, Alberto; Fonio, Paolo; Gandini, Giovanni [Breast Imaging Service, Radiology - University of Turin, Department of Diagnostic Imaging and Radiotherapy, A.O.U. Citta della Salute e della Scienza, Torino (Italy); Houssami, Nehmat [University of Sydney, Screening and Test Evaluation Program, School of Public Health, Sydney Medical School, Sydney, NSW (Australia); Campanino, Pier Paolo [Ospedale Koelliker, Breast Imaging Service, Torino (Italy); Bussone, Riccardo [A.O.U. Citta della Salute e della Scienza of Turin, SSCVD Breast Surgery. Department of Surgery, Torino (Italy); Castellano, Isabella; Sapino, Anna [University of Turin, Department of Biomedical Sciences and Human Oncology, A.O.U. Citta della Salute e della Scienza, Torino (Italy)

2015-09-15

Preoperative breast magnetic resonance (MR) often generates additional suspicious findings needing further investigations. Targeted breast ultrasound (US) is the standard tool to characterize MR additional lesions. The purpose of this study is to evaluate the potential role of digital breast tomosynthesis (DBT) to characterize MR detected additional findings, unidentified at targeted breast US. This prospective study included women who a) had biopsy-proven, newly diagnosed breast cancers detected at conventional 2D mammography and/or US, referred to breast MR for tumour staging; and b) had DBT if additional MR findings were not detected at targeted ('second look') US. In 520 patients, MR identified 164 (in 114 women, 22 %) additional enhancing lesions. Targeted US identified 114/164 (69.5 %) of these, whereas 50/164 (30.5 %) remained unidentified. DBT identified 32/50 of these cases, increasing the overall characterization of MR detected additional findings to 89.0 % (146/164). Using DBT the identified lesions were significantly more likely to be malignant than benign MR-detected additional lesions (p = 0.04). DBT improves the characterization of additional MR findings not identified at targeted breast US in preoperative breast cancer staging. (orig.)

Description and benefits of dynamic collimation in digital breast tomosynthesis

International Nuclear Information System (INIS)

Popova, Y.; Hersemeule, G.; Klausz, R.; Souchay, H.

2015-01-01

X-ray field to image receptor active area alignment is usually tested in mammographic QC. In digital breast tomosynthesis (dBT), the source moves during the acquisition, generating a displacement of the X-ray beam edges relative to the detector, in or out of the detector active area. To minimise unnecessary radiation while maximising the useful field of view, a solution consisting in adjusting the collimation with the source rotation was implemented on the GE SenoClaire dBT system. This solution is described and tested using three different methods based on: (1) images from the detector, (2) a non-screen film and (3) a semiconductor tool providing the X-ray intensity profile. Method 1 demonstrated a maximum positioning error of 0.3 mm. Method 2 was found non-applicable; Method 3 provided measurements within 1.5 mm. Dynamic collimation enables maintaining an X-ray field to detector congruence comparable with 2D. Measuring the position of the X-ray field edges using a dedicated tool makes routine QC possible. (authors)

Denoised ordered subset statistically penalized algebraic reconstruction technique (DOS-SPART) in digital breast tomosynthesis

Science.gov (United States)

Garrett, John; Li, Yinsheng; Li, Ke; Chen, Guang-Hong

2017-03-01

Digital breast tomosynthesis (DBT) is a three dimensional (3D) breast imaging modality in which projections are acquired over a limited angular span around the compressed breast and reconstructed into image slices parallel to the detector. DBT has been shown to help alleviate the breast tissue overlapping issues of two dimensional (2D) mammography. Since the overlapping tissues may simulate cancer masses or obscure true cancers, this improvement is critically important for improved breast cancer screening and diagnosis. In this work, a model-based image reconstruction method is presented to show that spatial resolution in DBT volumes can be maintained while dose is reduced using the presented method when compared to that of a state-of-the-art commercial reconstruction technique. Spatial resolution was measured in phantom images and subjectively in a clinical dataset. Noise characteristics were explored in a cadaver study. In both the quantitative and subjective results the image sharpness was maintained and overall image quality was maintained at reduced doses when the model-based iterative reconstruction was used to reconstruct the volumes.

Tomosynthesis Breast Imaging: Early Detection and Characterization of Breast Cancer

National Research Council Canada - National Science Library

Hamberg, Leena

1999-01-01

Our aim for the second year of this grant was to investigate the tomosynthetic image quality by performing experimental studies using the specially developed phantoms and to quantitate tomosynthesis...

Anatomical background and generalized detectability in tomosynthesis and cone-beam CT

International Nuclear Information System (INIS)

Gang, G. J.; Tward, D. J.; Lee, J.; Siewerdsen, J. H.

2010-01-01

Purpose: Anatomical background presents a major impediment to detectability in 2D radiography as well as 3D tomosynthesis and cone-beam CT (CBCT). This article incorporates theoretical and experimental analysis of anatomical background ''noise'' in cascaded systems analysis of 2D and 3D imaging performance to yield ''generalized'' metrics of noise-equivalent quanta (NEQ) and detectability index as a function of the orbital extent of the (circular arc) source-detector orbit. Methods: A physical phantom was designed based on principles of fractal self-similarity to exhibit power-law spectral density (κ/f β ) comparable to various anatomical sites (e.g., breast and lung). Background power spectra [S B (f)] were computed as a function of source-detector orbital extent, including tomosynthesis (∼10 deg. - 180 deg.) and CBCT (180 deg. +fan to 360 deg.) under two acquisition schemes: (1) Constant angular separation between projections (variable dose) and (2) constant total number of projections (constant dose). The resulting S B was incorporated in the generalized NEQ, and detectability index was computed from 3D cascaded systems analysis for a variety of imaging tasks. Results: The phantom yielded power-law spectra within the expected spatial frequency range, quantifying the dependence of clutter magnitude (κ) and correlation (β) with increasing tomosynthesis angle. Incorporation of S B in the 3D NEQ provided a useful framework for analyzing the tradeoffs among anatomical, quantum, and electronic noise with dose and orbital extent. Distinct implications are posed for breast and chest tomosynthesis imaging system design--applications varying significantly in κ and β, and imaging task and, therefore, in optimal selection of orbital extent, number of projections, and dose. For example, low-frequency tasks (e.g., soft-tissue masses or nodules) tend to benefit from larger orbital extent and more fully 3D tomographic imaging, whereas high-frequency tasks (e

Breast Tomosynthesis

Science.gov (United States)

... in distinguishing non-cancerous breast conditions from breast cancers. Breast implants may also impede accurate mammogram readings because both ... view as much as possible without rupturing the implant. top of ... discuss breast cancer screening options with their doctors: Breast Density and ...

TU-EF-207-00: Advances in Breast Imaging

Energy Technology Data Exchange (ETDEWEB)

NONE

2015-06-15

Breast imaging technology is advancing on several fronts. In digital mammography, the major technological trend has been on optimization of approaches for performing combined mammography and tomosynthesis using the same system. In parallel, photon-counting slot-scan mammography is now in clinical use and more efforts are directed towards further development of this approach for spectral imaging. Spectral imaging refers to simultaneous acquisition of two or more energy-windowed images. Depending on the detector and associated electronics, there are a number of ways this can be accomplished. Spectral mammography using photon-counting detectors can suppress electronic noise and importantly, it enables decomposition of the image into various material compositions of interest facilitating quantitative imaging. Spectral imaging can be particularly important in intravenously injected contrast mammography and eventually tomosynthesis. The various approaches and applications of spectral mammography are discussed. Digital breast tomosynthesis relies on the mechanical movement of the x-ray tube to acquire a number of projections in a predefined arc, typically from 9 to 25 projections over a scan angle of +/−7.5 to 25 degrees depending on the particular system. The mechanical x-ray tube motion requires relatively long acquisition time, typically between 3.7 to 25 seconds depending on the system. Moreover, mechanical scanning may have an effect on the spatial resolution due to internal x-ray filament or external mechanical vibrations. New x-ray source arrays have been developed and they are aimed at replacing the scanned x-ray tube for improved acquisition time and potentially for higher spatial resolution. The potential advantages and challenges of this approach are described. Combination of digital mammography and tomosynthesis in a single system places increased demands on certain functional aspects of the detector and overall performance, particularly in the tomosynthesis

Optimization of a dual-energy contrast-enhanced technique for a photon-counting digital breast tomosynthesis system: I. A theoretical model

International Nuclear Information System (INIS)

Carton, Ann-Katherine; Ullberg, Christer; Lindman, Karin; Acciavatti, Raymond; Francke, Tom; Maidment, Andrew D. A.

2010-01-01

Purpose: Dual-energy (DE) iodine contrast-enhanced x-ray imaging of the breast has been shown to identify cancers that would otherwise be mammographically occult. In this article, theoretical modeling was performed to obtain optimally enhanced iodine images for a photon-counting digital breast tomosynthesis (DBT) system using a DE acquisition technique. Methods: In the system examined, the breast is scanned with a multislit prepatient collimator aligned with a multidetector camera. Each detector collects a projection image at a unique angle during the scan. Low-energy (LE) and high-energy (HE) projection images are acquired simultaneously in a single scan by covering alternate collimator slits with Sn and Cu filters, respectively. Sn filters ranging from 0.08 to 0.22 mm thickness and Cu filters from 0.11 to 0.27 mm thickness were investigated. A tube voltage of 49 kV was selected. Tomographic images, hereafter referred to as DBT images, were reconstructed using a shift-and-add algorithm. Iodine-enhanced DBT images were acquired by performing a weighted logarithmic subtraction of the HE and LE DBT images. The DE technique was evaluated for 20-80 mm thick breasts. Weighting factors, w t , that optimally cancel breast tissue were computed. Signal-difference-to-noise ratios (SDNRs) between iodine-enhanced and nonenhanced breast tissue normalized to the square root of the mean glandular dose (MGD) were computed as a function of the fraction of the MGD allocated to the HE images. Peak SDNR/√(MGD) and optimal dose allocations were identified. SDNR/√(MGD) and dose allocations were computed for several practical feasible system configurations (i.e., determined by the number of collimator slits covered by Sn and Cu). A practical system configuration and Sn-Cu filter pair that accounts for the trade-off between SDNR, tube-output, and MGD were selected. Results: w t depends on the Sn-Cu filter combination used, as well as on the breast thickness; to optimally cancel 0

The role of digital tomosynthesis in reducing the number of equivocal breast reportings

Science.gov (United States)

Alakhras, Maram; Mello-Thoms, Claudia; Rickard, Mary; Bourne, Roger; Brennan, Patrick C.

2015-03-01

Purpose To compare radiologists' confidence in assessing breast cancer using combined digital mammography (DM) and digital breast tomosynthesis (DBT) compared with DM alone as a function of previous experience with DBT. Materials and Methods Institutional ethics approval was obtained. Twenty-three experienced breast radiologists reviewed 50 cases in two modes, DM alone and DM+DBT. Twenty-seven cases presented with breast cancer. Each radiologist was asked to detect breast lesions and give a confidence score of 1-5 (1- Normal, 2- Benign, 3- Equivocal, 4- Suspicious, 5- Malignant). Radiologists were divided into three sub-groups according to their prior experience with DBT (none, workshop experience, and clinical experience). Confidence scores using DM+DBT were compared with DM alone for all readers combined and for each DBT experience subgroup. Statistical analyses, using GraphPad Prism 5, were carried out using the Wilcoxon signed-rank test with statistical significance set at pResults Confidence scores were higher for true positive cancer cases using DM+DBT compared with DM alone for all readers (p Conclusion Addition of DBT to DM increases the confidence level of radiologists in scoring cancer and normal/benign cases. This finding appears to apply across radiologists with varying levels of DBT experience, however further work involving greater numbers of radiologists is required.

Digital Tomosynthesis System Geometry Analysis Using Convolution-Based Blur-and-Add (BAA) Model.

Science.gov (United States)

Wu, Meng; Yoon, Sungwon; Solomon, Edward G; Star-Lack, Josh; Pelc, Norbert; Fahrig, Rebecca

2016-01-01

Digital tomosynthesis is a three-dimensional imaging technique with a lower radiation dose than computed tomography (CT). Due to the missing data in tomosynthesis systems, out-of-plane structures in the depth direction cannot be completely removed by the reconstruction algorithms. In this work, we analyzed the impulse responses of common tomosynthesis systems on a plane-to-plane basis and proposed a fast and accurate convolution-based blur-and-add (BAA) model to simulate the backprojected images. In addition, the analysis formalism describing the impulse response of out-of-plane structures can be generalized to both rotating and parallel gantries. We implemented a ray tracing forward projection and backprojection (ray-based model) algorithm and the convolution-based BAA model to simulate the shift-and-add (backproject) tomosynthesis reconstructions. The convolution-based BAA model with proper geometry distortion correction provides reasonably accurate estimates of the tomosynthesis reconstruction. A numerical comparison indicates that the simulated images using the two models differ by less than 6% in terms of the root-mean-squared error. This convolution-based BAA model can be used in efficient system geometry analysis, reconstruction algorithm design, out-of-plane artifacts suppression, and CT-tomosynthesis registration.

High resolution stationary digital breast tomosynthesis using distributed carbon nanotube x-ray source array.

Science.gov (United States)

Qian, Xin; Tucker, Andrew; Gidcumb, Emily; Shan, Jing; Yang, Guang; Calderon-Colon, Xiomara; Sultana, Shabana; Lu, Jianping; Zhou, Otto; Spronk, Derrek; Sprenger, Frank; Zhang, Yiheng; Kennedy, Don; Farbizio, Tom; Jing, Zhenxue

2012-04-01

The purpose of this study is to investigate the feasibility of increasing the system spatial resolution and scanning speed of Hologic Selenia Dimensions digital breast tomosynthesis (DBT) scanner by replacing the rotating mammography x-ray tube with a specially designed carbon nanotube (CNT) x-ray source array, which generates all the projection images needed for tomosynthesis reconstruction by electronically activating individual x-ray sources without any mechanical motion. The stationary digital breast tomosynthesis (s-DBT) design aims to (i) increase the system spatial resolution by eliminating image blurring due to x-ray tube motion and (ii) reduce the scanning time. Low spatial resolution and long scanning time are the two main technical limitations of current DBT technology. A CNT x-ray source array was designed and evaluated against a set of targeted system performance parameters. Simulations were performed to determine the maximum anode heat load at the desired focal spot size and to design the electron focusing optics. Field emission current from CNT cathode was measured for an extended period of time to determine the stable life time of CNT cathode for an expected clinical operation scenario. The source array was manufactured, tested, and integrated with a Selenia scanner. An electronic control unit was developed to interface the source array with the detection system and to scan and regulate x-ray beams. The performance of the s-DBT system was evaluated using physical phantoms. The spatially distributed CNT x-ray source array comprised 31 individually addressable x-ray sources covering a 30 angular span with 1 pitch and an isotropic focal spot size of 0.6 mm at full width at half-maximum. Stable operation at 28 kV(peak) anode voltage and 38 mA tube current was demonstrated with extended lifetime and good source-to-source consistency. For the standard imaging protocol of 15 views over 14, 100 mAs dose, and 2 × 2 detector binning, the projection

Geometric calibration of a stationary digital breast tomosynthesis system based on distributed carbon nanotube X-ray source arrays.

Directory of Open Access Journals (Sweden)

Changhui Jiang

Full Text Available Stationary digital breast tomosynthesis (sDBT with distributed X-ray sources based on carbon nanotube (CNT field emission cathodes has been recently proposed as an approach that can prevent motion blur produced by traditional DBT systems. In this paper, we simulate a geometric calibration method based on a proposed multi-source CNT X-ray sDBT system. This method is a projection matrix-based approach with seven geometric parameters, all of which can be obtained from only one projection datum of the phantom. To our knowledge, this study reports the first application of this approach in a CNT-based multi-beam X-ray sDBT system. The simulation results showed that the extracted geometric parameters from the calculated projection matrix are extremely close to the input values and that the proposed method is effective and reliable for a square sDBT system. In addition, a traditional cone-beam computed tomography (CT system was also simulated, and the uncalibrated and calibrated geometric parameters were used in image reconstruction based on the filtered back-projection (FBP method. The results indicated that the images reconstructed with calibrated geometric parameters have fewer artifacts and are closer to the reference image. All the simulation tests showed that this geometric calibration method is optimized for sDBT systems but can also be applied to other application-specific CT imaging systems.

Geometric calibration of a stationary digital breast tomosynthesis system based on distributed carbon nanotube X-ray source arrays.

Science.gov (United States)

Jiang, Changhui; Zhang, Na; Gao, Juan; Hu, Zhanli

2017-01-01

Stationary digital breast tomosynthesis (sDBT) with distributed X-ray sources based on carbon nanotube (CNT) field emission cathodes has been recently proposed as an approach that can prevent motion blur produced by traditional DBT systems. In this paper, we simulate a geometric calibration method based on a proposed multi-source CNT X-ray sDBT system. This method is a projection matrix-based approach with seven geometric parameters, all of which can be obtained from only one projection datum of the phantom. To our knowledge, this study reports the first application of this approach in a CNT-based multi-beam X-ray sDBT system. The simulation results showed that the extracted geometric parameters from the calculated projection matrix are extremely close to the input values and that the proposed method is effective and reliable for a square sDBT system. In addition, a traditional cone-beam computed tomography (CT) system was also simulated, and the uncalibrated and calibrated geometric parameters were used in image reconstruction based on the filtered back-projection (FBP) method. The results indicated that the images reconstructed with calibrated geometric parameters have fewer artifacts and are closer to the reference image. All the simulation tests showed that this geometric calibration method is optimized for sDBT systems but can also be applied to other application-specific CT imaging systems.

WE-DE-207B-09: Scatter Radiation Measurement From a Digital Breast Tomosynthesis System and Its Impact On Shielding Consideration

Energy Technology Data Exchange (ETDEWEB)

Yang, K; Li, X; Liu, B [Massachusetts General Hospital, Boston, MA (United States)

2016-06-15

Purpose: To accurately measure the scatter radiation from a Hologic digital breast tomosynthesis (DBT) system and to provide updated scatter distribution to guide radiation shielding calculation for DBT rooms. Methods: A high sensitivity GOS-based linear detector was used to measure the angular distribution of scatter radiation from a Hologic Selenia Dimensions DBT system. The linear detector was calibrated for its energy response of typical DBT spectra. Following the NCRP147 approach, the measured scatter intensity was normalized by the primary beam area and primary air kerma at 1m from the scatter phantom center and presented as the scatter fraction. Direct comparison was made against Simpkin’s initial measurement. Key parameters including the phantom size, primary beam area, and kV/anode/target combination were also studied. Results: The measured scatter-to-primary-ratio and scatter fraction data closely matched with previous data from Simpkin. The measured data demonstrated the unique nonisotropic distribution of the scattered radiation around a Hologic DBT system, with two strong peaks around 25° and 160°. The majority scatter radiation (>70%) originated from the imaging detector assembly, instead of the phantom. With a workload from a previous local survey, the scatter air kerma at 1m from the phantom center for wall/door is 0.018mGy/patient, for floor is 0.164mGy/patient, and for ceiling is 0.037mGy/patient. Conclusion: Comparing to Simpkin’s previous data, the scatter air kerma from Holgoic DBT is at least two times higher. The main reasons include the harder primary beam with higher workload, added tomosynthesis acquisition, and strong small angle forward scattering. Due to the highly conservative initial assumptions, the shielding recommendation from NCRP147 is still sufficient for the Hologic DBT system given the workload from a previous local survey. With the data provided from this study, accurate shielding calculation can be performed for

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

Science.gov (United States)

Zhao, Chumin; Kanicki, Jerzy

2017-09-01

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.

Digital tomosynthesis parallel imaging computational analysis with shift and add and back projection reconstruction algorithms.

Science.gov (United States)

Chen, Ying; Balla, Apuroop; Rayford II, Cleveland E; Zhou, Weihua; Fang, Jian; Cong, Linlin

2010-01-01

Digital tomosynthesis is a novel technology that has been developed for various clinical applications. Parallel imaging configuration is utilised in a few tomosynthesis imaging areas such as digital chest tomosynthesis. Recently, parallel imaging configuration for breast tomosynthesis began to appear too. In this paper, we present the investigation on computational analysis of impulse response characterisation as the start point of our important research efforts to optimise the parallel imaging configurations. Results suggest that impulse response computational analysis is an effective method to compare and optimise imaging configurations.

Average glandular dose in digital mammography and digital breast tomosynthesis: comparison of phantom and patient data

International Nuclear Information System (INIS)

Bouwman, R W; Van Engen, R E; Den Heeten, G J; Broeders, M J M; Veldkamp, W J H; Young, K C; Dance, D R; Schopphoven, S; Jeukens, C R L P N

2015-01-01

For the evaluation of the average glandular dose (AGD) in digital mammography (DM) and digital breast tomosynthesis (DBT) phantoms simulating standard model breasts are used. These phantoms consist of slabs of polymethyl methacrylate (PMMA) or a combination of PMMA and polyethylene (PE). In the last decades the automatic exposure control (AEC) increased in complexity and became more sensitive to (local) differences in breast composition. The question is how well the AGD estimated using these simple dosimetry phantoms agrees with the average patient AGD. In this study the AGDs for both dosimetry phantoms and for patients have been evaluated for 5 different x-ray systems in DM and DBT modes. It was found that the ratios between patient and phantom AGD did not differ considerably using both dosimetry phantoms. These ratios averaged over all breast thicknesses were 1.14 and 1.15 for the PMMA and PMMA-PE dosimetry phantoms respectively in DM mode and 1.00 and 1.02 in the DBT mode. These ratios were deemed to be sufficiently close to unity to be suitable for dosimetry evaluation in quality control procedures. However care should be taken when comparing systems for DM and DBT since depending on the AEC operation, ratios for particular breast thicknesses may differ substantially (0.83–1.96). Although the predictions of both phantoms are similar we advise the use of PMMA  +  PE slabs for both DM and DBT to harmonize dosimetry protocols and avoid any potential issues with the use of spacers with the PMMA phantoms. (paper)

TU-EF-207-05: Dedicated Cone-beam Breast CT

International Nuclear Information System (INIS)

Vedantham, S.

2015-01-01

Breast imaging technology is advancing on several fronts. In digital mammography, the major technological trend has been on optimization of approaches for performing combined mammography and tomosynthesis using the same system. In parallel, photon-counting slot-scan mammography is now in clinical use and more efforts are directed towards further development of this approach for spectral imaging. Spectral imaging refers to simultaneous acquisition of two or more energy-windowed images. Depending on the detector and associated electronics, there are a number of ways this can be accomplished. Spectral mammography using photon-counting detectors can suppress electronic noise and importantly, it enables decomposition of the image into various material compositions of interest facilitating quantitative imaging. Spectral imaging can be particularly important in intravenously injected contrast mammography and eventually tomosynthesis. The various approaches and applications of spectral mammography are discussed. Digital breast tomosynthesis relies on the mechanical movement of the x-ray tube to acquire a number of projections in a predefined arc, typically from 9 to 25 projections over a scan angle of +/−7.5 to 25 degrees depending on the particular system. The mechanical x-ray tube motion requires relatively long acquisition time, typically between 3.7 to 25 seconds depending on the system. Moreover, mechanical scanning may have an effect on the spatial resolution due to internal x-ray filament or external mechanical vibrations. New x-ray source arrays have been developed and they are aimed at replacing the scanned x-ray tube for improved acquisition time and potentially for higher spatial resolution. The potential advantages and challenges of this approach are described. Combination of digital mammography and tomosynthesis in a single system places increased demands on certain functional aspects of the detector and overall performance, particularly in the tomosynthesis

TU-EF-207-05: Dedicated Cone-beam Breast CT

Energy Technology Data Exchange (ETDEWEB)

Vedantham, S. [Univ. of Massachusetts Medical School (United States)

2015-06-15

Breast imaging technology is advancing on several fronts. In digital mammography, the major technological trend has been on optimization of approaches for performing combined mammography and tomosynthesis using the same system. In parallel, photon-counting slot-scan mammography is now in clinical use and more efforts are directed towards further development of this approach for spectral imaging. Spectral imaging refers to simultaneous acquisition of two or more energy-windowed images. Depending on the detector and associated electronics, there are a number of ways this can be accomplished. Spectral mammography using photon-counting detectors can suppress electronic noise and importantly, it enables decomposition of the image into various material compositions of interest facilitating quantitative imaging. Spectral imaging can be particularly important in intravenously injected contrast mammography and eventually tomosynthesis. The various approaches and applications of spectral mammography are discussed. Digital breast tomosynthesis relies on the mechanical movement of the x-ray tube to acquire a number of projections in a predefined arc, typically from 9 to 25 projections over a scan angle of +/−7.5 to 25 degrees depending on the particular system. The mechanical x-ray tube motion requires relatively long acquisition time, typically between 3.7 to 25 seconds depending on the system. Moreover, mechanical scanning may have an effect on the spatial resolution due to internal x-ray filament or external mechanical vibrations. New x-ray source arrays have been developed and they are aimed at replacing the scanned x-ray tube for improved acquisition time and potentially for higher spatial resolution. The potential advantages and challenges of this approach are described. Combination of digital mammography and tomosynthesis in a single system places increased demands on certain functional aspects of the detector and overall performance, particularly in the tomosynthesis

Evaluation of the image quality in digital breast tomosynthesis (DBT) employed with a compressed-sensing (CS)-based reconstruction algorithm by using the mammographic accreditation phantom

Energy Technology Data Exchange (ETDEWEB)

Park, Yeonok; Cho, Heemoon; Je, Uikyu; Cho, Hyosung, E-mail: hscho1@yonsei.ac.kr; Park, Chulkyu; Lim, Hyunwoo; Kim, Kyuseok; Kim, Guna; Park, Soyoung; Woo, Taeho; Choi, Sungil

2015-12-21

In this work, we have developed a prototype digital breast tomosynthesis (DBT) system which mainly consists of an x-ray generator (28 kV{sub p}, 7 mA s), a CMOS-type flat-panel detector (70-μm pixel size, 230.5×339 mm{sup 2} active area), and a rotational arm to move the x-ray generator in an arc. We employed a compressed-sensing (CS)-based reconstruction algorithm, rather than a common filtered-backprojection (FBP) one, for more accurate DBT reconstruction. Here the CS is a state-of-the-art mathematical theory for solving the inverse problems, which exploits the sparsity of the image with substantially high accuracy. We evaluated the reconstruction quality in terms of the detectability, the contrast-to-noise ratio (CNR), and the slice-sensitive profile (SSP) by using the mammographic accreditation phantom (Model 015, CIRS Inc.) and compared it to the FBP-based quality. The CS-based algorithm yielded much better image quality, preserving superior image homogeneity, edge sharpening, and cross-plane resolution, compared to the FBP-based one. - Highlights: • A prototype digital breast tomosynthesis (DBT) system is developed. • Compressed-sensing (CS) based reconstruction framework is employed. • We reconstructed high-quality DBT images by using the proposed reconstruction framework.

Influence of X-ray scatter radiation on image quality in Digital Breast Tomosynthesis (DBT)

International Nuclear Information System (INIS)

Rodrigues, M.J.; Di Maria, S.; Baptista, M.; Belchior, A.; Afonso, J.; Venâncio, J.; Vaz, P.

2017-01-01

Digital breast tomosynthesis (DBT) is a quasi-three-dimensional imaging technique that was developed to solve the principal limitation of mammography, namely the overlapping tissue effect. This issue in standard mammography (SM) leads to two main problems: low sensitivity (difficulty to detect lesions) and low specificity (non-negligible percentage of false positives). Although DBT is now being introduced in clinical practice the features of this technique have not yet been fully and accurately assessed. Consequently, optimization studies in terms of choosing the most suitable parameters which maximize image quality according to the known limits of breast dosimetry are currently performing. In DBT, scatter radiation can lead to a loss of contrast and to an increase of image noise by reducing the signal-to-difference-noise ratio (SDNR) of a lesion. Moreover the use of an anti-scatter grid is a concern due to the low exposure of the photon flux available per projection. For this reason the main aim of this study was to analyze the influence of the scatter radiation on image quality and the dose delivered to the breast. In particular a detailed analysis of the scatter radiation on the optimal energy that maximizes the SDNR was performed for different monochromatic energies and voltages. To reach this objective the PenEasy Monte Carlo (MC) simulation tool imbedded in the general-purpose main program PENELOPE, was used. After a successful validation of the MC model with measurements, 2D projection images of primary, coherent and incoherent photons were obtained. For that, a homogeneous breast phantom (2, 4, 6, 8 cm) with 25%, 50% and 75% glandular compositions was used, including a 5 mm thick tumor. The images were generated for each monochromatic X-ray energies in the range from 16 keV to 32 keV. For each angular projection considered (25 angular projections covering an arc of 50°) the scatter-to-primary ratio (SPR), the mean glandular dose (MGD) and the signal

Tomosynthesis in the Diagnostic Setting: Changing Rates of BI-RADS Final Assessment over Time.

Science.gov (United States)

Raghu, Madhavi; Durand, Melissa A; Andrejeva, Liva; Goehler, Alexander; Michalski, Mark H; Geisel, Jaime L; Hooley, Regina J; Horvath, Laura J; Butler, Reni; Forman, Howard P; Philpotts, Liane E

2016-10-01

Purpose To evaluate the effect of tomosynthesis in diagnostic mammography on the Breast Imaging Reporting and Data System (BI-RADS) final assessment categories over time. Materials and Methods This retrospective study was approved by the institutional review board. The authors reviewed all diagnostic mammograms obtained during a 12-month interval before (two-dimensional [2D] mammography [June 2, 2010, to June 1, 2011]) and for 3 consecutive years after (tomosynthesis year 1 [2012], tomosynthesis year 2 [2013], and tomosynthesis year 3 [2014]) the implementation of tomosynthesis. The requirement to obtain informed consent was waived. The rates of BI-RADS final assessment categories 1-5 were compared between the 2D and tomosynthesis groups. The positive predictive values after biopsy (PPV3) for BI-RADS category 4 and 5 cases were compared. The mammographic features (masses, architectural distortions, calcifications, focal asymmetries) of lesions categorized as probably benign (BI-RADS category 3) and those for which biopsy was recommended (BI-RADS category 4 or 5) were reviewed. The χ(2) test was used to compare the rates of BI-RADS final assessment categories 1-5 between the two groups, and multivariate logistic regression analysis was performed to compare all diagnostic studies categorized as BI-RADS 3-5. Results There was an increase in the percentage of cases reported as negative or benign (BI-RADS category 1 or 2) with tomosynthesis (58.7% with 2D mammography vs 75.8% with tomosynthesis at year 3, P tomosynthesis at year 3, P tomosynthesis (8.0% with 2D mammography vs 7.8% with tomosynthesis at year 3, P = .2), there was a significant increase in the PPV3 (29.6% vs 50%, respectively; P tomosynthesis use. Conclusion Tomosynthesis in the diagnostic setting resulted in progressive shifts in the BI-RADS final assessment categories over time, with a significant increase in the proportion of studies classified as normal, a continued decrease in the rate of studies

Experimental validation of a three-dimensional linear system model for breast tomosynthesis

International Nuclear Information System (INIS)

Zhao Bo; Zhou Jun; Hu Yuehoung; Mertelmeier, Thomas; Ludwig, Jasmina; Zhao Wei

2009-01-01

A three-dimensional (3D) linear model for digital breast tomosynthesis (DBT) was developed to investigate the effects of different imaging system parameters on the reconstructed image quality. In the present work, experimental validation of the model was performed on a prototype DBT system equipped with an amorphous selenium (a-Se) digital mammography detector and filtered backprojection (FBP) reconstruction methods. The detector can be operated in either full resolution with 85 μm pixel size or 2x1 pixel binning mode to reduce acquisition time. Twenty-five projection images were acquired with a nominal angular range of ±20 deg. The images were reconstructed using a slice thickness of 1 mm with 0.085x0.085 mm in-plane pixel dimension. The imaging performance was characterized by spatial frequency-dependent parameters including a 3D noise power spectrum (NPS) and in-plane modulation transfer function (MTF). Scatter-free uniform x-ray images were acquired at four different exposure levels for noise analysis. An aluminum (Al) edge phantom with 0.2 mm thickness was imaged to measure the in-plane presampling MTF. The measured in-plane MTF and 3D NPS were both in good agreement with the model. The dependence of DBT image quality on reconstruction filters was investigated. It was found that the slice thickness (ST) filter, a Hanning window to limit the high-frequency components in the slice thickness direction, reduces noise aliasing and improves 3D DQE. An ACR phantom was imaged to investigate the effects of angular range and detector operational modes on reconstructed image quality. It was found that increasing the angular range improves the MTF at low frequencies, resulting in better detection of large-area, low-contrast mass lesions in the phantom. There is a trade-off between noise and resolution for pixel binning and full resolution modes, and the choice of detector mode will depend on radiation dose and the targeted lesion.

Experimental validation of a three-dimensional linear system model for breast tomosynthesis

Energy Technology Data Exchange (ETDEWEB)

Zhao Bo; Zhou Jun; Hu Yuehoung; Mertelmeier, Thomas; Ludwig, Jasmina; Zhao Wei [Department of Radiology, State University of New York at Stony Brook, L-4 120 Health Sciences Center, Stony Brook, New York 11794-8460 (United States); Siemens AG Healthcare, Henkestrasse 127, D-91052 Erlangen (Germany); Department of Radiology, State University of New York at Stony Brook, L-4 120 Health Sciences Center, Stony Brook, New York 11794-8460 (United States)

2009-01-15

A three-dimensional (3D) linear model for digital breast tomosynthesis (DBT) was developed to investigate the effects of different imaging system parameters on the reconstructed image quality. In the present work, experimental validation of the model was performed on a prototype DBT system equipped with an amorphous selenium (a-Se) digital mammography detector and filtered backprojection (FBP) reconstruction methods. The detector can be operated in either full resolution with 85 {mu}m pixel size or 2x1 pixel binning mode to reduce acquisition time. Twenty-five projection images were acquired with a nominal angular range of {+-}20 deg. The images were reconstructed using a slice thickness of 1 mm with 0.085x0.085 mm in-plane pixel dimension. The imaging performance was characterized by spatial frequency-dependent parameters including a 3D noise power spectrum (NPS) and in-plane modulation transfer function (MTF). Scatter-free uniform x-ray images were acquired at four different exposure levels for noise analysis. An aluminum (Al) edge phantom with 0.2 mm thickness was imaged to measure the in-plane presampling MTF. The measured in-plane MTF and 3D NPS were both in good agreement with the model. The dependence of DBT image quality on reconstruction filters was investigated. It was found that the slice thickness (ST) filter, a Hanning window to limit the high-frequency components in the slice thickness direction, reduces noise aliasing and improves 3D DQE. An ACR phantom was imaged to investigate the effects of angular range and detector operational modes on reconstructed image quality. It was found that increasing the angular range improves the MTF at low frequencies, resulting in better detection of large-area, low-contrast mass lesions in the phantom. There is a trade-off between noise and resolution for pixel binning and full resolution modes, and the choice of detector mode will depend on radiation dose and the targeted lesion.

Interpretation of digital breast tomosynthesis: preliminary study on comparison with picture archiving and communication system (PACS) and dedicated workstation.

Science.gov (United States)

Kim, Young Seon; Chang, Jung Min; Yi, Ann; Shin, Sung Ui; Lee, Myung Eun; Kim, Won Hwa; Cho, Nariya; Moon, Woo Kyung

2017-08-01

To compare the diagnostic accuracy and efficiency in the interpretation of digital breast tomosynthesis (DBT) images using a picture archiving and communication system (PACS) and a dedicated workstation. 97 DBT images obtained for screening or diagnostic purposes were stored in both a workstation and a PACS and evaluated in combination with digital mammography by three independent radiologists retrospectively. Breast Imaging-Reporting and Data System final assessments and likelihood of malignancy (%) were assigned and the interpretation time when using the workstation and PACS was recorded. Receiver operating characteristic curve analysis, sensitivities and specificities were compared with histopathological examination and follow-up data as a reference standard. Area under the receiver operating characteristic curve values for cancer detection (0.839 vs 0.815, p = 0.6375) and sensitivity (81.8% vs 75.8%, p = 0.2188) showed no statistically significant differences between the workstation and PACS. However, specificity was significantly higher when analysing on the workstation than when using PACS (83.7% vs 76.9%, p = 0.009). When evaluating DBT images using PACS, only one case was deemed necessary to be reanalysed using the workstation. The mean time to interpret DBT images on PACS (1.68 min/case) was significantly longer than that to interpret on the workstation (1.35 min/case) (p < 0.0001). Interpretation of DBT images using PACS showed comparable diagnostic performance to a dedicated workstation, even though it required a longer reading time. Advances in knowledge: Interpretation of DBT images using PACS is an alternative to evaluate the images when a dedicated workstation is not available.

TU-EF-207-01: Introductory Remarks on Recent Advances in Breast Imaging

Energy Technology Data Exchange (ETDEWEB)

Karellas, A. [University of Massachusetts Medical School (United States)

2015-06-15

Breast imaging technology is advancing on several fronts. In digital mammography, the major technological trend has been on optimization of approaches for performing combined mammography and tomosynthesis using the same system. In parallel, photon-counting slot-scan mammography is now in clinical use and more efforts are directed towards further development of this approach for spectral imaging. Spectral imaging refers to simultaneous acquisition of two or more energy-windowed images. Depending on the detector and associated electronics, there are a number of ways this can be accomplished. Spectral mammography using photon-counting detectors can suppress electronic noise and importantly, it enables decomposition of the image into various material compositions of interest facilitating quantitative imaging. Spectral imaging can be particularly important in intravenously injected contrast mammography and eventually tomosynthesis. The various approaches and applications of spectral mammography are discussed. Digital breast tomosynthesis relies on the mechanical movement of the x-ray tube to acquire a number of projections in a predefined arc, typically from 9 to 25 projections over a scan angle of +/−7.5 to 25 degrees depending on the particular system. The mechanical x-ray tube motion requires relatively long acquisition time, typically between 3.7 to 25 seconds depending on the system. Moreover, mechanical scanning may have an effect on the spatial resolution due to internal x-ray filament or external mechanical vibrations. New x-ray source arrays have been developed and they are aimed at replacing the scanned x-ray tube for improved acquisition time and potentially for higher spatial resolution. The potential advantages and challenges of this approach are described. Combination of digital mammography and tomosynthesis in a single system places increased demands on certain functional aspects of the detector and overall performance, particularly in the tomosynthesis

TU-EF-207-01: Introductory Remarks on Recent Advances in Breast Imaging

International Nuclear Information System (INIS)

Karellas, A.

2015-01-01

Breast imaging technology is advancing on several fronts. In digital mammography, the major technological trend has been on optimization of approaches for performing combined mammography and tomosynthesis using the same system. In parallel, photon-counting slot-scan mammography is now in clinical use and more efforts are directed towards further development of this approach for spectral imaging. Spectral imaging refers to simultaneous acquisition of two or more energy-windowed images. Depending on the detector and associated electronics, there are a number of ways this can be accomplished. Spectral mammography using photon-counting detectors can suppress electronic noise and importantly, it enables decomposition of the image into various material compositions of interest facilitating quantitative imaging. Spectral imaging can be particularly important in intravenously injected contrast mammography and eventually tomosynthesis. The various approaches and applications of spectral mammography are discussed. Digital breast tomosynthesis relies on the mechanical movement of the x-ray tube to acquire a number of projections in a predefined arc, typically from 9 to 25 projections over a scan angle of +/−7.5 to 25 degrees depending on the particular system. The mechanical x-ray tube motion requires relatively long acquisition time, typically between 3.7 to 25 seconds depending on the system. Moreover, mechanical scanning may have an effect on the spatial resolution due to internal x-ray filament or external mechanical vibrations. New x-ray source arrays have been developed and they are aimed at replacing the scanned x-ray tube for improved acquisition time and potentially for higher spatial resolution. The potential advantages and challenges of this approach are described. Combination of digital mammography and tomosynthesis in a single system places increased demands on certain functional aspects of the detector and overall performance, particularly in the tomosynthesis

Comparison of the diagnostic performance of digital breast tomosynthesis and magnetic resonance imaging added to digital mammography in women with known breast cancers

Energy Technology Data Exchange (ETDEWEB)

Kim, Won Hwa; Chang, Jung Min; Moon, Woo Kyung [Seoul National University Hospital, Department of Radiology, 101 Daehangno, Jongno-gu, Seoul (Korea, Republic of); Moon, Hyeong-Gon [Seoul National University Hospital, Department of Surgery, Seoul (Korea, Republic of); Yi, Ann [Seoul National University Hospital, Department of Radiology, Gangnan Healthcare Center, Seoul (Korea, Republic of); Koo, Hye Ryoung [Hanyang University College of Medicine, Department of Radiology, Seoul (Korea, Republic of); Gweon, Hye Mi [Yonsei University College of Medicine, Department of Radiology, Gangnam Severance Hospital, Seoul (Korea, Republic of)

2016-06-15

To compare the diagnostic performance of digital breast tomosynthesis (DBT) and magnetic resonance imaging (MRI) added to mammography in women with known breast cancers. Three radiologists independently reviewed image sets of 172 patients with 184 cancers; mammography alone, DBT plus mammography and MRI plus mammography, and scored for cancer probability using the Breast Imaging Reporting and Data System (BI-RADS). Jack-knife alternative free-response receiver-operating characteristic (JAFROC), which allows diagnostic performance estimation using single lesion as a statistical unit in a cancer-only population, was used. Sensitivity and positive predictive value (PPV) were compared using the McNemar and Fisher-exact tests. The JAFROC figures of merit (FOMs) was lower in DBT plus mammography (0.937) than MRI plus mammography (0.978, P = 0.0006) but higher than mammography alone (0.900, P = 0.0013). The sensitivity was lower in DBT plus mammography (88.2 %) than MRI plus mammography (97.8 %) but higher than mammography alone (78.3 %, both P < 0.0001). The PPV was significantly higher in DBT plus mammography (93.3 %) than MRI plus mammography (89.6 %, P = 0.0282). DBT provided lower diagnostic performance than MRI as an adjunctive imaging to mammography. However, DBT had higher diagnostic performance than mammography and higher PPV than MRI. (orig.)

Comparison of the diagnostic performance of digital breast tomosynthesis and magnetic resonance imaging added to digital mammography in women with known breast cancers

International Nuclear Information System (INIS)

Kim, Won Hwa; Chang, Jung Min; Moon, Woo Kyung; Moon, Hyeong-Gon; Yi, Ann; Koo, Hye Ryoung; Gweon, Hye Mi

2016-01-01

To compare the diagnostic performance of digital breast tomosynthesis (DBT) and magnetic resonance imaging (MRI) added to mammography in women with known breast cancers. Three radiologists independently reviewed image sets of 172 patients with 184 cancers; mammography alone, DBT plus mammography and MRI plus mammography, and scored for cancer probability using the Breast Imaging Reporting and Data System (BI-RADS). Jack-knife alternative free-response receiver-operating characteristic (JAFROC), which allows diagnostic performance estimation using single lesion as a statistical unit in a cancer-only population, was used. Sensitivity and positive predictive value (PPV) were compared using the McNemar and Fisher-exact tests. The JAFROC figures of merit (FOMs) was lower in DBT plus mammography (0.937) than MRI plus mammography (0.978, P = 0.0006) but higher than mammography alone (0.900, P = 0.0013). The sensitivity was lower in DBT plus mammography (88.2 %) than MRI plus mammography (97.8 %) but higher than mammography alone (78.3 %, both P < 0.0001). The PPV was significantly higher in DBT plus mammography (93.3 %) than MRI plus mammography (89.6 %, P = 0.0282). DBT provided lower diagnostic performance than MRI as an adjunctive imaging to mammography. However, DBT had higher diagnostic performance than mammography and higher PPV than MRI. (orig.)

Development of low-dose photon-counting contrast-enhanced tomosynthesis with spectral imaging.

Science.gov (United States)

Schmitzberger, Florian F; Fallenberg, Eva Maria; Lawaczeck, Rüdiger; Hemmendorff, Magnus; Moa, Elin; Danielsson, Mats; Bick, Ulrich; Diekmann, Susanne; Pöllinger, Alexander; Engelken, Florian J; Diekmann, Felix

2011-05-01

To demonstrate the feasibility of low-dose photon-counting tomosynthesis in combination with a contrast agent (contrast material-enhanced tomographic mammography) for the differentiation of breast cancer. All studies were approved by the institutional review board, and all patients provided written informed consent. A phantom model with wells of iodinated contrast material (3 mg of iodine per milliliter) 1, 2, 5, 10, and 15 mm in diameter was assessed. Nine patients with malignant lesions and one with a high-risk lesion (atypical papilloma) were included (all women; mean age, 60.7 years). A multislit photon-counting tomosynthesis system was utilized (spectral imaging) to produce both low- and high-energy tomographic data (below and above the k edge of iodine, respectively) in a single scan, which allowed for dual-energy visualization of iodine. Images were obtained prior to contrast material administration and 120 and 480 seconds after contrast material administration. Four readers independently assessed the images along with conventional mammograms, ultrasonographic images, and magnetic resonance images. Glandular dose was estimated. Contrast agent was visible in the phantom model with simulated spherical tumor diameters as small as 5 mm. The average glandular dose was measured as 0.42 mGy per complete spectral imaging tomosynthesis scan of one breast. Because there were three time points (prior to contrast medium administration and 120 and 480 seconds after contrast medium administration), this resulted in a total dose of 1.26 mGy for the whole procedure in the breast with the abnormality. Seven of 10 cases were categorized as Breast Imaging Reporting and Data System score of 4 or higher by all four readers when reviewing spectral images in combination with mammograms. One lesion near the chest wall was not captured on the spectral image because of a positioning problem. The use of contrast-enhanced tomographic mammography has been demonstrated successfully in

SU-E-P-31: Quantifying the Amount of Missing Tissue in a Digital Breast Tomosynthesis

International Nuclear Information System (INIS)

Goodenough, D; Olafsdottir, H; Olafsson, I; Fredriksson, J; Kristinsson, S; Oskarsdottir, G; Kristbjornsson, A; Mallozzi, R; Healy, A; Levy, J

2015-01-01

Purpose: To automatically quantify the amount of missing tissue in a digital breast tomosynthesis system using four stair-stepped chest wall missing tissue gauges in the Tomophan™ from the Phantom Laboratory and image processing from Image Owl. Methods: The Tomophan™ phantom incorporates four stair-stepped missing tissue gauges by the chest wall, allowing measurement of missing chest wall in two different locations along the chest wall at two different heights. Each of the four gauges has 12 steps in 0.5 mm increments rising from the chest wall. An image processing algorithm was developed by Image Owl that first finds the two slices containing the steps then finds the signal through the highest step in all four gauges. Using the signal drop at the beginning of each gauge the distance to the end of the image gives the length of the missing tissue gauge in millimeters. Results: The Tomophan™ was imaged in digital breast tomosynthesis (DBT) systems from various vendors resulting in 46 cases used for testing. The results showed that on average 1.9 mm of 6 mm of the gauges are visible. A small focus group was asked to count the number of visible steps for each case which resulted in a good agreement between observer counts and computed data. Conclusion: First, the results indicate that the amount of missing chest wall can differ between vendors. Secondly it was shown that an automated method to estimate the amount of missing chest wall gauges agreed well with observer assessments. This finding indicates that consistency testing may be simplified using the Tomophan™ phantom and analysis by an automated image processing named Tomo QA. In general the reason for missing chest wall may be due to a function of the beam profile at the chest wall as DBT projects through the angular sampling. Research supported by Image Owl, Inc., The Phantom Laboratory, Inc. and Raforninn ehf; Mallozzi and Healy employed by The Phantom Laboratory, Inc.; Goodenough is a consultant to The

SU-E-P-31: Quantifying the Amount of Missing Tissue in a Digital Breast Tomosynthesis

Energy Technology Data Exchange (ETDEWEB)

Goodenough, D [George Washington University, Washington, DC (United States); Olafsdottir, H; Olafsson, I; Fredriksson, J; Kristinsson, S; Oskarsdottir, G; Kristbjornsson, A [Raforninn Ehf., Reykjavik, Gullbringusysla (Iceland); Mallozzi, R; Healy, A; Levy, J [The Phantom Laboratory, Salem, NY (United States)

2015-06-15

Purpose: To automatically quantify the amount of missing tissue in a digital breast tomosynthesis system using four stair-stepped chest wall missing tissue gauges in the Tomophan™ from the Phantom Laboratory and image processing from Image Owl. Methods: The Tomophan™ phantom incorporates four stair-stepped missing tissue gauges by the chest wall, allowing measurement of missing chest wall in two different locations along the chest wall at two different heights. Each of the four gauges has 12 steps in 0.5 mm increments rising from the chest wall. An image processing algorithm was developed by Image Owl that first finds the two slices containing the steps then finds the signal through the highest step in all four gauges. Using the signal drop at the beginning of each gauge the distance to the end of the image gives the length of the missing tissue gauge in millimeters. Results: The Tomophan™ was imaged in digital breast tomosynthesis (DBT) systems from various vendors resulting in 46 cases used for testing. The results showed that on average 1.9 mm of 6 mm of the gauges are visible. A small focus group was asked to count the number of visible steps for each case which resulted in a good agreement between observer counts and computed data. Conclusion: First, the results indicate that the amount of missing chest wall can differ between vendors. Secondly it was shown that an automated method to estimate the amount of missing chest wall gauges agreed well with observer assessments. This finding indicates that consistency testing may be simplified using the Tomophan™ phantom and analysis by an automated image processing named Tomo QA. In general the reason for missing chest wall may be due to a function of the beam profile at the chest wall as DBT projects through the angular sampling. Research supported by Image Owl, Inc., The Phantom Laboratory, Inc. and Raforninn ehf; Mallozzi and Healy employed by The Phantom Laboratory, Inc.; Goodenough is a consultant to The

Dependency of image quality on system configuration parameters in a stationary digital breast tomosynthesis system

Science.gov (United States)

Tucker, Andrew W.; Lu, Jianping; Zhou, Otto

2013-01-01

Purpose: In principle, a stationary digital breast tomosynthesis (s-DBT) system has better image quality when compared to continuous motion DBT systems due to zero motion blur of the source. The authors have developed a s-DBT system by using a linear carbon nanotube x-ray source array. The purpose of the current study was to quantitatively evaluate the performance of the s-DBT system; and investigate the dependence of imaging quality on the system configuration parameters. Methods: Physical phantoms were used to assess the image quality of each configuration including inplane resolution as measured by the modulation transfer function (MTF), inplane contrast as measured by the signal difference to noise ratio (SdNR), and depth resolution as measured by the z-axis artifact spread function. Five parameters were varied to create five groups of configurations: (1) total angular span; (2) total number of projection images; (3) distribution of exposure (mAs) across the projection images; (4) entrance dose; (5) detector pixel size. Results: It was found that the z-axis depth resolution increased with the total angular span but was insensitive to the number of projection images, mAs distribution, entrance dose, and detector pixel size. The SdNR was not affected by the angular span or the number of projection images. A decrease in SdNR was observed when the mAs was not evenly distributed across the projection images. As expected, the SdNR increased with entrance dose and when larger pixel sizes were used. For a given detector pixel size, the inplane resolution was found to be insensitive to the total angular span, number of projection images, mAs distribution, and entrance dose. A 25% increase in the MTF was observed when the detector was operating in full resolution mode (70 μm pixel size) compared to 2 × 2 binned mode (140 μm pixel size). Conclusions: The results suggest that the optimal imaging configuration for a s-DBT system is a large angular span, an intermittent

Initial Experience of Tomosynthesis-Guided Vacuum-Assisted Biopsies of Tomosynthesis-Detected (2D Mammography and Ultrasound Occult) Architectural Distortions.

Science.gov (United States)

Patel, Bhavika K; Covington, Matthew; Pizzitola, Victor J; Lorans, Roxanne; Giurescu, Marina; Eversman, William; Lewin, John

2018-03-23

As experience and aptitude in digital breast tomosynthesis (DBT) have increased, radiologists are seeing more areas of architectural distortion (AD) on DBT images compared with standard 2D mammograms. The purpose of this study is to report our experience using tomosynthesis-guided vacuum-assisted biopsies (VABs) for ADs that were occult at 2D mammography and ultrasound and to analyze the positive predictive value for malignancy. We performed a retrospective review of 34 DBT-detected ADs that were occult at mammography and ultrasound. We found a positive predictive value of 26% (nine malignancies in 34 lesions). Eight of the malignancies were invasive and one was ductal carcinoma in situ. The invasive cancers were grade 1 (4/8; 50%), grade 2 (2/8; 25%), or grade 3 (1/8; 13%); information about one invasive cancer was not available. The mean size of the invasive cancers at pathologic examination was 7.5 mm (range, 6-30 mm). Tomosynthesis-guided VAB is a feasible method to sample ADs that are occult at 2D mammography and ultrasound. Tomosynthesis-guided VAB is a minimally invasive method that detected a significant number of carcinomas, most of which were grade 1 cancers. Further studies are needed.

Comparison of Two-dimensional Synthesized Mammograms versus Original Digital Mammograms Alone and in Combination with Tomosynthesis Images

Science.gov (United States)

Guo, Ben; Catullo, Victor J.; Chough, Denise M.; Kelly, Amy E.; Lu, Amy H.; Rathfon, Grace Y.; Lee Spangler, Marion; Sumkin, Jules H.; Wallace, Luisa P.; Bandos, Andriy I.

2014-01-01

Purpose To assess interpretation performance and radiation dose when two-dimensional synthesized mammography (SM) images versus standard full-field digital mammography (FFDM) images are used alone or in combination with digital breast tomosynthesis images. Materials and Methods A fully crossed, mode-balanced multicase (n = 123), multireader (n = 8), retrospective observer performance study was performed by using deidentified images acquired between 2008 and 2011 with institutional review board approved, HIPAA-compliant protocols, during which each patient signed informed consent. The cohort included 36 cases of biopsy-proven cancer, 35 cases of biopsy-proven benign lesions, and 52 normal or benign cases (Breast Imaging Reporting and Data System [BI-RADS] score of 1 or 2) with negative 1-year follow-up results. Accuracy of sequentially reported probability of malignancy ratings and seven-category forced BI-RADS ratings was evaluated by using areas under the receiver operating characteristic curve (AUCs) in the random-reader analysis. Results Probability of malignancy–based mean AUCs for SM and FFDM images alone was 0.894 and 0.889, respectively (difference, −0.005; 95% confidence interval [CI]: −0.062, 0.054; P = .85). Mean AUC for SM with tomosynthesis and FFDM with tomosynthesis was 0.916 and 0.939, respectively (difference, 0.023; 95% CI: −0.011, 0.057; P = .19). In terms of the reader-specific AUCs, five readers performed better with SM alone versus FFDM alone, and all eight readers performed better with combined FFDM and tomosynthesis (absolute differences from 0.003 to 0.052). Similar results were obtained by using a nonparametric analysis of forced BI-RADS ratings. Conclusion SM alone or in combination with tomosynthesis is comparable in performance to FFDM alone or in combination with tomosynthesis and may eliminate the need for FFDM as part of a routine clinical study. © RSNA, 2014 PMID:24475859

TOMOGRAPHIC MAMMOGRAPHY AND TOMOSYNTHESIS USING OPENGL

Directory of Open Access Journals (Sweden)

S. A. Zolotarev

2016-01-01

Full Text Available Computed tomography is still being intensively studied and widely used to solve a number of industrial and medical applications. The simultaneous algebraic reconstruction technique (SART and Bayesian inference reconstruction (BIR are considered as advantageous iteration methods that are most suitable for improving the quality of the reconstructed 3D-images. The paper deals with the parallel iterative algorithms to ensure the reconstruction of threedimensional images of the breast, recovered from a limited set of noisy X-ray projections. Algebraic method of reconstruction with simultaneous iterations – SART and iterative method for statistical reconstruction of BIR are deemed to be the most preferred iterative methods. We believe that these methods are particularly useful for improving the quality of breast reconstructed image. We use the graphics processor (GPU to accelerate the process of reconstruction. Preliminary results show that all investigated methods are useful in breast reconstruction layered images. However, it was found that the method of classical tomosynthesis SAA is less efficient than iterative methods SART and BIR as the worst suppress the anatomical noise. Despite the fact that the estimated ratio of the contrast / noise ratio in the presence of internal structures with low contrast is higher for classical tomosynthesis method the SAA, its effectiveness in the presence of highly structured background is low. In our opinion the best results can be achieved using statistical iterative reconstruction BIR.

Estimation of percentage breast tissue density: comparison between digital mammography (2D full field digital mammography) and digital breast tomosynthesis according to different BI-RADS categories.

Science.gov (United States)

Tagliafico, A S; Tagliafico, G; Cavagnetto, F; Calabrese, M; Houssami, N

2013-11-01

To compare breast density estimated from two-dimensional full-field digital mammography (2D FFDM) and from digital breast tomosynthesis (DBT) according to different Breast Imaging-Reporting and Data System (BI-RADS) categories, using automated software. Institutional review board approval and written informed patient consent were obtained. DBT and 2D FFDM were performed in the same patients to allow within-patient comparison. A total of 160 consecutive patients (mean age: 50±14 years; mean body mass index: 22±3) were included to create paired data sets of 40 patients for each BI-RADS category. Automatic software (MedDensity(©), developed by Giulio Tagliafico) was used to compare the percentage breast density between DBT and 2D FFDM. The estimated breast percentage density obtained using DBT and 2D FFDM was examined for correlation with the radiologists' visual BI-RADS density classification. The 2D FFDM differed from DBT by 16.0% in BI-RADS Category 1, by 11.9% in Category 2, by 3.5% in Category 3 and by 18.1% in Category 4. These differences were highly significant (pBI-RADS categories and the density evaluated using 2D FFDM and DBT (r=0.56, pBI-RADS categories. These data are relevant for clinical practice and research studies using density in determining the risk. On DBT, breast density values were lower than with 2D FFDM, with a non-linear relationship across the classical BI-RADS categories.

Tomosynthesis and contrast-enhanced digital mammography: recent advances in digital mammography

International Nuclear Information System (INIS)

Diekmann, Felix; Bick, Ulrich

2007-01-01

Digital mammography is more and more replacing conventional mammography. Initial concerns about an inferior image quality of digital mammography have been largely overcome and recent studies even show digital mammography to be superior in women with dense breasts, while at the same time reducing radiation exposure. Nevertheless, an important limitation of digital mammography remains: namely, the fact that summation may obscure lesions in dense breast tissue. However, digital mammography offers the option of so-called advanced applications, and two of these, contrast-enhanced mammography and tomosynthesis, are promising candidates for improving the detection of breast lesions otherwise obscured by the summation of dense tissue. Two techniques of contrast-enhanced mammography are available: temporal subtraction of images acquired before and after contrast administration and the so-called dual-energy technique, which means that pairs of low/high-energy images acquired after contrast administration are subtracted. Tomosynthesis on the other hand provides three-dimensional information on the breast. The images are acquired with different angulations of the X-ray tube while the object or detector is static. Various reconstruction algorithms can then be applied to the set of typically nine to 28 source images to reconstruct 1-mm slices with a reduced risk of obscuring pathology. Combinations of both advanced applications have only been investigated in individual experimental studies; more advanced software algorithms and CAD systems are still in their infancy and have only undergone preliminary clinical evaluation. (orig.)

TU-CD-207-09: Analysis of the 3-D Shape of Patients’ Breast for Breast Imaging and Surgery Planning

Energy Technology Data Exchange (ETDEWEB)

Agasthya, G; Sechopoulos, I [Emory University, Atlanta, GA (United States)

2015-06-15

Purpose: Develop a method to accurately capture the 3-D shape of patients’ external breast surface before and during breast compression for mammography/tomosynthesis. Methods: During this IRB-approved, HIPAA-compliant study, 50 women were recruited to undergo 3-D breast surface imaging during breast compression and imaging for the cranio-caudal (CC) view on a digital mammography/breast tomosynthesis system. Digital projectors and cameras mounted on tripods were used to acquire 3-D surface images of the breast, in three conditions: (a) positioned on the support paddle before compression, (b) during compression by the compression paddle and (c) the anterior-posterior view with the breast in its natural, unsupported position. The breast was compressed to standard full compression with the compression paddle and a tomosynthesis image was acquired simultaneously with the 3-D surface. The 3-D surface curvature and deformation with respect to the uncompressed surface was analyzed using contours. The 3-D surfaces were voxelized to capture breast shape in a format that can be manipulated for further analysis. Results: A protocol was developed to accurately capture the 3-D shape of patients’ breast before and during compression for mammography. Using a pair of 3-D scanners, the 50 patient breasts were scanned in three conditions, resulting in accurate representations of the breast surfaces. The surfaces were post processed, analyzed using contours and voxelized, with 1 mm{sup 3} voxels, converting the breast shape into a format that can be easily modified as required. Conclusion: Accurate characterization of the breast curvature and shape for the generation of 3-D models is possible. These models can be used for various applications such as improving breast dosimetry, accurate scatter estimation, conducting virtual clinical trials and validating compression algorithms. Ioannis Sechopoulos is consultant for Fuji Medical Systems USA.

Additional findings at preoperative breast MRI: the value of second-look digital breast tomosynthesis

Energy Technology Data Exchange (ETDEWEB)

Clauser, Paola; Pancot, Martina; Girometti, Rossano; Bazzocchi, Massimo; Zuiani, Chiara [University of Udine, Azienda Ospedaliero-Universitaria, ' ' S.Maria della Misericordia' ' , Institute of Diagnostic Radiology, Department of Medical and Biological Sciences, Udine (Italy); Carbonaro, Luca A. [IRCCS Policlinico San Donato, Unit of Radiology, Milan (Italy); Sardanelli, Francesco [IRCCS Policlinico San Donato, Unit of Radiology, Milan (Italy); Universita degli Studi di Milano, Department of Biomedical Sciences of Health, Milan (Italy)

2015-10-15

To evaluate second-look digital breast tomosynthesis (SL-DBT) for additional findings (AFs) at preoperative MRI compared with second-look ultrasound (SL-US). We included 135 patients with breast cancer who underwent digital mammography (DM), DBT, US, and MRI at two centres. MR images were retrospectively evaluated to find AFs, described as focus, mass, or non-mass; ≤10 mm or >10 mm in size; BI-RADS 3, 4, or 5. DM and DBT exams were reviewed looking for MRI AFs; data on SL-US were collected. Reference standard was histopathology or ≥12-month negative follow-up. Fisher exact test and McNemar test were used. Eighty-four AFs were detected in 53/135 patients (39 %, 95 %CI 31-48 %). A correlate was found for 44/84 (52 %, 95 %CI 41-63 %) at SL-US, for 20/84 (24 %, 95 %CI 11-28 %) at SL-DM, for 42/84 (50 %, 95 %CI 39-61 %) at SL-DBT, for 63/84 (75 %, 95 %CI 64-84 %) at SL-DBT, and/or SL-US, the last rate being higher than for SL-US only, overall (p < 0.001), for mass or non-mass, ≤ or >10 mm, BI-RADS 4 or 5, or malignant lesions (p < 0.031). Of 21 AFs occult at both SLs, 17 were malignant (81 %, 95 %CI 58-94 %). When adding SL-DBT to SL-US, AFs detection increased from 52 % to 75 %. MR-guided biopsy is needed for the remaining 25 %. (orig.)

Comparative study of patient doses calculated with two methods for breast digital tomosynthesis; Estudio de los valores de dosis a pacientes en examenes de tomosintesis de mama estimados con dos metodos distintos

Energy Technology Data Exchange (ETDEWEB)

Castillo, M.; Chevalier, M.; Calzado, A.; Garayo, J.; Valverde, J.

2015-07-01

In this study, the average glandular doses (DG) delivered in breast tomosynthesis examinations were estimated over a sample of 150 patients using two different methods. In method 1, the conversion factors air-kerma to DG used were those tabulated by Dance et al. and in method 2 were the ones from Feng et al. The protocol for the examination followed in the unit of this study consists in two views per breast, each view composed by a 2D acquisition and a tomosynthesis scan (3D). The resulting DG values from both methods present statistically significant differences (p=0.02) for the 2D modality and were similar for the 3D scan (p=0.22). The estimated median value of DG for the most frequent breasts (thicknesses between 50 and 60 mm) delivered in a single 3D acquisition is 1.7 mGy (36% and 17% higher than the value for the 2D mode estimated with each method) which lies far below the tolerances established by the Spanish Protocol Quality Control in Radiodiagnostic (2011). The total DG for a tomosynthesis examination (6.0 mGy) is a factor 2.4 higher than the dose delivered in a 2D examination with two views (method 1). (Author)

Amorphous In–Ga–Zn–O thin-film transistor active pixel sensor x-ray imager for digital breast tomosynthesis

Energy Technology Data Exchange (ETDEWEB)

Zhao, Chumin; Kanicki, Jerzy, E-mail: kanicki@eecs.umich.edu [Solid-State Electronic Laboratory, Department of Electrical Engineering and Computer Science, University of Michigan, Ann Arbor, Michigan 48109 (United States)

2014-09-15

Purpose: The breast cancer detection rate for digital breast tomosynthesis (DBT) is limited by the x-ray image quality. The limiting Nyquist frequency for current DBT systems is around 5 lp/mm, while the fine image details contained in the high spatial frequency region (>5 lp/mm) are lost. Also today the tomosynthesis patient dose is high (0.67–3.52 mGy). To address current issues, in this paper, for the first time, a high-resolution low-dose organic photodetector/amorphous In–Ga–Zn–O thin-film transistor (a-IGZO TFT) active pixel sensor (APS) x-ray imager is proposed for next generation DBT systems. Methods: The indirect x-ray detector is based on a combination of a novel low-cost organic photodiode (OPD) and a cesium iodide-based (CsI:Tl) scintillator. The proposed APS x-ray imager overcomes the difficulty of weak signal detection, when small pixel size and low exposure conditions are used, by an on-pixel signal amplification with a significant charge gain. The electrical performance of a-IGZO TFT APS pixel circuit is investigated by SPICE simulation using modified Rensselaer Polytechnic Institute amorphous silicon (a-Si:H) TFT model. Finally, the noise, detective quantum efficiency (DQE), and resolvability of the complete system are modeled using the cascaded system formalism. Results: The result demonstrates that a large charge gain of 31–122 is achieved for the proposed high-mobility (5–20 cm{sup 2}/V s) amorphous metal-oxide TFT APS. The charge gain is sufficient to eliminate the TFT thermal noise, flicker noise as well as the external readout circuit noise. Moreover, the low TFT (<10{sup −13} A) and OPD (<10{sup −8} A/cm{sup 2}) leakage currents can further reduce the APS noise. Cascaded system analysis shows that the proposed APS imager with a 75 μm pixel pitch can effectively resolve the Nyquist frequency of 6.67 lp/mm, which can be further improved to ∼10 lp/mm if the pixel pitch is reduced to 50 μm. Moreover, the

Amorphous In–Ga–Zn–O thin-film transistor active pixel sensor x-ray imager for digital breast tomosynthesis

International Nuclear Information System (INIS)

Zhao, Chumin; Kanicki, Jerzy

2014-01-01

Purpose: The breast cancer detection rate for digital breast tomosynthesis (DBT) is limited by the x-ray image quality. The limiting Nyquist frequency for current DBT systems is around 5 lp/mm, while the fine image details contained in the high spatial frequency region (>5 lp/mm) are lost. Also today the tomosynthesis patient dose is high (0.67–3.52 mGy). To address current issues, in this paper, for the first time, a high-resolution low-dose organic photodetector/amorphous In–Ga–Zn–O thin-film transistor (a-IGZO TFT) active pixel sensor (APS) x-ray imager is proposed for next generation DBT systems. Methods: The indirect x-ray detector is based on a combination of a novel low-cost organic photodiode (OPD) and a cesium iodide-based (CsI:Tl) scintillator. The proposed APS x-ray imager overcomes the difficulty of weak signal detection, when small pixel size and low exposure conditions are used, by an on-pixel signal amplification with a significant charge gain. The electrical performance of a-IGZO TFT APS pixel circuit is investigated by SPICE simulation using modified Rensselaer Polytechnic Institute amorphous silicon (a-Si:H) TFT model. Finally, the noise, detective quantum efficiency (DQE), and resolvability of the complete system are modeled using the cascaded system formalism. Results: The result demonstrates that a large charge gain of 31–122 is achieved for the proposed high-mobility (5–20 cm 2 /V s) amorphous metal-oxide TFT APS. The charge gain is sufficient to eliminate the TFT thermal noise, flicker noise as well as the external readout circuit noise. Moreover, the low TFT (<10 −13 A) and OPD (<10 −8 A/cm 2 ) leakage currents can further reduce the APS noise. Cascaded system analysis shows that the proposed APS imager with a 75 μm pixel pitch can effectively resolve the Nyquist frequency of 6.67 lp/mm, which can be further improved to ∼10 lp/mm if the pixel pitch is reduced to 50 μm. Moreover, the detector entrance

Real time radial and tangential tomosynthesis system dedicated to on line x-ray examination of moving objects

International Nuclear Information System (INIS)

Antonakios, M.; Rizo, Ph.; Lamarque, P.

2000-01-01

This presentation describes a system able to compute and display in real time a reconstructed image of a moving object using tomosynthesis methods. The object being moved on a known trajectory between the x-ray source and a detector, the tomosynthesis is focused on a given surface of the object and allows to reconstruct a sharp image of the structure on the surface superimposed to a blurred image of the surrounding plane. The developed tomosynthesis algorithm is based on a set of look up tables which provide for each position of the object on the trajectory, the projection of a given point of the imaged surface of the object on the detector. Several hundreds of frames can be combined to compute the tomosynthesis image. The signal-to-noise ratio obtained on processed images is equivalent to the one obtained by averaging images with a static object. In order to speed up the tomosynthesis reconstruction and to reach the video frame rate, we integrated a DSP based hardware in a PC host. The geometric calibration parameters and the look up tables are pre-computed on the PC. The on-line tomosynthesis calculation is carried out by the multi DSP architecture which manages in real time, frame acquisition, parallel tomosynthesis calculation and output image display. On this particular implementation of tomosynthesis, up to hundred video frames can be combined. We illustrate the potential of this system on an application of the tomosynthesis to solid rocket motor examination

Transfer learning with convolutional neural networks for lesion classification on clinical breast tomosynthesis

Science.gov (United States)

Mendel, Kayla R.; Li, Hui; Sheth, Deepa; Giger, Maryellen L.

2018-02-01

With growing adoption of digital breast tomosynthesis (DBT) in breast cancer screening protocols, it is important to compare the performance of computer-aided diagnosis (CAD) in the diagnosis of breast lesions on DBT images compared to conventional full-field digital mammography (FFDM). In this study, we retrospectively collected FFDM and DBT images of 78 lesions from 76 patients, each containing lesions that were biopsy-proven as either malignant or benign. A square region of interest (ROI) was placed to fully cover the lesion on each FFDM, DBT synthesized 2D images, and DBT key slice images in the cranial-caudal (CC) and mediolateral-oblique (MLO) views. Features were extracted on each ROI using a pre-trained convolutional neural network (CNN). These features were then input to a support vector machine (SVM) classifier, and area under the ROC curve (AUC) was used as the figure of merit. We found that in both the CC view and MLO view, the synthesized 2D image performed best (AUC = 0.814, AUC = 0.881 respectively) in the task of lesion characterization. Small database size was a key limitation in this study, and could lead to overfitting in the application of the SVM classifier. In future work, we plan to expand this dataset and to explore more robust deep learning methodology such as fine-tuning.

Balancing dose and image registration accuracy for cone beam tomosynthesis (CBTS) for breast patient setup

International Nuclear Information System (INIS)

Winey, B. A.; Zygmanski, P.; Cormack, R. A.; Lyatskaya, Y.

2010-01-01

Purpose: To balance dose reduction and image registration accuracy in breast setup imaging. In particular, the authors demonstrate the relationship between scan angle and dose delivery for cone beam tomosynthesis (CBTS) when employed for setup verification of breast cancer patients with surgical clips. Methods: The dose measurements were performed in a female torso phantom for varying scan angles of CBTS. Setup accuracy was measured using three registration methods: Clip centroid localization accuracy and the accuracy of two semiautomatic registration algorithms. The dose to the organs outside of the ipsilateral breast and registration accuracy information were compared to determine the optimal scan angle for CBTS for breast patient setup verification. Isocenter positions at the center of the patient and at the breast-chest wall interface were considered. Results: Image registration accuracy was within 1 mm for the CBTS scan angles θ above 20 deg. for some scenarios and as large as 80 deg. for the worst case, depending on the imaged breast and registration algorithm. Registration accuracy was highest based on clip centroid localization. For left and right breast imaging with the isocenter at the chest wall, the dose to the contralateral side of the patient was very low (<0.5 cGy) for all scan angles considered. For central isocenter location, the optimal scan angles were 30 deg. - 50 deg. for the left breast imaging and 40 deg. - 50 deg. for the right breast imaging, with the difference due to the geometric asymmetry of the current clinical imaging system. Conclusions: The optimal scan angles for CBTS imaging were found to be between 10 deg. and 50 deg., depending on the isocenter location and ipsilateral breast. Use of the isocenter at the breast-chest wall locations always resulted in greater accuracy of image registration (<1 mm) at smaller angles (10 deg. - 20 deg.) and at lower doses (<0.1 cGy) to the contralateral organs. For chest wall isocenters, doses

Enhanced imaging of microcalcifications in digital breast tomosynthesis through improved image-reconstruction algorithms

International Nuclear Information System (INIS)

Sidky, Emil Y.; Pan Xiaochuan; Reiser, Ingrid S.; Nishikawa, Robert M.; Moore, Richard H.; Kopans, Daniel B.

2009-01-01

Purpose: The authors develop a practical, iterative algorithm for image-reconstruction in undersampled tomographic systems, such as digital breast tomosynthesis (DBT). Methods: The algorithm controls image regularity by minimizing the image total p variation (TpV), a function that reduces to the total variation when p=1.0 or the image roughness when p=2.0. Constraints on the image, such as image positivity and estimated projection-data tolerance, are enforced by projection onto convex sets. The fact that the tomographic system is undersampled translates to the mathematical property that many widely varied resultant volumes may correspond to a given data tolerance. Thus the application of image regularity serves two purposes: (1) Reduction in the number of resultant volumes out of those allowed by fixing the data tolerance, finding the minimum image TpV for fixed data tolerance, and (2) traditional regularization, sacrificing data fidelity for higher image regularity. The present algorithm allows for this dual role of image regularity in undersampled tomography. Results: The proposed image-reconstruction algorithm is applied to three clinical DBT data sets. The DBT cases include one with microcalcifications and two with masses. Conclusions: Results indicate that there may be a substantial advantage in using the present image-reconstruction algorithm for microcalcification imaging.

In-plane visibility of lesions using breast tomosynthesis and digital mammography

International Nuclear Information System (INIS)

Timberg, P.; Baath, M.; Andersson, I.; Mattsson, S.; Tingberg, A.; Ruschin, M.

2010-01-01

Purpose: The purpose of this work was to evaluate the visibility of simulated lesions in 2D digital mammography (DM) and breast tomosynthesis (BT) images of patients. Methods: Images of the same women were acquired on both a DM system (Mammomat Novation, Siemens Healthcare, Erlangen, Germany) and a BT prototype system adapted from the same type of DM system. Using the geometrical properties of the two systems, simulated lesions were projected and added to each DM image as well as to each BT projection image prior to 3D reconstruction. The same beam quality and approximately the same total absorbed dose to the glandular tissue were used for each breast image acquisition on the two systems. A series of four-alternative forced choice human observer experiments was conducted for each of five simulated lesion diameters: 0.2, 1, 3, 8, and 25 mm. An additional experiment was conducted for the 0.2 mm lesion in BT only at twice the dose level (BT 2x ). Threshold signal was defined as the lesion signal intensity required for a detectability index (d ' ) of 2.5. Four medical physicists participated in all experiments. One experiment, consisting of 60 cases, was conducted per test condition (i.e., lesion size and signal combination). Results: For the smallest lesions (0.2 mm), the threshold signal for DM was 21% lower than for BT at equivalent dose levels, and BT 2x was 26% lower than DM. For the lesions larger than 1 mm, the threshold signal increased linearly (in log space) with the lesion diameter for both DM and BT, with DM requiring around twice the signal as BT. The difference in the threshold signal between BT and DM at each lesion size was statistically significant, except for the 0.2 mm lesion between BT 2x and DM. Conclusions: The results of this study indicate that low-signal lesions larger than 1.0 mm may be more visible in BT compared to DM, whereas 0.2 mm lesions may be better visualized with DM compared to BT, when compared at equal dose.

Evaluation of a breast software model for 2D and 3D X-ray imaging studies of the breast.

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Baneva, Yanka; Bliznakova, Kristina; Cockmartin, Lesley; Marinov, Stoyko; Buliev, Ivan; Mettivier, Giovanni; Bosmans, Hilde; Russo, Paolo; Marshall, Nicholas; Bliznakov, Zhivko

2017-09-01

In X-ray imaging, test objects reproducing breast anatomy characteristics are realized to optimize issues such as image processing or reconstruction, lesion detection performance, image quality and radiation induced detriment. Recently, a physical phantom with a structured background has been introduced for both 2D mammography and breast tomosynthesis. A software version of this phantom and a few related versions are now available and a comparison between these 3D software phantoms and the physical phantom will be presented. The software breast phantom simulates a semi-cylindrical container filled with spherical beads of different diameters. Four computational breast phantoms were generated with a dedicated software application and for two of these, physical phantoms are also available and they are used for the side by side comparison. Planar projections in mammography and tomosynthesis were simulated under identical incident air kerma conditions. Tomosynthesis slices were reconstructed with an in-house developed reconstruction software. In addition to a visual comparison, parameters like fractal dimension, power law exponent β and second order statistics (skewness, kurtosis) of planar projections and tomosynthesis reconstructed images were compared. Visually, an excellent agreement between simulated and real planar and tomosynthesis images is observed. The comparison shows also an overall very good agreement between parameters evaluated from simulated and experimental images. The computational breast phantoms showed a close match with their physical versions. The detailed mathematical analysis of the images confirms the agreement between real and simulated 2D mammography and tomosynthesis images. The software phantom is ready for optimization purpose and extrapolation of the phantom to other breast imaging techniques. Copyright © 2017 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

Comparison of synthetic mammography, reconstructed from digital breast tomosynthesis, and digital mammography: evaluation of lesion conspicuity and BI-RADS assessment categories.

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Mariscotti, Giovanna; Durando, Manuela; Houssami, Nehmat; Fasciano, Mirella; Tagliafico, Alberto; Bosco, Davide; Casella, Cristina; Bogetti, Camilla; Bergamasco, Laura; Fonio, Paolo; Gandini, Giovanni

2017-12-01

To compare the interpretive performance of synthetic mammography (SM), reconstructed from digital breast tomosynthesis (DBT), and full-field digital mammography (FFDM) in a diagnostic setting, covering different conditions of breast density and mammographic signs. A retrospective analysis was conducted on 231 patients, who underwent FFDM and DBT (from which SM images were reconstructed) between September 2014-September 2015. The study included 250 suspicious breast lesions, all biopsy proven: 148 (59.2%) malignant and 13 (5.2%) high-risk lesions were confirmed by surgery, 89 (35.6%) benign lesions had radiological follow-up. Two breast radiologists, blinded to histology, independently reviewed all cases. Readings were performed with SM alone, then with FFDM, collecting data on: probability of malignancy for each finding, lesion conspicuity, mammographic features and dimensions of detected lesions. Agreement between readers was good for BI-RADS classification (Cohen's k-coefficient = 0.93 ± 0.02) and for lesion dimension (Wilcoxon's p = 0.76). Visibility scores assigned to SM and FFDM for each lesion were similar for non-dense and dense breasts, however, there were significant differences (p = 0.0009) in distribution of mammographic features subgroups. SM and FFDM had similar sensitivities in non-dense (respectively 94 vs. 91%) and dense breasts (88 vs. 80%) and for all mammographic signs (93 vs. 87% for asymmetric densities, 96 vs. 75% for distortion, 92 vs. 85% for microcalcifications, and both 94% for masses). Based on all data, there was a significant difference in sensitivity for SM (92%) vs. FFDM (87%), p = 0.02, whereas the two modalities yielded similar results for specificity (SM: 60%, FFDM: 62%, p = 0.21). SM alone showed similar interpretive performance to FFDM, confirming its potential role as an alternative to FFDM in women having tomosynthesis, with the added advantage of halving the patient's dose exposure.

Comparative evaluation of average glandular dose and breast cancer detection between single-view digital breast tomosynthesis (DBT) plus single-view digital mammography (DM) and two-view DM: correlation with breast thickness and density

International Nuclear Information System (INIS)

Shin, Sung Ui; Chang, Jung Min; Bae, Min Sun; Lee, Su Hyun; Cho, Nariya; Seo, Mirinae; Kim, Won Hwa; Moon, Woo Kyung

2015-01-01

To compare the average glandular dose (AGD) and diagnostic performance of mediolateral oblique (MLO) digital breast tomosynthesis (DBT) plus cranio-caudal (CC) digital mammography (DM) with two-view DM, and to evaluate the correlation of AGD with breast thickness and density. MLO and CC DM and DBT images of both breasts were obtained in 149 subjects. AGDs of DBT and DM per exposure were recorded, and their correlation with breast thickness and density were evaluated. Paired data of MLO DBT plus CC DM and two-view DM were reviewed for presence of malignancy in a jack-knife alternative free-response ROC (JAFROC) method. The AGDs of both DBT and DM, and differences in AGD between DBT and DM (ΔAGD), were correlated with breast thickness and density. The average JAFROC figure of merit (FOM) was significantly higher on the combined technique than two-view DM (P = 0.005). In dense breasts, the FOM and sensitivity of the combined technique was higher than that of two-view DM (P = 0.003) with small ΔAGD. MLO DBT plus CC DM provided higher diagnostic performance than two-view DM in dense breasts with a small increase in AGD. (orig.)

Comparative evaluation of average glandular dose and breast cancer detection between single-view digital breast tomosynthesis (DBT) plus single-view digital mammography (DM) and two-view DM: correlation with breast thickness and density

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Shin, Sung Ui; Chang, Jung Min; Bae, Min Sun; Lee, Su Hyun; Cho, Nariya; Seo, Mirinae; Kim, Won Hwa; Moon, Woo Kyung [Seoul National University Hospital, Department of Radiology, Seoul (Korea, Republic of)

2015-01-15

To compare the average glandular dose (AGD) and diagnostic performance of mediolateral oblique (MLO) digital breast tomosynthesis (DBT) plus cranio-caudal (CC) digital mammography (DM) with two-view DM, and to evaluate the correlation of AGD with breast thickness and density. MLO and CC DM and DBT images of both breasts were obtained in 149 subjects. AGDs of DBT and DM per exposure were recorded, and their correlation with breast thickness and density were evaluated. Paired data of MLO DBT plus CC DM and two-view DM were reviewed for presence of malignancy in a jack-knife alternative free-response ROC (JAFROC) method. The AGDs of both DBT and DM, and differences in AGD between DBT and DM (ΔAGD), were correlated with breast thickness and density. The average JAFROC figure of merit (FOM) was significantly higher on the combined technique than two-view DM (P = 0.005). In dense breasts, the FOM and sensitivity of the combined technique was higher than that of two-view DM (P = 0.003) with small ΔAGD. MLO DBT plus CC DM provided higher diagnostic performance than two-view DM in dense breasts with a small increase in AGD. (orig.)

Digital breast tomosynthesis: studies of the effects of acquisition geometry on contrast-to-noise ratio and observer preference of low-contrast objects in breast phantom images

International Nuclear Information System (INIS)

Goodsitt, Mitchell M; Chan, Heang-Ping; Telang, Santosh; Hadjiiski, Lubomir; Helvie, Mark A; Paramagul, Chintana; Neal, Colleen; Christodoulou, Emmanuel; Larson, Sandra C; Carson, Paul L; Schmitz, Andrea; Zelakiewicz, Scott; Watcharotone, Kuanwong

2014-01-01

The effect of acquisition geometry in digital breast tomosynthesis was evaluated with studies of contrast-to-noise ratios (CNRs) and observer preference. Contrast-detail (CD) test objects in 5 cm thick phantoms with breast-like backgrounds were imaged. Twelve different angular acquisitions (average glandular dose for each ∼1.1 mGy) were performed ranging from narrow angle 16° with 17 projection views (16d17p) to wide angle 64d17p. Focal slices of SART-reconstructed images of the CD arrays were selected for CNR computations and the reader preference study. For the latter, pairs of images obtained with different acquisition geometries were randomized and scored by 7 trained readers. The total scores for all images and readings for each acquisition geometry were compared as were the CNRs. In general, readers preferred images acquired with wide angle as opposed to narrow angle geometries. The mean percent preferred was highly correlated with tomosynthesis angle (R = 0.91). The highest scoring geometries were 60d21p (95%), 64d17p (80%), and 48d17p (72%); the lowest scoring were 16d17p (4%), 24d9p (17%) and 24d13p (33%). The measured CNRs for the various acquisitions showed much overlap but were overall highest for wide-angle acquisitions. Finally, the mean reader scores were well correlated with the mean CNRs (R = 0.83). (paper)

Digital breast tomosynthesis: Studies of the effects of acquisition geometry on contrast-to-noise ratio and observer preference of low-contrast objects in breast phantom images

Science.gov (United States)

Goodsitt, Mitchell M.; Chan, Heang-Ping; Schmitz, Andrea; Zelakiewicz, Scott; Telang, Santosh; Hadjiiski, Lubomir; Watcharotone, Kuanwong; Helvie, Mark A.; Paramagul, Chintana; Neal, Colleen; Christodoulou, Emmanuel; Larson, Sandra C.; Carson, Paul L.

2014-01-01

The effect of acquisition geometry in digital breast tomosynthesis (DBT) was evaluated with studies of contrast-to-noise ratios (CNRs) and observer preference. Contrast-detail (CD) test objects in 5 cm thick phantoms with breast-like backgrounds were imaged. Twelve different angular acquisitions (average glandular dose for each ~1.1 mGy) were performed ranging from narrow angle 16° with 17 projection views (16d17p) to wide angle 64d17p. Focal slices of SART-reconstructed images of the CD arrays were selected for CNR computations and the reader preference study. For the latter, pairs of images obtained with different acquisition geometries were randomized and scored by 7 trained readers. The total scores for all images and readings for each acquisition geometry were compared as were the CNRs. In general, readers preferred images acquired with wide angle as opposed to narrow angle geometries. The mean percent preferred was highly correlated with tomosynthesis angle (R=0.91). The highest scoring geometries were 60d21p (95%), 64d17p (80%), and 48d17p (72%); the lowest scoring were 16d17p (4%), 24d9p (17%) and 24d13p (33%). The measured CNRs for the various acquisitions showed much overlap but were overall highest for wide-angle acquisitions. Finally, the mean reader scores were well correlated with the mean CNRs (R=0.83). PMID:25211509

New reconstruction algorithm for digital breast tomosynthesis: better image quality for humans and computers.

Science.gov (United States)

Rodriguez-Ruiz, Alejandro; Teuwen, Jonas; Vreemann, Suzan; Bouwman, Ramona W; van Engen, Ruben E; Karssemeijer, Nico; Mann, Ritse M; Gubern-Merida, Albert; Sechopoulos, Ioannis

2017-01-01

Background The image quality of digital breast tomosynthesis (DBT) volumes depends greatly on the reconstruction algorithm. Purpose To compare two DBT reconstruction algorithms used by the Siemens Mammomat Inspiration system, filtered back projection (FBP), and FBP with iterative optimizations (EMPIRE), using qualitative analysis by human readers and detection performance of machine learning algorithms. Material and Methods Visual grading analysis was performed by four readers specialized in breast imaging who scored 100 cases reconstructed with both algorithms (70 lesions). Scoring (5-point scale: 1 = poor to 5 = excellent quality) was performed on presence of noise and artifacts, visualization of skin-line and Cooper's ligaments, contrast, and image quality, and, when present, lesion visibility. In parallel, a three-dimensional deep-learning convolutional neural network (3D-CNN) was trained (n = 259 patients, 51 positives with BI-RADS 3, 4, or 5 calcifications) and tested (n = 46 patients, nine positives), separately with FBP and EMPIRE volumes, to discriminate between samples with and without calcifications. The partial area under the receiver operating characteristic curve (pAUC) of each 3D-CNN was used for comparison. Results EMPIRE reconstructions showed better contrast (3.23 vs. 3.10, P = 0.010), image quality (3.22 vs. 3.03, P algorithm provides DBT volumes with better contrast and image quality, fewer artifacts, and improved visibility of calcifications for human observers, as well as improved detection performance with deep-learning algorithms.

Digital Breast Tomosynthesis Practice Patterns Following 2011 FDA Approval: A Survey of Breast Imaging Radiologists.

Science.gov (United States)

Gao, Yiming; Babb, James S; Toth, Hildegard K; Moy, Linda; Heller, Samantha L

2017-08-01

To evaluate uptake, patterns of use, and perception of digital breast tomosynthesis (DBT) among practicing breast radiologists. Institutional Review Board exemption was obtained for this Health Insurance Portability and Accountability Act-compliant electronic survey, sent to 7023 breast radiologists identified via the Radiological Society of North America database. Respondents were asked of their geographic location and practice type. DBT users reported length of use, selection criteria, interpretive sequences, recall rate, and reading time. Radiologist satisfaction with DBT as a diagnostic tool was assessed (1-5 scale). There were 1156 (16.5%) responders, 65.8% from the United States and 34.2% from abroad. Of these, 749 (68.6%) use DBT; 22.6% in academia, 56.5% private, and 21% other. Participants are equally likely to report use of DBT if they worked in academics versus in private practice (78.2% [169 of 216] vs 71% [423 of 596]) (odds ratio, 1.10; 95% confidence interval: 0.87-1.40; P = 1.000). Of nonusers, 43% (147 of 343) plan to adopt DBT. No US regional differences in uptake were observed (P = 1.000). Although 59.3% (416 of 702) of DBT users include synthetic 2D (s2D) for interpretation, only 24.2% (170 of 702) use s2D alone. Majority (66%; 441 of 672) do not perform DBT-guided procedures. Radiologist (76.6%) (544 of 710) satisfaction with DBT as a diagnostic tool is high (score ≥ 4/5). DBT is being adopted worldwide across all practice types, yet variations in examination indication, patient selection, utilization of s2D images, and access to DBT-guided procedures persist, highlighting the need for consensus and standardization. Copyright © 2017 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

SU-E-J-63: Feasibility Study of Proton Digital Tomosynthesis in Proton Beam Therapy.

Science.gov (United States)

Min, B; Kwak, J; Lee, J; Cho, S; Park, S; Yoo, S; Chung, K; Cho, S; Lim, Y; Shin, D; Lee, S; Kim, J

2012-06-01

We investigated the feasibility of proton tomosynthesis as daily positioning of patients and compared the results with photon tomosynthesis as an alternative to conventional portal imaging or on-board cone-beam computed tomography. Dedicated photon-like proton beam using the passively scattered proton beams by the cyclotron was generated for proton imaging. The eleven projections were acquired over 30 degree with 3 degree increment in order to investigate the performance of proton tomosynthesis. The cylinder blocks and resolution phantom were used to evaluate imaging performance. Resolution phantom of a cylinder of diameter 12 cm was used to investigate the reconstructed imaging characteristics. Electron density cylinder blocks with diameter of 28 mm and height of 70 mm were employed to assess the imaging quality. The solid water, breast, bone, adipose, lung, muscle, and liver, which were tissue equivalent inserts, were positioned around the resolution phantom. The images were reconstructed by projection onto convex sets (POCS) algorithm and total variation minimization (TVM) methods. The Gafchromic EBT films were utilized for measuring the photon-like proton beams as a proton detector. In addition, the photon tomosynthesis images were obtained for a comparison with proton tomosynthesis images. The same angular sampling data were acquired for both proton and photon tomosynthesis. In the resolution phantom image obtained proton tomosynthesis, down to 1.6 mm diameter rods were resolved visually, although the separation between adjacent rods was less distinct. In contrast, down to 1.2 mm diameter rods were resolved visually in the reconstructed image obtained photon tomosynthesis. Both proton and photon tomosynthesis images were similar in intensities of different density blocks. Our results demonstrated that proton tomosynthesis could make it possible to provide comparable tomography imaging to photon tomosynthesis for positioning as determined by manual registration

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

Science.gov (United States)

Wu, Di; Yan, Aimin; Li, Yuhua; Wong, Molly D; Zheng, Bin; Wu, Xizeng; Liu, Hong

2015-05-01

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

Preliminary Clinical Experience with Digital Breast Tomosynthesis in the Visualization of Breast Microcalcifications

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Stamatia V Destounis

2013-01-01

Full Text Available Objectives: To compare the visualization and image quality of microcalcifications imaged with digital breast tomosynthesis (DBT versus conventional digital mammography. Materials and Methods: Patients with microcalcifications detected on full field digital mammography (FFDM recommended for needle core biopsy were enrolled in the study after obtaining patient′s consent and institutional review board approval (n = 177 patients, 179 lesions. All had a bilateral combination DBT exam, after undergoing routine digital mammography, prior to biopsy. The study radiologist reviewed the FFDM and DBT images in a non-blinded comparison and assessed the visibility of the microcalcifications with both methods, including image quality and clarity with which the calcifications were seen. Data recorded included patient demographics, lesion size on FFDM, DBT, and surgical excision (when applicable, biopsy, and surgical pathology, if any. Results: Average lesion size on DBT was 1.5 cm; average lesion size on FFDM was 1.4 cm. The image quality of DBT was assessed as equivalent or superior in 92.2% of cases. In 7.8% of the cases, the FFDM image quality was assessed as equivalent or superior. Conclusion: In our review, DBT image quality appears to be comparable to or better than conventional FFDM in terms of demonstrating microcalcifications, as shown in 92.2% of cases.

Correlation of contrast agent kinetics between iodinated contrast-enhanced spectral tomosynthesis and gadolinium-enhanced MRI of breast lesions

International Nuclear Information System (INIS)

Froeling, Vera; Diekmann, Felix; Renz, Diane M.; Fallenberg, Eva M.; Steffen, Ingo G.; Diekmann, Susanne; Schmitzberger, Florian F.; Lawaczeck, Ruediger

2013-01-01

Assessment of contrast agent kinetics in contrast-enhanced MRI (CE-MRI) with gadolinium-containing contrast agents offers the opportunity to predict breast lesion malignancy. The goal of our study was to determine if similar patterns exist for spectral contrast-enhanced digital breast tomosynthesis (CE-DBT) using an iodinated contrast agent. The protocol of our prospective study was approved by the relevant institutional review board and the German Federal Office for Radiation Protection. All patients provided written informed consent. We included 21 women with a mean age of 62.4 years. All underwent ultrasound-guided biopsy of a suspect breast lesion, spectral CE-DBT and CE-MRI. For every breast lesion, contrast agent kinetics was assessed by signal intensity-time curves for spectral CE-DBT and CE-MRI. Statistical comparison used Cohen's kappa and Spearman's rho test. Spearman's rho of 0.49 showed significant (P = 0.036) correlation regarding the contrast agent kinetics in signal intensity-time curves for spectral CE-DBT and CE-MRI. Cohen's kappa indicated moderate agreement (kappa = 0.438). There is a statistically significant correlation between contrast agent kinetics in the signal intensity-time curves for spectral CE-DBT and CE-MRI. Observing intralesional contrast agent kinetics in spectral CE-DBT may aid evaluation of malignant breast lesions. (orig.)

A limited memory BFGS method for a nonlinear inverse problem in digital breast tomosynthesis

Science.gov (United States)

Landi, G.; Loli Piccolomini, E.; Nagy, J. G.

2017-09-01

Digital breast tomosynthesis (DBT) is an imaging technique that allows the reconstruction of a pseudo three-dimensional image of the breast from a finite number of low-dose two-dimensional projections obtained by different x-ray tube angles. An issue that is often ignored in DBT is the fact that an x-ray beam is polyenergetic, i.e. it is composed of photons with different levels of energy. The polyenergetic model requires solving a large-scale, nonlinear inverse problem, which is more expensive than the typically used simplified, linear monoenergetic model. However, the polyenergetic model is much less susceptible to beam hardening artifacts, which show up as dark streaks and cupping (i.e. background nonuniformities) in the reconstructed image. In addition, it has been shown that the polyenergetic model can be exploited to obtain additional quantitative information about the material of the object being imaged. In this paper we consider the multimaterial polyenergetic DBT model, and solve the nonlinear inverse problem with a limited memory BFGS quasi-Newton method. Regularization is enforced at each iteration using a diagonally modified approximation of the Hessian matrix, and by truncating the iterations.

Evaluation of the possibility to use thick slabs of reconstructed outer breast tomosynthesis slice images

Science.gov (United States)

Petersson, Hannie; Dustler, Magnus; Tingberg, Anders; Timberg, Pontus

2016-03-01

The large image volumes in breast tomosynthesis (BT) have led to large amounts of data and a heavy workload for breast radiologists. The number of slice images can be decreased by combining adjacent image planes (slabbing) but the decrease in depth resolution can considerably affect the detection of lesions. The aim of this work was to assess if thicker slabbing of the outer slice images (where lesions seldom are present) could be a viable alternative in order to reduce the number of slice images in BT image volumes. The suggested slabbing (an image volume with thick outer slabs and thin slices between) were evaluated in two steps. Firstly, a survey of the depth of 65 cancer lesions within the breast was performed to estimate how many lesions would be affected by outer slabs of different thicknesses. Secondly, a selection of 24 lesions was reconstructed with 2, 6 and 10 mm slab thickness to evaluate how the appearance of lesions located in the thicker slabs would be affected. The results show that few malignant breast lesions are located at a depth less than 10 mm from the surface (especially for breast thicknesses of 50 mm and above). Reconstruction of BT volumes with 6 mm slab thickness yields an image quality that is sufficient for lesion detection for a majority of the investigated cases. Together, this indicates that thicker slabbing of the outer slice images is a promising option in order to reduce the number of slice images in BT image volumes.

Simulation of dose reduction in tomosynthesis

International Nuclear Information System (INIS)

Svalkvist, Angelica; Baath, Magnus

2010-01-01

Purpose: Methods for simulating dose reduction are valuable tools in the work of optimizing radiographic examinations. Using such methods, clinical images can be simulated to have been collected at other, lower, dose levels without the need of additional patient exposure. A recent technology introduced to healthcare that needs optimization is tomosynthesis, where a number of low-dose projection images collected at different angles is used to reconstruct section images of an imaged object. The aim of the present work was to develop a method of simulating dose reduction for digital radiographic systems, suitable for tomosynthesis. Methods: The developed method uses information about the noise power spectrum (NPS) at the original dose level and the simulated dose level to create a noise image that is added to the original image to produce an image that has the same noise properties as an image actually collected at the simulated dose level. As the detective quantum efficiency (DQE) of digital detectors operating at the low dose levels used for tomosynthesis may show a strong dependency on the dose level, it is important that a method for simulating dose reduction for tomosynthesis takes this dependency into account. By applying an experimentally determined relationship between pixel mean and pixel variance, variations in both dose and DQE in relevant dose ranges are taken into account. Results: The developed method was tested on a chest tomosynthesis system and was shown to produce NPS of simulated dose-reduced projection images that agreed well with the NPS of images actually collected at the simulated dose level. The simulated dose reduction method was also applied to tomosynthesis examinations of an anthropomorphic chest phantom, and the obtained noise in the reconstructed section images was very similar to that of an examination actually performed at the simulated dose level. Conclusions: In conclusion, the present article describes a method for simulating dose

A novel solid-angle tomosynthesis (SAT) scanning scheme

International Nuclear Information System (INIS)

Zhang Jin; Yu, Cedric

2010-01-01

Purpose: Digital tomosynthesis (DTS) recently gained extensive research interests in both diagnostic and radiation therapy fields. Conventional DTS images are generated by scanning an x-ray source and flat-panel detector pair on opposite sides of an object, with the scanning trajectory on a one-dimensional curve. A novel tomosynthesis method named solid-angle tomosynthesis (SAT) is proposed, where the x-ray source scans on an arbitrary shaped two-dimensional surface. Methods: An iterative algorithm in the form of total variation regulated expectation maximization is developed for SAT image reconstruction. The feasibility and effectiveness of SAT is corroborated by computer simulation studies using three-dimensional (3D) numerical phantoms including a 3D Shepp-Logan phantom and a volumetric CT image set of a human breast. Results: SAT is able to cover more space in Fourier domain more uniformly than conventional DTS. Greater coverage and more isotropy in the frequency domain translate to fewer artifacts and more accurately restored features in the in-plane reconstruction. Conclusions: Comparing with conventional DTS, SAT allows cone-shaped x-ray beams to project from more solid angles, thus provides more coverage in the spatial-frequency domain, resulting in better quality of reconstructed image.

Breast tissue classification in digital tomosynthesis images based on global gradient minimization and texture features

Science.gov (United States)

Qin, Xulei; Lu, Guolan; Sechopoulos, Ioannis; Fei, Baowei

2014-03-01

Digital breast tomosynthesis (DBT) is a pseudo-three-dimensional x-ray imaging modality proposed to decrease the effect of tissue superposition present in mammography, potentially resulting in an increase in clinical performance for the detection and diagnosis of breast cancer. Tissue classification in DBT images can be useful in risk assessment, computer-aided detection and radiation dosimetry, among other aspects. However, classifying breast tissue in DBT is a challenging problem because DBT images include complicated structures, image noise, and out-of-plane artifacts due to limited angular tomographic sampling. In this project, we propose an automatic method to classify fatty and glandular tissue in DBT images. First, the DBT images are pre-processed to enhance the tissue structures and to decrease image noise and artifacts. Second, a global smooth filter based on L0 gradient minimization is applied to eliminate detailed structures and enhance large-scale ones. Third, the similar structure regions are extracted and labeled by fuzzy C-means (FCM) classification. At the same time, the texture features are also calculated. Finally, each region is classified into different tissue types based on both intensity and texture features. The proposed method is validated using five patient DBT images using manual segmentation as the gold standard. The Dice scores and the confusion matrix are utilized to evaluate the classified results. The evaluation results demonstrated the feasibility of the proposed method for classifying breast glandular and fat tissue on DBT images.

X-ray induced formation of γ-H2AX foci after full-field digital mammography and digital breast-tomosynthesis.

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Siegfried A Schwab

Full Text Available PURPOSE: To determine in-vivo formation of x-ray induced γ-H2AX foci in systemic blood lymphocytes of patients undergoing full-field digital mammography (FFDM and to estimate foci after FFDM and digital breast-tomosynthesis (DBT using a biological phantom model. MATERIALS AND METHODS: The study complies with the Declaration of Helsinki and was performed following approval by the ethic committee of the University of Erlangen-Nuremberg. Written informed consent was obtained from every patient. For in-vivo tests, systemic blood lymphocytes were obtained from 20 patients before and after FFDM. In order to compare in-vivo post-exposure with pre-exposure foci levels, the Wilcoxon matched pairs test was used. For in-vitro experiments, isolated blood lymphocytes from healthy volunteers were irradiated at skin and glandular level of a porcine breast using FFDM and DBT. Cells were stained against the phosphorylated histone variant γ-H2AX, and foci representing distinct DNA damages were quantified. RESULTS: Median in-vivo foci level/cell was 0.086 (range 0.067-0.116 before and 0.094 (0.076-0.126 after FFDM (p = 0.0004. In the in-vitro model, the median x-ray induced foci level/cell after FFDM was 0.120 (range 0.086-0.140 at skin level and 0.035 (range 0.030-0.050 at glandular level. After DBT, the median x-ray induced foci level/cell was 0.061 (range 0.040-0.081 at skin level and 0.015 (range 0.006-0.020 at glandular level. CONCLUSION: In patients, mammography induces a slight but significant increase of γ-H2AX foci in systemic blood lymphocytes. The introduced biological phantom model is suitable for the estimation of x-ray induced DNA damages in breast tissue in different breast imaging techniques.

50 μm pixel pitch wafer-scale CMOS active pixel sensor x-ray detector for digital breast tomosynthesis.

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Zhao, C; Konstantinidis, A C; Zheng, Y; Anaxagoras, T; Speller, R D; Kanicki, J

2015-12-07

Wafer-scale CMOS active pixel sensors (APSs) have been developed recently for x-ray imaging applications. The small pixel pitch and low noise are very promising properties for medical imaging applications such as digital breast tomosynthesis (DBT). In this work, we evaluated experimentally and through modeling the imaging properties of a 50 μm pixel pitch CMOS APS x-ray detector named DynAMITe (Dynamic Range Adjustable for Medical Imaging Technology). A modified cascaded system model was developed for CMOS APS x-ray detectors by taking into account the device nonlinear signal and noise properties. The imaging properties such as modulation transfer function (MTF), noise power spectrum (NPS), and detective quantum efficiency (DQE) were extracted from both measurements and the nonlinear cascaded system analysis. The results show that the DynAMITe x-ray detector achieves a high spatial resolution of 10 mm(-1) and a DQE of around 0.5 at spatial frequencies  CMOS APS x-ray detector, image aquisition geometry and image reconstruction techniques should be considered.

Three-Dimensional Computer-Aided Detection of Microcalcification Clusters in Digital Breast Tomosynthesis

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Ji-wook Jeong

2016-01-01

Full Text Available We propose computer-aided detection (CADe algorithm for microcalcification (MC clusters in reconstructed digital breast tomosynthesis (DBT images. The algorithm consists of prescreening, MC detection, clustering, and false-positive (FP reduction steps. The DBT images containing the MC-like objects were enhanced by a multiscale Hessian-based three-dimensional (3D objectness response function and a connected-component segmentation method was applied to extract the cluster seed objects as potential clustering centers of MCs. Secondly, a signal-to-noise ratio (SNR enhanced image was also generated to detect the individual MC candidates and prescreen the MC-like objects. Each cluster seed candidate was prescreened by counting neighboring individual MC candidates nearby the cluster seed object according to several microcalcification clustering criteria. As a second step, we introduced bounding boxes for the accepted seed candidate, clustered all the overlapping cubes, and examined. After the FP reduction step, the average number of FPs per case was estimated to be 2.47 per DBT volume with a sensitivity of 83.3%.

Breast Imaging: How We Manage Diagnostic Technology at a Multidisciplinary Breast Center

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Alejandro Tejerina Bernal

2012-01-01

Full Text Available This paper discusses the most important aspects and problems related to the management of breast cancer imaging, at a center specialized in breast pathology. We review the established and emerging diagnostic techniques, their indications, and peculiarities: digital mammography, CAD systems, and the recent digital breast tomosynthesis, ultrasound and complementary elastography, molecular imaging techniques, magnetic resonance imaging, advanced sequences (diffusion, and positron emission mammography (PEM. The adequate integration and rational management of these techniques is essential, but this is not always easy, in order to achieve a successful diagnosis.

Strategies to Increase Cancer Detection: Review of True-Positive and False-Negative Results at Digital Breast Tomosynthesis Screening

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Weinstein, Susan P.; McDonald, Elizabeth S.; Conant, Emily F.

2016-01-01

Digital breast tomosynthesis (DBT) represents a valuable addition to breast cancer screening by decreasing recall rates while increasing cancer detection rates. The increased accuracy achieved with DBT is due to the quasi–three-dimensional format of the reconstructed images and the ability to “scroll through” breast tissue in the reconstructed images, thereby reducing the effect of tissue superimposition found with conventional planar digital mammography. The margins of both benign and malignant lesions are more conspicuous at DBT, which allows improved lesion characterization, increased reader confidence, and improved screening outcomes. However, even with the improvements in accuracy achieved with DBT, there remain differences in breast cancer conspicuity by mammographic view. Early data suggest that breast cancers may be more conspicuous on craniocaudal (CC) views than on mediolateral oblique (MLO) views. While some very laterally located breast cancers may be visualized on only the MLO view, the increased conspicuity of cancers on the CC view compared with the MLO view suggests that DBT screening should be performed with two-view imaging. Even with the improved conspicuity of lesions at DBT, there may still be false-negative studies. Subtle lesions seen on only one view may be discounted, and dense and/or complex tissue patterns may make some cancers occult or extremely difficult to detect. Therefore, radiologists should be cognizant of both perceptual and cognitive errors to avoid potential pitfalls in lesion detection and characterization. ©RSNA, 2016 Online supplemental material is available for this article. PMID:27715711

An experimental study of the scatter correction by using a beam-stop-array algorithm with digital breast tomosynthesis

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Kim, Ye-Seul; Park, Hye-Suk; Kim, Hee-Joung [Yonsei University, Wonju (Korea, Republic of); Choi, Young-Wook; Choi, Jae-Gu [Korea Electrotechnology Research Institute, Ansan (Korea, Republic of)

2014-12-15

Digital breast tomosynthesis (DBT) is a technique that was developed to overcome the limitations of conventional digital mammography by reconstructing slices through the breast from projections acquired at different angles. In developing and optimizing DBT, The x-ray scatter reduction technique remains a significant challenge due to projection geometry and radiation dose limitations. The most common approach to scatter reduction is a beam-stop-array (BSA) algorithm; however, this method raises concerns regarding the additional exposure involved in acquiring the scatter distribution. The compressed breast is roughly symmetric, and the scatter profiles from projections acquired at axially opposite angles are similar to mirror images. The purpose of this study was to apply the BSA algorithm with only two scans with a beam stop array, which estimates the scatter distribution with minimum additional exposure. The results of the scatter correction with angular interpolation were comparable to those of the scatter correction with all scatter distributions at each angle. The exposure increase was less than 13%. This study demonstrated the influence of the scatter correction obtained by using the BSA algorithm with minimum exposure, which indicates its potential for practical applications.

Addition of tomosynthesis to conventional digital mammography: effect on image interpretation time of screening examinations.

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Dang, Pragya A; Freer, Phoebe E; Humphrey, Kathryn L; Halpern, Elkan F; Rafferty, Elizabeth A

2014-01-01

To determine the effect of implementing a screening tomosynthesis program on real-world clinical performance by quantifying differences between interpretation times for conventional screening mammography and combined tomosynthesis and mammography for multiple participating radiologists with a wide range of experience in a large academic center. In this HIPAA-compliant, institutional review board-approved study, 10 radiologists prospectively read images from screening digital mammography or screening combined tomosynthesis and mammography examinations for 1-hour-long uninterrupted sessions. Images from 3665 examinations (1502 combined and 2163 digital mammography) from July 2012 to January 2013 were interpreted in at least five sessions per radiologist per modality. The number of cases reported during each session was recorded for each reader. The experience level for each radiologist was also correlated to the average number of cases reported per hour. Analysis of variance was used to assess the number of studies interpreted per hour. A linear regression model was used to evaluate correlation between breast imaging experience and time taken to interpret images from both modalities. The mean number of studies interpreted in hour was 23.8 ± 0.55 (standard deviation) (range, 14.4-40.4) for combined tomosynthesis and mammography and 34.0 ± 0.55 (range, 20.4-54.3) for digital mammography alone. A mean of 10.2 fewer studies were interpreted per hour during combined tomosynthesis and mammography compared with digital mammography sessions (P tomosynthesis and mammography and 1.9 minutes ± 0.6 (range, 1.1-3.0) for digital mammography; interpretation time with combined tomosynthesis and mammography was 0.9 minute longer (47% longer) compared with digital mammography alone (P tomosynthesis and mammography examinations decreased (R(2) = 0.52, P = .03). Addition of tomosynthesis to mammography results in increased time to interpret images from screening examinations compared

Digital breast tomosynthesis: computer-aided detection of clustered microcalcifications on planar projection images

International Nuclear Information System (INIS)

Samala, Ravi K; Chan, Heang-Ping; Lu, Yao; Hadjiiski, Lubomir M; Wei, Jun; Helvie, Mark A

2014-01-01

This paper describes a new approach to detect microcalcification clusters (MCs) in digital breast tomosynthesis (DBT) via its planar projection (PPJ) image. With IRB approval, two-view (cranio-caudal and mediolateral oblique views) DBTs of human subject breasts were obtained with a GE GEN2 prototype DBT system that acquires 21 projection angles spanning 60° in 3° increments. A data set of 307 volumes (154 human subjects) was divided by case into independent training (127 with MCs) and test sets (104 with MCs and 76 free of MCs). A simultaneous algebraic reconstruction technique with multiscale bilateral filtering (MSBF) regularization was used to enhance microcalcifications and suppress noise. During the MSBF regularized reconstruction, the DBT volume was separated into high frequency (HF) and low frequency components representing microcalcifications and larger structures. At the final iteration, maximum intensity projection was applied to the regularized HF volume to generate a PPJ image that contained MCs with increased contrast-to-noise ratio (CNR) and reduced search space. High CNR objects in the PPJ image were extracted and labeled as microcalcification candidates. Convolution neural network trained to recognize the image pattern of microcalcifications was used to classify the candidates into true calcifications and tissue structures and artifacts. The remaining microcalcification candidates were grouped into MCs by dynamic conditional clustering based on adaptive CNR threshold and radial distance criteria. False positive (FP) clusters were further reduced using the number of candidates in a cluster, CNR and size of microcalcification candidates. At 85% sensitivity an FP rate of 0.71 and 0.54 was achieved for view- and case-based sensitivity, respectively, compared to 2.16 and 0.85 achieved in DBT. The improvement was significant (p-value = 0.003) by JAFROC analysis. (paper)

The diagnostic accuracy of dual-view digital mammography, single-view breast tomo-synthesis and a dual-view combination of breast tomo-synthesis and digital mammography in a free-response observer performance study

International Nuclear Information System (INIS)

Svahn, T.; Andersson, I.; Chakraborty, D.; Svensson, S.; Ikeda, D.; Foernvik, D.; Mattsson, S.; Tingberg, A.; Zackrisson, S.

2010-01-01

The purpose of the present study was to compare the diagnostic accuracy of dual-view digital mammography (DM), single view breast tomo-synthesis (BT) and BT combined with the opposite DM view. Patients with subtle lesions were selected to undergo BT examinations. Two radiologists who are non-participants in the study and have experience in using DM and BT determined the locations and extents of lesions in the images. Five expert mammographers interpreted the cases using the free-response paradigm. The task was to mark and rate clinically reportable findings suspicious for malignancy and clinically relevant benign findings. The marks were scored with reference to the outlined regions into lesion localization or non-lesion localization, and analysed by the jackknife alternative free-response receiver operating characteristic method. The analysis yielded statistically significant differences between the combined modality and dual-view DM (p < 0.05). No differences were found between single-view BT and dual-view DM or between single-view BT and the combined modality. (authors)

Comparison of power spectra for tomosynthesis projections and reconstructed images

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Engstrom, Emma; Reiser, Ingrid; Nishikawa, Robert

2009-01-01

Burgess et al. [Med. Phys. 28, 419-437 (2001)] showed that the power spectrum of mammographic breast background follows a power law and that lesion detectability is affected by the power-law exponent β which measures the amount of structure in the background. Following the study of Burgess et al., the authors measured and compared the power-law exponent of mammographic backgrounds in tomosynthesis projections and reconstructed slices to investigate the effect of tomosynthesis imaging on background structure. Our data set consisted of 55 patient cases. For each case, regions of interest (ROIs) were extracted from both projection images and reconstructed slices. The periodogram of each ROI was computed by taking the squared modulus of the Fourier transform of the ROI. The power-law exponent was determined for each periodogram and averaged across all ROIs extracted from all projections or reconstructed slices for each patient data set. For the projections, the mean β averaged across the 55 cases was 3.06 (standard deviation of 0.21), while it was 2.87 (0.24) for the corresponding reconstructions. The difference in β for a given patient between the projection ROIs and the reconstructed ROIs averaged across the 55 cases was 0.194, which was statistically significant (p<0.001). The 95% CI for the difference between the mean value of β for the projections and reconstructions was [0.170, 0.218]. The results are consistent with the observation that the amount of breast structure in the tomosynthesis slice is reduced compared to projection mammography and that this may lead to improved lesion detectability.

Validation of a power-law noise model for simulating small-scale breast tissue

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Reiser, I; Edwards, A; Nishikawa, R M

2013-01-01

We have validated a small-scale breast tissue model based on power-law noise. A set of 110 patient images served as truth. The statistical model parameters were determined by matching the radially averaged power-spectrum of the projected simulated tissue with that of the central tomosynthesis patient breast projections. Observer performance in a signal-known exactly detection task in simulated and actual breast backgrounds was compared. Observers included human readers, a pre-whitening observer model and a channelized Hotelling observer model. For all observers, good agreement between performance in the simulated and actual backgrounds was found, both in the tomosynthesis central projections and the reconstructed images. This tissue model can be used for breast x-ray imaging system optimization. The complete statistical description of the model is provided. (paper)

50 μm pixel pitch wafer-scale CMOS active pixel sensor x-ray detector for digital breast tomosynthesis

International Nuclear Information System (INIS)

Zhao, C; Kanicki, J; Konstantinidis, A C; Zheng, Y; Speller, R D; Anaxagoras, T

2015-01-01

Wafer-scale CMOS active pixel sensors (APSs) have been developed recently for x-ray imaging applications. The small pixel pitch and low noise are very promising properties for medical imaging applications such as digital breast tomosynthesis (DBT). In this work, we evaluated experimentally and through modeling the imaging properties of a 50 μm pixel pitch CMOS APS x-ray detector named DynAMITe (Dynamic Range Adjustable for Medical Imaging Technology). A modified cascaded system model was developed for CMOS APS x-ray detectors by taking into account the device nonlinear signal and noise properties. The imaging properties such as modulation transfer function (MTF), noise power spectrum (NPS), and detective quantum efficiency (DQE) were extracted from both measurements and the nonlinear cascaded system analysis. The results show that the DynAMITe x-ray detector achieves a high spatial resolution of 10 mm −1 and a DQE of around 0.5 at spatial frequencies  <1 mm −1 . In addition, the modeling results were used to calculate the image signal-to-noise ratio (SNR i ) of microcalcifications at various mean glandular dose (MGD). For an average breast (5 cm thickness, 50% glandular fraction), 165 μm microcalcifications can be distinguished at a MGD of 27% lower than the clinical value (∼1.3 mGy). To detect 100 μm microcalcifications, further optimizations of the CMOS APS x-ray detector, image aquisition geometry and image reconstruction techniques should be considered. (paper)

Staging of breast cancer and the advanced applications of digital mammogram: what the physician needs to know?

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Helal, Maha H; Mansour, Sahar M; Zaglol, Mai; Salaleldin, Lamia A; Nada, Omniya M; Haggag, Marwa A

2017-03-01

To study the role of advanced applications of digital mammogram, whether contrast-enhanced spectral mammography (CESM) or digital breast tomosynthesis (DBT), in the "T" staging of histologically proven breast cancer before planning for treatment management. In this prospective analysis, we evaluated 98 proved malignant breast masses regarding their size, multiplicity and the presence of associated clusters of microcalcifications. Evaluation methods included digital mammography (DM), 3D tomosynthesis and CESM. Traditional DM was first performed then in a period of 10-14-day interval; breast tomosynthesis and contrast-based mammography were performed for the involved breast only. Views at tomosynthesis were acquired in a "step-and-shoot" tube motion mode to produce multiple (11-15), low-dose images and in contrast-enhanced study, low-energy (22-33 kVp) and high-energy (44-49 kVp) exposures were taken after the i.v. injection of the contrast agent. Operative data were the gold standard reference. Breast tomosynthesis showed the highest accuracy in size assessment (n = 69, 70.4%) than contrast-enhanced (n = 49, 50%) and regular mammography (n = 59, 60.2%). Contrast-enhanced mammography presented the least performance in assessing calcifications, yet it was most sensitive in the detection of multiplicity (92.3%), followed by tomosynthesis (77%) and regular mammography (53.8%). The combined analysis of the three modalities provided an accuracy of 74% in the "T" staging of breast cancer. The combined application of tomosynthesis and contrast-enhanced digital mammogram enhanced the performance of the traditional DM and presented an informative method in the staging of breast cancer. Advances in knowledge: Staging and management planning of breast cancer can divert according to tumour size, multiplicity and the presence of microcalcifications. DBT shows sharp outlines of the tumour with no overlap tissue and spots microcalcifications. Contrast

Scatter radiation intensities around a clinical digital breast tomosynthesis unit and the impact on radiation shielding considerations

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Yang, Kai, E-mail: kyang11@mgh.harvard.edu; Li, Xinhua; Liu, Bob [Division of Diagnostic Imaging Physics, Department of Radiology, Massachusetts General Hospital, 55 Fruit Street, Boston, Massachusetts 02114 (United States)

2016-03-15

Purpose: To measure the scattered radiation intensity around a clinical digital breast tomosynthesis (DBT) unit and to provide updated data for radiation shielding design for DBT systems with tungsten-anode x-ray tubes. Methods: The continuous distribution of scattered x-rays from a clinical DBT system (Hologic Selenia Dimensions) was measured within an angular range of 0°–180° using a linear-array x-ray detector (X-Scan 0.8f3-512, Detection Technology, Inc., Finland), which was calibrated for the x-ray spectrum range of the DBT unit. The effects of x-ray field size, phantom size, and x-ray kVp/filter combination were investigated. Following a previously developed methodology by Simpkin, scatter fraction was determined for the DBT system as a function of angle around the phantom center. Detailed calculations of the scatter intensity from a DBT system were demonstrated using the measured scatter fraction data. Results: For the 30 and 35 kVp acquisition, the scatter-to-primary-ratio and scatter fraction data closely matched with data previously measured by Simpkin. However, the measured data from this study demonstrated the nonisotropic distribution of the scattered radiation around a DBT system, with two strong peaks around 25° and 160°. The majority scatter radiation (>70%) originated from the imaging detector assembly, instead of the phantom. With a workload from a previous survey performed at MGH, the scatter air kerma at 1 m from the phantom center for wall/door is 1.76 × 10{sup −2} mGy patient{sup −1}, for floor is 1.64 × 10{sup −1} mGy patient{sup −1}, and for ceiling is 3.66 × 10{sup −2} mGy patient{sup −1}. Conclusions: Comparing to previously measured data for mammographic systems, the scatter air kerma from Holgoic DBT is at least two times higher. The main reasons include the harder primary beam with higher workload (measured with total mAs/week), added tomosynthesis acquisition, and strong small angle forward scattering. Due to the

The accuracy of digital breast tomosynthesis compared with coned compression magnification mammography in the assessment of abnormalities found on mammography

International Nuclear Information System (INIS)

Morel, J.C.; Iqbal, A.; Wasan, R.K.; Peacock, C.; Evans, D.R.; Rahim, R.; Goligher, J.; Michell, M.J.

2014-01-01

Aim: To compare the diagnostic accuracy of the digital breast tomosynthesis (DBT) with coned compression magnification mammography (CCMM). Materials and methods: The study design included two reading sessions completed by seven experienced radiologists. In the first session, all readers read bilateral standard two-view mammograms and a CCMM view of the lesion before giving a combined score for assessment. In the second session, readers read bilateral standard two-view mammograms plus one-view DBT. The two reading sessions of the experiment were separated by at least 2 weeks to reduce the chance of reader memory of the images read in the previous session from influencing the performance in the subsequent session. Results: Three hundred and fifty-four lesions were assessed and receiver-operative characteristic (ROC) analysis was used to evaluate the difference between the two modes. For standard two-view mammography plus CCMM, the area under the curve (AUC) was 0.87 [95% confidence interval (CI): 0.83–0.91] and for standard two-view mammography plus DBT the AUC was 0.93 (95% CI: 0.91–0.95). The difference between the AUCs was 0.06 with p-value of 0.0014. Conclusion: Two-view mammography with one-view DBT showed significantly improved accuracy compared to two-view mammography and CCMM in the assessment of mammographic abnormalities. These results show that DBT can be used effectively in the further evaluation of mammographic abnormalities found at screening and in symptomatic diagnostic practice. - Highlights: • Diagnostic accuracy of magnification mammography and digital breast tomosynthesis. • There is statistical difference between CCMM and DBT. • DBT has a role in evaluating mammographic abnormalities

Chest Tomosynthesis: Technical Principles and Clinical Update

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Dobbins, James T.; McAdams, H. Page

2009-01-01

Digital tomosynthesis is a radiographic technique that can produce an arbitrary number of section images of a patient from a single pass of the x-ray tube. It utilizes a conventional x-ray tube, a flat-panel detector, a computer-controlled tube mover, and special reconstruction algorithms to produce section images. While it does not have the depth resolution of computed tomography (CT), tomosynthesis provides some of the tomographic benefits of CT but at lower cost and radiation dose than CT. Compared to conventional chest radiography, chest tomosynthesis results in improved visibility of normal structures such as vessels, airway and spine. By reducing visual clutter from overlying normal anatomy, it also enhances detection of small lung nodules. This review article outlines the components of a tomosynthesis system, discusses results regarding improved lung nodule detection from the recent literature, and presents examples of nodule detection from a clinical trial in human subjects. Possible implementation strategies for use in clinical chest imaging are discussed. PMID:19616909

Investigating the feasibility of using partial least squares as a method of extracting salient information for the evaluation of digital breast tomosynthesis

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Zhang, George Z.; Myers, Kyle J.; Park, Subok

2013-03-01

Digital breast tomosynthesis (DBT) has shown promise for improving the detection of breast cancer, but it has not yet been fully optimized due to a large space of system parameters to explore. A task-based statistical approach1 is a rigorous method for evaluating and optimizing this promising imaging technique with the use of optimal observers such as the Hotelling observer (HO). However, the high data dimensionality found in DBT has been the bottleneck for the use of a task-based approach in DBT evaluation. To reduce data dimensionality while extracting salient information for performing a given task, efficient channels have to be used for the HO. In the past few years, 2D Laguerre-Gauss (LG) channels, which are a complete basis for stationary backgrounds and rotationally symmetric signals, have been utilized for DBT evaluation2, 3 . But since background and signal statistics from DBT data are neither stationary nor rotationally symmetric, LG channels may not be efficient in providing reliable performance trends as a function of system parameters. Recently, partial least squares (PLS) has been shown to generate efficient channels for the Hotelling observer in detection tasks involving random backgrounds and signals.4 In this study, we investigate the use of PLS as a method for extracting salient information from DBT in order to better evaluate such systems.

Comparing search patterns in digital breast tomosynthesis and full-field digital mammography: an eye tracking study.

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Aizenman, Avi; Drew, Trafton; Ehinger, Krista A; Georgian-Smith, Dianne; Wolfe, Jeremy M

2017-10-01

As a promising imaging modality, digital breast tomosynthesis (DBT) leads to better diagnostic performance than traditional full-field digital mammograms (FFDM) alone. DBT allows different planes of the breast to be visualized, reducing occlusion from overlapping tissue. Although DBT is gaining popularity, best practices for search strategies in this medium are unclear. Eye tracking allowed us to describe search patterns adopted by radiologists searching DBT and FFDM images. Eleven radiologists examined eight DBT and FFDM cases. Observers marked suspicious masses with mouse clicks. Eye position was recorded at 1000 Hz and was coregistered with slice/depth plane as the radiologist scrolled through the DBT images, allowing a 3-D representation of eye position. Hit rate for masses was higher for tomography cases than 2-D cases and DBT led to lower false positive rates. However, search duration was much longer for DBT cases than FFDM. DBT was associated with longer fixations but similar saccadic amplitude compared with FFDM. When comparing radiologists' eye movements to a previous study, which tracked eye movements as radiologists read chest CT, we found DBT viewers did not align with previously identified "driller" or "scanner" strategies, although their search strategy most closely aligns with a type of vigorous drilling strategy.

Investigation on location-dependent detectability of a small mass for digital breast tomosynthesis evaluation

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Lee, Changwoo; Baek, Jongduk; Park, Subok

2016-03-01

Digital breast tomosynthesis (DBT) is an emerging imaging modality for improved breast cancer detection and diagnosis [1-5]. Numerous efforts have been made to find quantitative metrics associated with mammographic image quality assessment, such as the exponent β of anatomical noise power spectrum, glandularity, contrast noise ratio, etc. [6-8]. In addition, with the use of Fourier-domain detectability for a task-based assessment of DBT, a stationarity assumption on reconstructed image statistics was often made [9-11], resulting in the use of multiple regions-of-interest (ROIs) from different locations in order to increase sample size. While all these metrics provide some information on mammographic image characteristics and signal detection, the relationship between these metrics and detectability in DBT evaluation has not been fully understood. In this work, we investigated spatial-domain detectability trends and levels as a function of the number of slices Ns at three different ROI locations on the same image slice, where background statistics differ in terms of the aforementioned metrics. Detectabilities for the three ROI locations were calculated using multi-slice channelized Hotelling observers with 2D/3D Laguerre-Gauss channels. Our simulation results show that detectability levels and trends as a function of Ns vary across these three ROI locations. They also show that the exponent β, mean glandularity, and mean attenuation coefficient vary across the three ROI locations but they do not necessarily predict the ranking of detectability levels and trends across these ROI locations.

Technical Note: Comparison of first- and second-generation photon-counting slit-scanning tomosynthesis systems.

Science.gov (United States)

Berggren, Karl; Cederström, Björn; Lundqvist, Mats; Fredenberg, Erik

2018-02-01

Digital breast tomosynthesis (DBT) is an emerging tool for breast-cancer screening and diagnostics. The purpose of this study is to present a second-generation photon-counting slit-scanning DBT system and compare it to the first-generation system in terms of geometry and image quality. The study presents the first image-quality measurements on the second-generation system. The geometry of the new system is based on a combined rotational and linear motion, in contrast to a purely rotational scan motion in the first generation. In addition, the calibration routines have been updated. Image quality was measured in the center of the image field in terms of in-slice modulation transfer function (MTF), artifact spread function (ASF), and in-slice detective quantum efficiency (DQE). Images were acquired using a W/Al 29 kVp spectrum at 13 mAs with 2 mm Al additional filtration and reconstructed using simple back-projection. The in-slice 50% MTF was improved in the chest-mammilla direction, going from 3.2 to 3.5 lp/mm, and the zero-frequency DQE increased from 0.71 to 0.77. The MTF and ASF were otherwise found to be on par for the two systems. The new system has reduced in-slice variation of the tomographic angle. The new geometry is less curved, which reduces in-slice tomographic-angle variation, and increases the maximum compression height, making the system accessible for a larger population. The improvements in MTF and DQE were attributed to the updated calibration procedures. We conclude that the second-generation system maintains the key features of the photon-counting system while maintaining or improving image quality and improving the maximum compression height. © 2017 American Association of Physicists in Medicine.

Digital tomosynthesis of the chest: A literature review

International Nuclear Information System (INIS)

Molk, N.; Seeram, E.

2015-01-01

Digital tomosynthesis is a relatively novel imaging modality using limited angle tomography to provide 3D imaging. The purpose of this review is to compare the sensitivity of digital tomosynthesis of the chest and plain film chest imaging in accurately identifying pulmonary nodules and to compare the effective dose between standard chest examinations using digital tomosynthesis and CT. A review of current literature has shown that small scale studies found digital tomosynthesis to be three times more effective in identifying pulmonary nodules compared to conventional radiography and at lower doses compared with routine chest CT examinations. This indicates that tomosynthesis could potentially be a beneficial imaging modality and could be used in a number of ways to detect and monitor pulmonary nodules for cancer. However with limited research, large-scale studies would need to be performed to confirm its benefits and identify where it is best used in the clinical setting. - Highlights: • The detection of pulmonary nodules is compared between tomosynthesis and plain film. • The effective dose of digital chest tomosynthesis and chest CT are compared. • The place of digital tomosynthesis of the chest in the clinical setting is explored. • Three times more pulmonary nodules are seen with tomosynthesis. • The effective dose of tomosynthesis is significantly lower than CT

Influence of X-ray scatter radiation on image quality in Digital Breast Tomosynthesis (DBT)

Science.gov (United States)

Rodrigues, M. J.; Di Maria, S.; Baptista, M.; Belchior, A.; Afonso, J.; Venâncio, J.; Vaz, P.

2017-11-01

Digital breast tomosynthesis (DBT) is a quasi-three-dimensional imaging technique that was developed to solve the principal limitation of mammography, namely the overlapping tissue effect. This issue in standard mammography (SM) leads to two main problems: low sensitivity (difficulty to detect lesions) and low specificity (non-negligible percentage of false positives). Although DBT is now being introduced in clinical practice the features of this technique have not yet been fully and accurately assessed. Consequently, optimization studies in terms of choosing the most suitable parameters which maximize image quality according to the known limits of breast dosimetry are currently performing. In DBT, scatter radiation can lead to a loss of contrast and to an increase of image noise by reducing the signal-to-difference-noise ratio (SDNR) of a lesion. Moreover the use of an anti-scatter grid is a concern due to the low exposure of the photon flux available per projection. For this reason the main aim of this study was to analyze the influence of the scatter radiation on image quality and the dose delivered to the breast. In particular a detailed analysis of the scatter radiation on the optimal energy that maximizes the SDNR was performed for different monochromatic energies and voltages. To reach this objective the PenEasy Monte Carlo (MC) simulation tool imbedded in the general-purpose main program PENELOPE, was used. After a successful validation of the MC model with measurements, 2D projection images of primary, coherent and incoherent photons were obtained. For that, a homogeneous breast phantom (2, 4, 6, 8 cm) with 25%, 50% and 75% glandular compositions was used, including a 5 mm thick tumor. The images were generated for each monochromatic X-ray energies in the range from 16 keV to 32 keV. For each angular projection considered (25 angular projections covering an arc of 50°) the scatter-to-primary ratio (SPR), the mean glandular dose (MGD) and the signal

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

Science.gov (United States)

Cockmartin, L; Bosmans, H; Marshall, N W

2013-08-01

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). 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. 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

Chest tomosynthesis: technical and clinical perspectives.

Science.gov (United States)

Johnsson, Ase Allansdotter; Vikgren, Jenny; Bath, Magnus

2014-02-01

The recent implementation of chest tomosynthesis is built on the availability of large, dose-efficient, high-resolution flat panel detectors, which enable the acquisition of the necessary number of projection radiographs to allow reconstruction of section images of the chest within one breath hold. A chest tomosynthesis examination obtains the increased diagnostic information provided by volumetric imaging at a radiation dose comparable to that of conventional chest radiography. There is evidence that the sensitivity of chest tomosynthesis may be at least three times higher than for conventional chest radiography for detection of pulmonary nodules. The sensitivity increases with increasing nodule size and attenuation and decreases for nodules with subpleural location. Differentiation between pleural and subpleural lesions is a known pitfall due to the limited depth resolution in chest tomosynthesis. Studies on different types of pathology report increased detectability in favor of chest tomosynthesis in comparison to chest radiography. The technique provides improved diagnostic accuracy and confidence in the diagnosis of suspected pulmonary lesions on chest radiography and facilitates the exclusion of pulmonary lesions in a majority of patients, avoiding the need for computed tomography (CT). However, motion artifacts can be a cumbersome limitation and breathing during the tomosynthesis image acquisition may result in severe artifacts significantly affecting the detectability of pathology. In summary, chest tomosynthesis has been shown to be superior to chest conventional radiography for many tasks and to be able to replace CT in selected cases. In our experience chest tomosynthesis is an efficient problem solver in daily clinical work. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Design and application of a structured phantom for detection performance comparison between breast tomosynthesis and digital mammography

Science.gov (United States)

Cockmartin, L.; Marshall, N. W.; Zhang, G.; Lemmens, K.; Shaheen, E.; Van Ongeval, C.; Fredenberg, E.; Dance, D. R.; Salvagnini, E.; Michielsen, K.; Bosmans, H.

2017-02-01

This paper introduces and applies a structured phantom with inserted target objects for the comparison of detection performance of digital breast tomosynthesis (DBT) against 2D full field digital mammography (FFDM). The phantom consists of a 48 mm thick breast-shaped polymethyl methacrylate (PMMA) container filled with water and PMMA spheres of different diameters. Three-dimensionally (3D) printed spiculated masses (diameter range: 3.8-9.7 mm) and non-spiculated masses (1.6-6.2 mm) along with microcalcifications (90-250 µm) were inserted as targets. Reproducibility of the phantom application was studied on a single system using 30 acquisitions. Next, the phantom was evaluated on five different combined FFDM & DBT systems and target detection was compared for FFDM and DBT modes. Ten phantom images in both FFDM and DBT modes were acquired on these 5 systems using automatic exposure control. Five readers evaluated target detectability. Images were read with the four-alternative forced-choice (4-AFC) paradigm, with always one segment including a target and 3 normal background segments. The percentage of correct responses (PC) was assessed based on 10 trials of each reader for each object type, size and imaging modality. Additionally, detection threshold diameters at 62.5 PC were assessed via non-linear regression fitting of the psychometric curve. The reproducibility study showed no significant differences in PC values. Evaluation of target detection in FFDM showed that microcalcification detection thresholds ranged between 110 and 118 µm and were similar compared to the detection in DBT (range of 106-158 µm). In DBT, detection of both mass types increased significantly (p  =  0.0001 and p  =  0.0002 for non-spiculated and spiculated masses respectively) compared to FFDM, achieving almost 100% detection for all spiculated mass diameters. In conclusion, a structured phantom with inserted targets was able to show evidence for detectability

Breast cancer screening in Korean woman with dense breast tissue

International Nuclear Information System (INIS)

Shin, Hee Jung; Ko, Eun Sook; Yi, Ann

2015-01-01

Asian women, including Korean, have a relatively higher incidence of dense breast tissue, compared with western women. Dense breast tissue has a lower sensitivity for the detection of breast cancer and a higher relative risk for breast cancer, compared with fatty breast tissue. Thus, there were limitations in the mammographic screening for women with dense breast tissue, and many studies for the supplemental screening methods. This review included appropriate screening methods for Korean women with dense breasts. We also reviewed the application and limitation of supplemental screening methods, including breast ultrasound, digital breast tomosynthesis, and breast magnetic resonance imaging; and furthermore investigated the guidelines, as well as the study results

Breast cancer screening in Korean woman with dense breast tissue

Energy Technology Data Exchange (ETDEWEB)

Shin, Hee Jung [Dept. of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul (Korea, Republic of); Ko, Eun Sook [Dept. of Radiology, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul (Korea, Republic of); Yi, Ann [Dept. of Radiology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul (Korea, Republic of)

2015-11-15

Asian women, including Korean, have a relatively higher incidence of dense breast tissue, compared with western women. Dense breast tissue has a lower sensitivity for the detection of breast cancer and a higher relative risk for breast cancer, compared with fatty breast tissue. Thus, there were limitations in the mammographic screening for women with dense breast tissue, and many studies for the supplemental screening methods. This review included appropriate screening methods for Korean women with dense breasts. We also reviewed the application and limitation of supplemental screening methods, including breast ultrasound, digital breast tomosynthesis, and breast magnetic resonance imaging; and furthermore investigated the guidelines, as well as the study results.

Improvements of an objective model of compressed breasts undergoing mammography: Generation and characterization of breast shapes

NARCIS (Netherlands)

Rodriguez Ruiz, A.; Feng, S.S.J.; Zelst, J.C.M. van; Vreemann, S.; Mann, J.R.; D'Orsi, C.J.; Sechopoulos, I.

2017-01-01

PURPOSE: To develop a set of accurate 2D models of compressed breasts undergoing mammography or breast tomosynthesis, based on objective analysis, to accurately characterize mammograms with few linearly independent parameters, and to generate novel clinically realistic paired cranio-caudal (CC) and

Dose to patient in tomosynthesis

International Nuclear Information System (INIS)

Minambres Moro, A.; Fernandez Leton, P.; Garcia Rui-Zorrilla, J.; Perez Moreno, J. M.; Zucca Aparicio, D.

2013-01-01

They are beginning to implement digital mammography with the possibility of acquiring in tomosynthesis, whose biggest advantage is to distinguish structures without overlapping through of pseudotridimensionals images. With these modified mammograms can acquire a planar mammography, with fixed x-ray tube, or a tomosynthesis with tube by turning. For acquire tomosynthesis is necessary a detector of high efficiency together with tungsten white tubes. The objective of this study is to know the dose received by the patient with this new imaging. (Author)

TH-A-18A-01: Innovation in Clinical Breast Imaging

International Nuclear Information System (INIS)

Liu, B; Yang, K; Yaffe, M; Chen, J

2014-01-01

Several novel modalities have been or are on the verge of being introduced into the breast imaging clinic. These include tomosynthesis imaging, dedicated breast CT, contrast-enhanced digital mammography, and automated breast ultrasound, all of which are covered in this course. Tomosynthesis and dedicated breast CT address the problem of tissue superimposition that limits mammography screening performance, by improved or full resolution of the 3D breast morphology. Contrast-enhanced digital mammography provides functional information that allows for visualization of tumor angiogenesis. 3D breast ultrasound has high sensitivity for tumor detection in dense breasts, but the imaging exam was traditionally performed by radiologists. In automated breast ultrasound, the scan is performed in an automated fashion, making for a more practical imaging tool, that is now used as an adjunct to digital mammography in breast cancer screening. This course will provide medical physicists with an in-depth understanding of the imaging physics of each of these four novel imaging techniques, as well as the rationale and implementation of QC procedures. Further, basic clinical applications and work flow issues will be discussed. Learning Objectives: To be able to describe the underlying physical and physiological principles of each imaging technique, and to understand the corresponding imaging acquisition process. To be able to describe the critical system components and their performance requirements. To understand the rationale and implementation of quality control procedures, as well as regulatory requirements for systems with FDA approval. To learn about clinical applications and understand risks and benefits/strength and weakness of each modality in terms of clinical breast imaging

Model observer for assessing digital breast tomosynthesis for multi-lesion detection in the presence of anatomical noise

Science.gov (United States)

Wen, Gezheng; Markey, Mia K.; Miner Haygood, Tamara; Park, Subok

2018-02-01

Model observers are widely used in task-based assessments of medical image quality. The presence of multiple abnormalities in a single set of images, such as in multifocal multicentric breast cancer (MFMC), has an immense clinical impact on treatment planning and survival outcomes. Detecting multiple breast tumors is challenging as MFMC is relatively uncommon, and human observers do not know the number or locations of tumors a priori. Digital breast tomosynthesis (DBT), in which an x-ray beam sweeps over a limited angular range across the breast, has the potential to improve the detection of multiple tumors. However, prior studies of DBT image quality all focus on unifocal breast cancers. In this study, we extended our 2D multi-lesion (ML) channelized Hotelling observer (CHO) into a 3D ML-CHO that detects multiple lesions from volumetric imaging data. Then we employed the 3D ML-CHO to identify optimal DBT acquisition geometries for detection of MFMC. Digital breast phantoms with multiple embedded synthetic lesions were scanned by simulated DBT scanners of different geometries (wide/narrow angular span, different number of projections per scan) to simulate MFMC cases. With new implementations of 3D partial least squares (PLS) and modified Laguerre-Gauss (LG) channels, the 3D ML-CHO made detection decisions based upon the overall information from individual DBT slices and their correlations. Our evaluation results show that: (1) the 3D ML-CHO could achieve good detection performance with a small number of channels, and 3D PLS channels on average outperform the counterpart LG channels; (2) incorporating locally varying anatomical backgrounds and their correlations as in the 3D ML-CHO is essential for multi-lesion detection; (3) the most effective DBT geometry for detection of MFMC may vary when the task of clinical interest changes, and a given DBT geometry may not yield images that are equally informative for detecting MF, MC, and unifocal cancers.

Average glandular dose in paired digital mammography and digital breast tomosynthesis acquisitions in a population based screening program: effects of measuring breast density, air kerma and beam quality

Science.gov (United States)

Helge Østerås, Bjørn; Skaane, Per; Gullien, Randi; Catrine Trægde Martinsen, Anne

2018-02-01

The main purpose was to compare average glandular dose (AGD) for same-compression digital mammography (DM) and digital breast tomosynthesis (DBT) acquisitions in a population based screening program, with and without breast density stratification, as determined by automatically calculated breast density (Quantra™). Secondary, to compare AGD estimates based on measured breast density, air kerma and half value layer (HVL) to DICOM metadata based estimates. AGD was estimated for 3819 women participating in the screening trial. All received craniocaudal and mediolateral oblique views of each breasts with paired DM and DBT acquisitions. Exposure parameters were extracted from DICOM metadata. Air kerma and HVL were measured for all beam qualities used to acquire the mammograms. Volumetric breast density was estimated using Quantra™. AGD was estimated using the Dance model. AGD reported directly from the DICOM metadata was also assessed. Mean AGD was 1.74 and 2.10 mGy for DM and DBT, respectively. Mean DBT/DM AGD ratio was 1.24. For fatty breasts: mean AGD was 1.74 and 2.27 mGy for DM and DBT, respectively. For dense breasts: mean AGD was 1.73 and 1.79 mGy, for DM and DBT, respectively. For breasts of similar thickness, dense breasts had higher AGD for DM and similar AGD for DBT. The DBT/DM dose ratio was substantially lower for dense compared to fatty breasts (1.08 versus 1.33). The average c-factor was 1.16. Using previously published polynomials to estimate glandularity from thickness underestimated the c-factor by 5.9% on average. Mean AGD error between estimates based on measurements (air kerma and HVL) versus DICOM header data was 3.8%, but for one mammography unit as high as 7.9%. Mean error of using the AGD value reported in the DICOM header was 10.7 and 13.3%, respectively. Thus, measurement of breast density, radiation dose and beam quality can substantially affect AGD estimates.

WE-DE-207B-05: Measuring Spatial Resolution in Digital Breast Tomosynthesis: Update of AAPM Task Group 245

Energy Technology Data Exchange (ETDEWEB)

Scaduto, DA; Hu, Y-H; Zhao, W [Stony Brook Medicine, Stony Brook, NY (United States); Goodsitt, M; Chan, H-P [University Michigan, Ann Arbor, MI (United States); Olafsdottir, H [Image Owl, 105 Reykjavik (Iceland); Das, M [University Houston, Houston, TX (United States); Fredenberg, E [Philips Healthcare, Solna (Sweden); Geiser, W [UT MD Anderson Cancer Center, Houston, TX (United States); Goodenough, D [The George Washington University, Washington, DC (United States); Heid, P [ARCADES, Marseille (France); Liu, B [Massachusetts General Hospital, Boston, MA (United States); Mainprize, J [Sunnybrook Health Sciences Centre, North York, ON (Canada); Reiser, I [The University of Chicago, Chicago, IL (United States); Van Engen, R [LRCB, Nijmegen (Netherlands); Varchena, V [CIRS Inc., Norfolk, VA (United States); Vecchio, S [I.M.S., Pontecchio Marconi (Italy); Glick, S [Food and Drug Administration, Silver Spring, MD (United States)

2016-06-15

Purpose: Spatial resolution in digital breast tomosynthesis (DBT) is affected by inherent/binned detector resolution, oblique entry of x-rays, and focal spot size/motion; the limited angular range further limits spatial resolution in the depth-direction. While DBT is being widely adopted clinically, imaging performance metrics and quality control protocols have not been standardized. AAPM Task Group 245 on Tomosynthesis Quality Control has been formed to address this deficiency. Methods: Methods of measuring spatial resolution are evaluated using two prototype quality control phantoms for DBT. Spatial resolution in the detector plane is measured in projection and reconstruction domains using edge-spread function (ESF), point-spread function (PSF) and modulation transfer function (MTF). Spatial resolution in the depth-direction and effective slice thickness are measured in the reconstruction domain using slice sensitivity profile (SSP) and artifact spread function (ASF). An oversampled PSF in the depth-direction is measured using a 50 µm angulated tungsten wire, from which the MTF is computed. Object-dependent PSF is derived and compared with ASF. Sensitivity of these measurements to phantom positioning, imaging conditions and reconstruction algorithms is evaluated. Results are compared from systems of varying acquisition geometry (9–25 projections over 15–60°). Dependence of measurements on feature size is investigated. Results: Measurements of spatial resolution using PSF and LSF are shown to depend on feature size; depth-direction spatial resolution measurements are shown to similarly depend on feature size for ASF, though deconvolution with an object function removes feature size-dependence. A slanted wire may be used to measure oversampled PSFs, from which MTFs may be computed for both in-plane and depth-direction resolution. Conclusion: Spatial resolution measured using PSF is object-independent with sufficiently small object; MTF is object

Stationary intraoral digital tomosynthesis using a carbon nanotube X-ray source array.

Science.gov (United States)

Shan, J; Tucker, A W; Gaalaas, L R; Wu, G; Platin, E; Mol, A; Lu, J; Zhou, O

2015-01-01

Intraoral dental tomosynthesis and closely related tuned-aperture CT (TACT) are low-dose three-dimensional (3D) imaging modalities that have shown improved detection of multiple dental diseases. Clinical interest in implementing these technologies waned owing to their time-consuming nature. Recently developed carbon nanotube (CNT) X-ray sources allow rapid multi-image acquisition without mechanical motion, making tomosynthesis a clinically viable technique. The objective of this investigation was to evaluate the feasibility of and produce high-quality images from a digital tomosynthesis system employing CNT X-ray technology. A test-bed stationary intraoral tomosynthesis unit was constructed using a CNT X-ray source array and a digital intraoral sensor. The source-to-image distance was modified to make the system comparable in image resolution to current two-dimensional intraoral radiography imaging systems. Anthropomorphic phantoms containing teeth with simulated and real caries lesions were imaged using a dose comparable to D-speed film dose with a rectangular collimation. Images were reconstructed and analysed. Tomosynthesis images of the phantom and teeth specimen demonstrated perceived image quality equivalent or superior to standard digital images with the added benefit of 3D information. The ability to "scroll" through slices in a buccal-lingual direction significantly improved visualization of anatomical details. In addition, the subjective visibility of dental caries was increased. Feasibility of the stationary intraoral tomosynthesis is demonstrated. The results show clinical promise and suitability for more robust observer and clinical studies.

Assembly and evaluation of a training module and dataset with feedback for improved interpretation of digital breast tomosynthesis examinations

Science.gov (United States)

Gur, David; Zuley, Margarita L.; Sumkin, Jules H.; Hakim, Christiane M.; Chough, Denise M.; Lovy, Linda; Sobran, Cynthia; Logue, Durwin; Zheng, Bin; Klym, Amy H.

2012-02-01

The FDA recently approved Digital Breast Tomosynthesis (DBT) for use in screening for the early detection of breast cancer. However, MQSA qualification for interpreting DBT through training was noted as important. Performance issues related to training are largely unknown. Therefore, we assembled a unique computerized training module to assess radiologists' performances before and after using the training module. Seventy-one actual baseline mammograms (no priors) with FFDM and DBT images were assembled to be read before and after training with the developed module. Fifty examinations of FFDM and DBT images enriched with positive findings were assembled for the training module. Depicted findings were carefully reviewed, summarized, and entered into a specially designed training database where findings were identified by case number and synchronized to the display of the related FFDM plus DBT examinations on a clinical workstation. Readers reported any findings using screening BIRADS (0, 1, or 2) followed by instantaneous feedback of the verified truth. Six radiologists participated in the study and reader average sensitivity and specificity were compared before and after training. Average sensitivity improved and specificity remained relatively the same after training. Performance changes may be affected by disease prevalence in the training set.

Breast Cancer Screening, Mammography, and Other Modalities.

Science.gov (United States)

Fiorica, James V

2016-12-01

This article is an overview of the modalities available for breast cancer screening. The modalities discussed include digital mammography, digital breast tomosynthesis, breast ultrasonography, magnetic resonance imaging, and clinical breast examination. There is a review of pertinent randomized controlled trials, studies and meta-analyses which contributed to the evolution of screening guidelines. Ultimately, 5 major medical organizations formulated the current screening guidelines in the United States. The lack of consensus in these guidelines represents an ongoing controversy about the optimal timing and method for breast cancer screening in women. For mammography screening, the Breast Imaging Reporting and Data System lexicon is explained which corresponds with recommended clinical management. The presentation and discussion of the data in this article are designed to help the clinician individualize breast cancer screening for each patient.

Organ dose variability and trends in tomosynthesis and radiography.

Science.gov (United States)

Hoye, Jocelyn; Zhang, Yakun; Agasthya, Greeshma; Sturgeon, Greg; Kapadia, Anuj; Segars, W Paul; Samei, Ehsan

2017-07-01

The purpose of this study was to investigate relationships between patient attributes and organ dose for a population of computational phantoms for 20 tomosynthesis and radiography protocols. Organ dose was estimated from 54 adult computational phantoms (age: 18 to 78 years, weight 52 to 117 kg) using a validated Monte-Carlo simulation (PENELOPE) of a system capable of performing tomosynthesis and radiography. The geometry and field of view for each exam were modeled to match clinical protocols. For each protocol, the energy deposited in each organ was estimated by the simulations, converted to dose units, and then normalized by exposure in air. Dose to radiosensitive organs was studied as a function of average patient thickness in the region of interest and as a function of body mass index. For tomosynthesis, organ doses were also studied as a function of x-ray tube position. This work developed comprehensive information for organ dose dependencies across a range of tomosynthesis and radiography protocols. The results showed a protocol-dependent exponential decrease with an increasing patient size. There was a variability in organ dose across the patient population, which should be incorporated in the metrology of organ dose. The results can be used to prospectively and retrospectively estimate organ dose for tomosynthesis and radiography.

A Monte Carlo estimation of effective dose in chest tomosynthesis

International Nuclear Information System (INIS)

Sabol, John M.

2009-01-01

Purpose: The recent introduction of digital tomosynthesis imaging into routine clinical use has enabled the acquisition of volumetric patient data within a standard radiographic examination. Tomosynthesis requires the acquisition of multiple projection views, requiring additional dose compared to a standard projection examination. Knowledge of the effective dose is needed to make an appropriate decision between standard projection, tomosynthesis, and CT for thoracic x-ray examinations. In this article, the effective dose to the patient of chest tomosynthesis is calculated and compared to a standard radiographic examination and to values published for thoracic CT. Methods: Radiographic technique data for posterior-anterior (PA) and left lateral (LAT) radiographic chest examinations of medium-sized adults was obtained from clinical sites. From these data, the average incident air kerma for the standard views was determined. A commercially available tomosynthesis system was used to define the acquisition technique and geometry for each projection view. Using Monte Carlo techniques, the effective dose of the PA, LAT, and each tomosynthesis projection view was calculated. The effective dose for all projections of the tomosynthesis sweep was summed and compared to the calculated PA and LAT values and to the published values for thoracic CT. Results: The average incident air kerma for the PA and left lateral clinical radiographic examinations were found to be 0.10 and 0.40 mGy, respectively. The effective dose for the PA view of a patient of the size of an average adult male was determined to be 0.017 mSv (ICRP 60) [0.018 mSv (ICRP 103)]. For the left lateral view of the same sized patient, the effective dose was determined to be 0.039 mSv (ICRP 60) [0.050 mSv (ICRP 103)]. The cumulative mA s for a tomosynthesis examination is recommended to be ten times the mA s of the PA image. With this technique, the effective dose for an average tomosynthesis examination was

Development of a prototype chest digital tomosynthesis (CDT) R/F system with fast image reconstruction using graphics processing unit (GPU) programming

Energy Technology Data Exchange (ETDEWEB)

Choi, Sunghoon, E-mail: choi.sh@yonsei.ac.kr [Department of Radiological Science, College of Health Science, Yonsei University, 1 Yonseidae-gil, Wonju, Gangwon-do 220-710 (Korea, Republic of); Lee, Seungwan [Department of Radiological Science, College of Medical Science, Konyang University, 158 Gwanjeodong-ro, Daejeon, 308-812 (Korea, Republic of); Lee, Haenghwa [Department of Radiological Science, College of Health Science, Yonsei University, 1 Yonseidae-gil, Wonju, Gangwon-do 220-710 (Korea, Republic of); Lee, Donghoon; Choi, Seungyeon [Department of Radiation Convergence Engineering, College of Health Science, Yonsei University, 1 Yonseidae-gil, Wonju, Gangwon-do 220-710 (Korea, Republic of); Shin, Jungwook [LISTEM Corporation, 94 Donghwagongdan-ro, Munmak-eup, Wonju (Korea, Republic of); Seo, Chang-Woo [Department of Radiological Science, College of Health Science, Yonsei University, 1 Yonseidae-gil, Wonju, Gangwon-do 220-710 (Korea, Republic of); Kim, Hee-Joung, E-mail: hjk1@yonsei.ac.kr [Department of Radiological Science, College of Health Science, Yonsei University, 1 Yonseidae-gil, Wonju, Gangwon-do 220-710 (Korea, Republic of); Department of Radiation Convergence Engineering, College of Health Science, Yonsei University, 1 Yonseidae-gil, Wonju, Gangwon-do 220-710 (Korea, Republic of)

2017-03-11

Digital tomosynthesis offers the advantage of low radiation doses compared to conventional computed tomography (CT) by utilizing small numbers of projections (~80) acquired over a limited angular range. It produces 3D volumetric data, although there are artifacts due to incomplete sampling. Based upon these characteristics, we developed a prototype digital tomosynthesis R/F system for applications in chest imaging. Our prototype chest digital tomosynthesis (CDT) R/F system contains an X-ray tube with high power R/F pulse generator, flat-panel detector, R/F table, electromechanical radiographic subsystems including a precise motor controller, and a reconstruction server. For image reconstruction, users select between analytic and iterative reconstruction methods. Our reconstructed images of Catphan700 and LUNGMAN phantoms clearly and rapidly described the internal structures of phantoms using graphics processing unit (GPU) programming. Contrast-to-noise ratio (CNR) values of the CTP682 module of Catphan700 were higher in images using a simultaneous algebraic reconstruction technique (SART) than in those using filtered back-projection (FBP) for all materials by factors of 2.60, 3.78, 5.50, 2.30, 3.70, and 2.52 for air, lung foam, low density polyethylene (LDPE), Delrin{sup ®} (acetal homopolymer resin), bone 50% (hydroxyapatite), and Teflon, respectively. Total elapsed times for producing 3D volume were 2.92 s and 86.29 s on average for FBP and SART (20 iterations), respectively. The times required for reconstruction were clinically feasible. Moreover, the total radiation dose from our system (5.68 mGy) was lower than that of conventional chest CT scan. Consequently, our prototype tomosynthesis R/F system represents an important advance in digital tomosynthesis applications.

Pulmonary nodule size evaluation with chest tomosynthesis.

Science.gov (United States)

Johnsson, Åse A; Fagman, Erika; Vikgren, Jenny; Fisichella, Valeria A; Boijsen, Marianne; Flinck, Agneta; Kheddache, Susanne; Svalkvist, Angelica; Båth, Magnus

2012-10-01

To evaluate intra- and interobserver variability, as well as agreement for nodule size measurements on chest tomosynthesis and computed tomographic (CT) images. The Regional Ethical Review Board approved this study, and all participants gave written informed consent. Thirty-six segmented nodules in 20 patients were included in the study. Eight observers measured the left-to-right, inferior-to-superior, and longest nodule diameters on chest tomosynthesis and CT images. Intra- and interobserver repeatability, as well as agreement between measurements on chest tomosynthesis and CT images, were assessed as recommended by Bland and Altman. The difference between the mean manual and the segmented diameter was -2.2 and -2.3 mm for left-to-right and -2.6 and -2.2 mm for the inferior-to-superior diameter for measurements on chest tomosynthesis and CT images, respectively. Intraobserver 95% limits of agreement (LOA) for the longest diameter ranged from a lower limit of -1.1 mm and an upper limit of 1.0 mm to -1.8 and 1.8 mm for chest tomosynthesis and from -0.6 and 0.9 mm to -3.1 and 2.2 mm for axial CT. Interobserver 95% LOA ranged from -1.3 and 1.5 mm to -2.0 and 2.1 mm for chest tomosynthesis and from -1.8 and 1.1 mm to -2.2 and 3.1 mm for axial CT. The 95% LOA concerning the mean of the observers' measurements of the longest diameter at chest tomosynthesis and axial CT were ±2.1 mm (mean measurement error, 0 mm). For the different observers, the 95% LOA between the modalities ranged from -2.2 and 1.6 mm to -3.2 and 2.8 mm. Measurements on chest tomosynthesis and CT images are comparable, because there is no evident bias between the modalities and the repeatability is similar. The LOA between measurements for the two modalities raise concern if measurements from chest tomosynthesis and CT were to be used interchangeably. © RSNA, 2012.

Multiscale bilateral filtering for improving image quality in digital breast tomosynthesis

Science.gov (United States)

Lu, Yao; Chan, Heang-Ping; Wei, Jun; Hadjiiski, Lubomir M.; Samala, Ravi K.

2015-01-01

Purpose: Detection of subtle microcalcifications in digital breast tomosynthesis (DBT) is a challenging task because of the large, noisy DBT volume. It is important to enhance the contrast-to-noise ratio (CNR) of microcalcifications in DBT reconstruction. Most regularization methods depend on local gradient and may treat the ill-defined margins or subtle spiculations of masses and subtle microcalcifications as noise because of their small gradient. The authors developed a new multiscale bilateral filtering (MSBF) regularization method for the simultaneous algebraic reconstruction technique (SART) to improve the CNR of microcalcifications without compromising the quality of masses. Methods: The MSBF exploits a multiscale structure of DBT images to suppress noise and selectively enhance high frequency structures. At the end of each SART iteration, every DBT slice is decomposed into several frequency bands via Laplacian pyramid decomposition. No regularization is applied to the low frequency bands so that subtle edges of masses and structured background are preserved. Bilateral filtering is applied to the high frequency bands to enhance microcalcifications while suppressing noise. The regularized DBT images are used for updating in the next SART iteration. The new MSBF method was compared with the nonconvex total p-variation (TpV) method for noise regularization with SART. A GE GEN2 prototype DBT system was used for acquisition of projections at 21 angles in 3° increments over a ±30° range. The reconstruction image quality with no regularization (NR) and that with the two regularization methods were compared using the DBT scans of a heterogeneous breast phantom and several human subjects with masses and microcalcifications. The CNR and the full width at half maximum (FWHM) of the line profiles of microcalcifications and across the spiculations within their in-focus DBT slices were used as image quality measures. Results: The MSBF method reduced contouring artifacts

Mass detection in digital breast tomosynthesis: Deep convolutional neural network with transfer learning from mammography.

Science.gov (United States)

Samala, Ravi K; Chan, Heang-Ping; Hadjiiski, Lubomir; Helvie, Mark A; Wei, Jun; Cha, Kenny

2016-12-01

Develop a computer-aided detection (CAD) system for masses in digital breast tomosynthesis (DBT) volume using a deep convolutional neural network (DCNN) with transfer learning from mammograms. A data set containing 2282 digitized film and digital mammograms and 324 DBT volumes were collected with IRB approval. The mass of interest on the images was marked by an experienced breast radiologist as reference standard. The data set was partitioned into a training set (2282 mammograms with 2461 masses and 230 DBT views with 228 masses) and an independent test set (94 DBT views with 89 masses). For DCNN training, the region of interest (ROI) containing the mass (true positive) was extracted from each image. False positive (FP) ROIs were identified at prescreening by their previously developed CAD systems. After data augmentation, a total of 45 072 mammographic ROIs and 37 450 DBT ROIs were obtained. Data normalization and reduction of non-uniformity in the ROIs across heterogeneous data was achieved using a background correction method applied to each ROI. A DCNN with four convolutional layers and three fully connected (FC) layers was first trained on the mammography data. Jittering and dropout techniques were used to reduce overfitting. After training with the mammographic ROIs, all weights in the first three convolutional layers were frozen, and only the last convolution layer and the FC layers were randomly initialized again and trained using the DBT training ROIs. The authors compared the performances of two CAD systems for mass detection in DBT: one used the DCNN-based approach and the other used their previously developed feature-based approach for FP reduction. The prescreening stage was identical in both systems, passing the same set of mass candidates to the FP reduction stage. For the feature-based CAD system, 3D clustering and active contour method was used for segmentation; morphological, gray level, and texture features were extracted and merged with a

Image reconstruction for digital breast tomosynthesis (DBT) by using projection-angle-dependent filter functions

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Park, Yeonok; Park, Chulkyu; Cho, Hyosung; Je, Uikyu; Hong, Daeki; Lee, Minsik; Cho, Heemoon; Choi, Sungil; Koo, Yangseo [Yonsei University, Wonju (Korea, Republic of)

2014-09-15

Digital breast tomosynthesis (DBT) is considered in clinics as a standard three-dimensional imaging modality, allowing the earlier detection of cancer. It typically acquires only 10-30 projections over a limited angle range of 15 - 60 .deg. with a stationary detector and typically uses a computationally-efficient filtered-backprojection (FBP) algorithm for image reconstruction. However, a common FBP algorithm yields poor image quality resulting from the loss of average image value and the presence of severe image artifacts due to the elimination of the dc component of the image by the ramp filter and to the incomplete data, respectively. As an alternative, iterative reconstruction methods are often used in DBT to overcome these difficulties, even though they are still computationally expensive. In this study, as a compromise, we considered a projection-angle dependent filtering method in which one-dimensional geometry-adapted filter kernels are computed with the aid of a conjugate-gradient method and are incorporated into the standard FBP framework. We implemented the proposed algorithm and performed systematic simulation works to investigate the imaging characteristics. Our results indicate that the proposed method is superior to a conventional FBP method for DBT imaging and has a comparable computational cost, while preserving good image homogeneity and edge sharpening with no serious image artifacts.

WE-DE-207B-08: Towards Standardization of X-Ray Filters in Digital Mammography-Enabled Breast Tomosynthesis Systems

International Nuclear Information System (INIS)

Shrestha, S; Vedantham, S; Karellas, A

2016-01-01

Purpose: In digital breast tomosynthesis (DBT) systems capable of digital mammography (DM), Al filters are used during DBT and K-edge filters during DM. The potential for standardizing the x-ray filters with Al, instead of K-edge filters, was investigated with intent to reduce exposure duration and to promote a simpler system design. Methods: Analytical computations of the half-value thickness (HVT) and the photon fluence per mAs (photons/mm2/mAs) for K-edge filters (50µm Rh; 50µm Ag) were compared with Al filters of varying thickness. Two strategies for matching the HVT from K-edge and Al filtered spectra were investigated: varying the kVp for fixed Al thickness, or varying the Al thickness at matched kVp. For both strategies, Al filters were an order of magnitude thicker than K-edge filters. Hence, Monte Carlo simulations were conducted with the GEANT4 toolkit to determine if the scatter-to-primary ratio (SPR) and the point spread function of scatter (scatter PSF) differed between Al and K-edge filters. Results: Results show the potential for replacing currently used Kedge filters with Al. For fixed Al thickness (700µm), ±1 kVp and +(1–3) kVp change, matched HVT of Rh and Ag filtered spectra. At matched kVp, Al thickness range (650,750)µm and (750,860)µm matched the HVT from Rh and Ag filtered spectra. Photon fluence/mAs with Al filters were 1.5–2.5 times higher, depending on kVp and Al thickness, compared to K-edge filters. Although Al thickness was an order higher than K-edge filters, neither the SPR nor the scatter PSF differed from K-edge filters. Conclusion: The use of Al filters for digital mammography is potentially feasible. The increased fluence/mAs with Al could decrease exposure duration for the combined DBT+DM exam and simplify system design. Effect of x-ray spectrum change due to Al filtration on radiation dose, signal, noise, contrast and related metrics are being investigated. Funding support: Supported in part by NIH R21CA176470 and R01

WE-DE-207B-08: Towards Standardization of X-Ray Filters in Digital Mammography-Enabled Breast Tomosynthesis Systems

Energy Technology Data Exchange (ETDEWEB)

Shrestha, S; Vedantham, S; Karellas, A [University of Massachusetts Medical School, Worcester, MA (United States)

2016-06-15

Purpose: In digital breast tomosynthesis (DBT) systems capable of digital mammography (DM), Al filters are used during DBT and K-edge filters during DM. The potential for standardizing the x-ray filters with Al, instead of K-edge filters, was investigated with intent to reduce exposure duration and to promote a simpler system design. Methods: Analytical computations of the half-value thickness (HVT) and the photon fluence per mAs (photons/mm2/mAs) for K-edge filters (50µm Rh; 50µm Ag) were compared with Al filters of varying thickness. Two strategies for matching the HVT from K-edge and Al filtered spectra were investigated: varying the kVp for fixed Al thickness, or varying the Al thickness at matched kVp. For both strategies, Al filters were an order of magnitude thicker than K-edge filters. Hence, Monte Carlo simulations were conducted with the GEANT4 toolkit to determine if the scatter-to-primary ratio (SPR) and the point spread function of scatter (scatter PSF) differed between Al and K-edge filters. Results: Results show the potential for replacing currently used Kedge filters with Al. For fixed Al thickness (700µm), ±1 kVp and +(1–3) kVp change, matched HVT of Rh and Ag filtered spectra. At matched kVp, Al thickness range (650,750)µm and (750,860)µm matched the HVT from Rh and Ag filtered spectra. Photon fluence/mAs with Al filters were 1.5–2.5 times higher, depending on kVp and Al thickness, compared to K-edge filters. Although Al thickness was an order higher than K-edge filters, neither the SPR nor the scatter PSF differed from K-edge filters. Conclusion: The use of Al filters for digital mammography is potentially feasible. The increased fluence/mAs with Al could decrease exposure duration for the combined DBT+DM exam and simplify system design. Effect of x-ray spectrum change due to Al filtration on radiation dose, signal, noise, contrast and related metrics are being investigated. Funding support: Supported in part by NIH R21CA176470 and R01

Mammographic density and breast cancer risk in breast screening assessment cases and women with a family history of breast cancer.

Science.gov (United States)

Duffy, Stephen W; Morrish, Oliver W E; Allgood, Prue C; Black, Richard; Gillan, Maureen G C; Willsher, Paula; Cooke, Julie; Duncan, Karen A; Michell, Michael J; Dobson, Hilary M; Maroni, Roberta; Lim, Yit Y; Purushothaman, Hema N; Suaris, Tamara; Astley, Susan M; Young, Kenneth C; Tucker, Lorraine; Gilbert, Fiona J

2018-01-01

Mammographic density has been shown to be a strong independent predictor of breast cancer and a causative factor in reducing the sensitivity of mammography. There remain questions as to the use of mammographic density information in the context of screening and risk management, and of the association with cancer in populations known to be at increased risk of breast cancer. To assess the association of breast density with presence of cancer by measuring mammographic density visually as a percentage, and with two automated volumetric methods, Quantra™ and VolparaDensity™. The TOMosynthesis with digital MammographY (TOMMY) study of digital breast tomosynthesis in the Breast Screening Programme of the National Health Service (NHS) of the United Kingdom (UK) included 6020 breast screening assessment cases (of whom 1158 had breast cancer) and 1040 screened women with a family history of breast cancer (of whom two had breast cancer). We assessed the association of each measure with breast cancer risk in these populations at enhanced risk, using logistic regression adjusted for age and total breast volume as a surrogate for body mass index (BMI). All density measures showed a positive association with presence of cancer and all declined with age. The strongest effect was seen with Volpara absolute density, with a significant 3% (95% CI 1-5%) increase in risk per 10 cm 3 of dense tissue. The effect of Volpara volumetric density on risk was stronger for large and grade 3 tumours. Automated absolute breast density is a predictor of breast cancer risk in populations at enhanced risk due to either positive mammographic findings or family history. In the screening context, density could be a trigger for more intensive imaging. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Practical applications of digital tomosynthesis of the chest

International Nuclear Information System (INIS)

Galea, A.; Durran, A.; Adlan, T.; Gay, D.; Riordan, R.; Dubbins, P.; Williams, M.P.

2014-01-01

Digital tomosynthesis is a radiographic technique that generates a number of coronal raw images of a patient from a single pass of the x-ray tube. Tomosynthesis provides some of the tomographic benefits of computed tomography (CT), but at a much lower dose of radiation and cost when compared to CT. This review illustrates the range of practical applications of digital tomosynthesis of the chest

Changes in frequency of recall recommendations of examinations depicting cancer with the availability of either priors or digital breast tomosynthesis

Science.gov (United States)

Hakim, Christiane M.; Bandos, Andriy I.; Ganott, Marie A.; Catullo, Victor J.; Chough, Denise M.; Kelly, Amy E.; Shinde, Dilip D.; Sumkin, Jules H.; Wallace, Luisa P.; Nishikawa, Robert M.; Gur, David

2016-03-01

Performance changes in a binary environment when using additional information is affected only when changes in recommendations are made due to the additional information in question. In a recent study, we have shown that, contrary to general expectation, introducing prior examinations improved recall rates, but not sensitivity. In this study, we assessed cancer detection differences when prior examinations and/or digital breast tomosynthesis (DBT) were made available to the radiologist. We identified a subset of 21 cancer cases with differences in the number of radiologists who recalled these cases after reviewing either a prior examination or DBT. For the cases with differences in recommendations after viewing either priors or DBT, separately, we evaluated the total number of readers that changed their recommendations, regardless of the specific radiologist in question. Confidence intervals for the number of readers and a test for the hypothesis of no difference was performed using the non-parameteric bootstrap approach addressing both case and reader-related sources of variability by resampling cases and readers. With the addition of priors, there were 14 cancer cases (out of 15) where the number of "recalling radiologists" decreased. With the addition of DBT, the number of "recalling radiologists" decreased in only five cases (out of 15) while increasing in the remaining 9 cases. Unlike most new approaches to breast imaging DBT seems to improve both recall rates and cancer detection rates. Changes in recommendations were noted by all radiologists for all cancers by type, size, and breast density.

Pipeline for effective denoising of digital mammography and digital breast tomosynthesis

Science.gov (United States)

Borges, Lucas R.; Bakic, Predrag R.; Foi, Alessandro; Maidment, Andrew D. A.; Vieira, Marcelo A. C.

2017-03-01

Denoising can be used as a tool to enhance image quality and enforce low radiation doses in X-ray medical imaging. The effectiveness of denoising techniques relies on the validity of the underlying noise model. In full-field digital mammography (FFDM) and digital breast tomosynthesis (DBT), calibration steps like the detector offset and flat-fielding can affect some assumptions made by most denoising techniques. Furthermore, quantum noise found in X-ray images is signal-dependent and can only be treated by specific filters. In this work we propose a pipeline for FFDM and DBT image denoising that considers the calibration steps and simplifies the modeling of the noise statistics through variance-stabilizing transformations (VST). The performance of a state-of-the-art denoising method was tested with and without the proposed pipeline. To evaluate the method, objective metrics such as the normalized root mean square error (N-RMSE), noise power spectrum, modulation transfer function (MTF) and the frequency signal-to-noise ratio (SNR) were analyzed. Preliminary tests show that the pipeline improves denoising. When the pipeline is not used, bright pixels of the denoised image are under-filtered and dark pixels are over-smoothed due to the assumption of a signal-independent Gaussian model. The pipeline improved denoising up to 20% in terms of spatial N-RMSE and up to 15% in terms of frequency SNR. Besides improving the denoising, the pipeline does not increase signal smoothing significantly, as shown by the MTF. Thus, the proposed pipeline can be used with state-of-the-art denoising techniques to improve the quality of DBT and FFDM images.

Image quality of microcalcifications in digital breast tomosynthesis: Effects of projection-view distributions

International Nuclear Information System (INIS)

Lu, Yao; Chan, Heang-Ping; Wei, Jun; Goodsitt, Mitch; Carson, Paul L.; Hadjiiski, Lubomir; Schmitz, Andrea; Eberhard, Jeffrey W.; Claus, Bernhard E. H.

2011-01-01

Purpose: To analyze the effects of projection-view (PV) distribution on the contrast and spatial blurring of microcalcifications on the tomosynthesized slices (X-Y plane) and along the depth (Z) direction for the same radiation dose in digital breast tomosynthesis (DBT). Methods: A GE GEN2 prototype DBT system was used for acquisition of DBT scans. The system acquires PV images from 21 angles in 3 deg. increments over a ±30 deg. range. From these acquired PV images, the authors selected six subsets of PV images to simulate DBT of different angular ranges and angular increments. The number of PV images in each subset was fixed at 11 to simulate a constant total dose. These different PV distributions were subjectively divided into three categories: uniform group, nonuniform central group, and nonuniform extreme group with different angular ranges and angular increments. The simultaneous algebraic reconstruction technique (SART) was applied to each subset to reconstruct the DBT slices. A selective diffusion regularization method was employed to suppress noise. The image quality of microcalcifications in the reconstructed DBTs with different PV distributions was compared using the DBT scans of an American College of Radiology phantom and three human subjects. The contrast-to-noise ratio (CNR) and the full width at half maximum (FWHM) of the line profiles of microcalcifications within their in-focus DBT slices (parallel to detector plane) and the FWHMs of the interplane artifact spread function (ASF) in the Z-direction (perpendicular to detector plane) were used as image quality measures. Results: The results indicate that DBT acquired with a large angular range or, for an equal angular range,with a large fraction of PVs at large angles yielded superior ASF with smaller FWHM in the Z-direction. PV distributions with a narrow angular range or a large fraction of PVs at small angles had stronger interplane artifacts. In the X-Y focal planes, the effect of PV

Ray tracing reconstruction investigation for C-arm tomosynthesis

Science.gov (United States)

Malalla, Nuhad A. Y.; Chen, Ying

2016-04-01

C-arm tomosynthesis is a three dimensional imaging technique. Both x-ray source and the detector are mounted on a C-arm wheeled structure to provide wide variety of movement around the object. In this paper, C-arm tomosynthesis was introduced to provide three dimensional information over a limited view angle (less than 180o) to reduce radiation exposure and examination time. Reconstruction algorithms based on ray tracing method such as ray tracing back projection (BP), simultaneous algebraic reconstruction technique (SART) and maximum likelihood expectation maximization (MLEM) were developed for C-arm tomosynthesis. C-arm tomosynthesis projection images of simulated spherical object were simulated with a virtual geometric configuration with a total view angle of 40 degrees. This study demonstrated the sharpness of in-plane reconstructed structure and effectiveness of removing out-of-plane blur for each reconstruction algorithms. Results showed the ability of ray tracing based reconstruction algorithms to provide three dimensional information with limited angle C-arm tomosynthesis.

Three-dimensional cascaded system analysis of a 50 µm pixel pitch wafer-scale CMOS active pixel sensor x-ray detector for digital breast tomosynthesis.

Science.gov (United States)

Zhao, C; Vassiljev, N; Konstantinidis, A C; Speller, R D; Kanicki, J

2017-03-07

High-resolution, low-noise x-ray detectors based on the complementary metal-oxide-semiconductor (CMOS) active pixel sensor (APS) technology have been developed and proposed for digital breast tomosynthesis (DBT). In this study, we evaluated the three-dimensional (3D) imaging performance of a 50 µm pixel pitch CMOS APS x-ray detector named DynAMITe (Dynamic Range Adjustable for Medical Imaging Technology). The two-dimensional (2D) angle-dependent modulation transfer function (MTF), normalized noise power spectrum (NNPS), and detective quantum efficiency (DQE) were experimentally characterized and modeled using the cascaded system analysis at oblique incident angles up to 30°. The cascaded system model was extended to the 3D spatial frequency space in combination with the filtered back-projection (FBP) reconstruction method to calculate the 3D and in-plane MTF, NNPS and DQE parameters. The results demonstrate that the beam obliquity blurs the 2D MTF and DQE in the high spatial frequency range. However, this effect can be eliminated after FBP image reconstruction. In addition, impacts of the image acquisition geometry and detector parameters were evaluated using the 3D cascaded system analysis for DBT. The result shows that a wider projection angle range (e.g.  ±30°) improves the low spatial frequency (below 5 mm -1 ) performance of the CMOS APS detector. In addition, to maintain a high spatial resolution for DBT, a focal spot size of smaller than 0.3 mm should be used. Theoretical analysis suggests that a pixelated scintillator in combination with the 50 µm pixel pitch CMOS APS detector could further improve the 3D image resolution. Finally, the 3D imaging performance of the CMOS APS and an indirect amorphous silicon (a-Si:H) thin-film transistor (TFT) passive pixel sensor (PPS) detector was simulated and compared.

Investigation of the dosimetry of chest tomosynthesis

Science.gov (United States)

Svalkvist, Angelica; Zachrisson, Sara; Månsson, Lars Gunnar; Båth, Magnus

2009-02-01

Chest tomosynthesis has recently been introduced to healthcare as a low-dose alternative to CT or as a tool for improved diagnostics in chest radiography with only a modest increase in radiation dose to the patient. However, no detailed description of the dosimetry for this type of examination has been presented. The aim of this work was therefore to investigate the dosimetry of chest tomosynthesis. The chest tomosynthesis examination was assumed to be performed using a stationary detector and a vertically moving x-ray tube, exposing the patient from different angles. The Monte Carlo based computer software PCXMC was used to determine the effective dose delivered to a standard-sized patient from various angles using different assumptions of the distribution of the effective dose over the different projections. The obtained conversion factors between input dose measures and effective dose for chest tomosynthesis for different angular intervals were then compared with the horizontal projection. The results indicate that the error introduced by using conversion factors for the PA projection in chest radiography for estimating the effective dose of chest tomosynthesis is small for normally sized patients, especially if a conversion factor between KAP and effective dose is used.

Breast cancer imaging

International Nuclear Information System (INIS)

Funke, M.; Villena, C.

2008-01-01

Advances in female breast imaging have substantially influenced the diagnosis, therapy, and prognosis of breast cancer in the past few years. Mammography using conventional or digital technique is considered the gold standard for the early detection of breast cancer. Other modalities such as breast ultrasound and contrast-enhanced magnetic resonance imaging of the breast play an important role in diagnostic imaging, staging, and follow-up of breast cancer. Percutaneous needle biopsy is a faster, less invasive, and more cost-effective method than surgical biopsy for verifying the histological diagnosis. New methods such as breast tomosynthesis, contrast-enhanced mammography, and positron emission tomography promise to further improve breast imaging. Further studies are mandatory to adapt these new methods to clinical needs and to evaluate their performance in clinical practice. (orig.) [de

Fast tomosynthesis

International Nuclear Information System (INIS)

Klotz, E.; Linde, R.; Tiemens, U.; Weiss, H.

1978-01-01

A system has been constructed for fast tomosynthesis, whereby X-ray photographs are made of a single layer of an object. Twenty five X-ray tubes illuminate the object simultaneously at different angles. The resulting coded image is decoded by projecting it with a pattern of lenses that have the same form as the pattern of X-ray tubes. The coded image is optically correlated with the pattern of the sources. The scale of this can be adjusted so that the desired layer of the object is portrayed. Experimental results of its use in a hospital are presented. (C.F.)

A Monte Carlo-based model for simulation of digital chest tomo-synthesis

International Nuclear Information System (INIS)

Ullman, G.; Dance, D. R.; Sandborg, M.; Carlsson, G. A.; Svalkvist, A.; Baath, M.

2010-01-01

The aim of this work was to calculate synthetic digital chest tomo-synthesis projections using a computer simulation model based on the Monte Carlo method. An anthropomorphic chest phantom was scanned in a computed tomography scanner, segmented and included in the computer model to allow for simulation of realistic high-resolution X-ray images. The input parameters to the model were adapted to correspond to the VolumeRAD chest tomo-synthesis system from GE Healthcare. Sixty tomo-synthesis projections were calculated with projection angles ranging from + 15 to -15 deg. The images from primary photons were calculated using an analytical model of the anti-scatter grid and a pre-calculated detector response function. The contributions from scattered photons were calculated using an in-house Monte Carlo-based model employing a number of variance reduction techniques such as the collision density estimator. Tomographic section images were reconstructed by transferring the simulated projections into the VolumeRAD system. The reconstruction was performed for three types of images using: (i) noise-free primary projections, (ii) primary projections including contributions from scattered photons and (iii) projections as in (ii) with added correlated noise. The simulated section images were compared with corresponding section images from projections taken with the real, anthropomorphic phantom from which the digital voxel phantom was originally created. The present article describes a work in progress aiming towards developing a model intended for optimisation of chest tomo-synthesis, allowing for simulation of both existing and future chest tomo-synthesis systems. (authors)

Comparison of patient specific dose metrics between chest radiography, tomosynthesis, and CT for adult patients of wide ranging body habitus

International Nuclear Information System (INIS)

Zhang, Yakun; Li, Xiang; Segars, W. Paul; Samei, Ehsan

2014-01-01

Purpose: Given the radiation concerns inherent to the x-ray modalities, accurately estimating the radiation doses that patients receive during different imaging modalities is crucial. This study estimated organ doses, effective doses, and risk indices for the three clinical chest x-ray imaging techniques (chest radiography, tomosynthesis, and CT) using 59 anatomically variable voxelized phantoms and Monte Carlo simulation methods. Methods: A total of 59 computational anthropomorphic male and female extended cardiac-torso (XCAT) adult phantoms were used in this study. Organ doses and effective doses were estimated for a clinical radiography system with the capability of conducting chest radiography and tomosynthesis (Definium 8000, VolumeRAD, GE Healthcare) and a clinical CT system (LightSpeed VCT, GE Healthcare). A Monte Carlo dose simulation program (PENELOPE, version 2006, Universitat de Barcelona, Spain) was used to mimic these two clinical systems. The Duke University (Durham, NC) technique charts were used to determine the clinical techniques for the radiographic modalities. An exponential relationship between CTDI vol and patient diameter was used to determine the absolute dose values for CT. The simulations of the two clinical systems compute organ and tissue doses, which were then used to calculate effective dose and risk index. The calculation of the two dose metrics used the tissue weighting factors from ICRP Publication 103 and BEIR VII report. Results: The average effective dose of the chest posteroanterior examination was found to be 0.04 mSv, which was 1.3% that of the chest CT examination. The average effective dose of the chest tomosynthesis examination was found to be about ten times that of the chest posteroanterior examination and about 12% that of the chest CT examination. With increasing patient average chest diameter, both the effective dose and risk index for CT increased considerably in an exponential fashion, while these two dose metrics

Comparison of patient specific dose metrics between chest radiography, tomosynthesis, and CT for adult patients of wide ranging body habitus

Energy Technology Data Exchange (ETDEWEB)

Zhang, Yakun [Department of Radiology, Duke University Medical Center, Durham, North Carolina 27705 (United States); Li, Xiang [Medical Physics Graduate Program, Department of Physics, Cleveland State University, Cleveland, Ohio 44115 (United States); Segars, W. Paul [Medical Physics Graduate Program, Carl E. Ravin Advanced Imaging Laboratories, and Department of Radiology, Duke University Medical Center, Durham, North Carolina 27705 (United States); Samei, Ehsan, E-mail: samei@duke.edu [Medical Physics Graduate Program, Carl E. Ravin Advanced Imaging Laboratories, Department of Radiology, Departments of Physics, Biomedical Engineering, and Electrical and Computer Engineering, Duke University Medical Center, Durham, North Carolina 27705 (United States)

2014-02-15

Purpose: Given the radiation concerns inherent to the x-ray modalities, accurately estimating the radiation doses that patients receive during different imaging modalities is crucial. This study estimated organ doses, effective doses, and risk indices for the three clinical chest x-ray imaging techniques (chest radiography, tomosynthesis, and CT) using 59 anatomically variable voxelized phantoms and Monte Carlo simulation methods. Methods: A total of 59 computational anthropomorphic male and female extended cardiac-torso (XCAT) adult phantoms were used in this study. Organ doses and effective doses were estimated for a clinical radiography system with the capability of conducting chest radiography and tomosynthesis (Definium 8000, VolumeRAD, GE Healthcare) and a clinical CT system (LightSpeed VCT, GE Healthcare). A Monte Carlo dose simulation program (PENELOPE, version 2006, Universitat de Barcelona, Spain) was used to mimic these two clinical systems. The Duke University (Durham, NC) technique charts were used to determine the clinical techniques for the radiographic modalities. An exponential relationship between CTDI{sub vol} and patient diameter was used to determine the absolute dose values for CT. The simulations of the two clinical systems compute organ and tissue doses, which were then used to calculate effective dose and risk index. The calculation of the two dose metrics used the tissue weighting factors from ICRP Publication 103 and BEIR VII report. Results: The average effective dose of the chest posteroanterior examination was found to be 0.04 mSv, which was 1.3% that of the chest CT examination. The average effective dose of the chest tomosynthesis examination was found to be about ten times that of the chest posteroanterior examination and about 12% that of the chest CT examination. With increasing patient average chest diameter, both the effective dose and risk index for CT increased considerably in an exponential fashion, while these two dose

A virtual trial framework for quantifying the detectability of masses in breast tomosynthesis projection data

International Nuclear Information System (INIS)

Young, Stefano; Bakic, Predrag R.; Myers, Kyle J.; Jennings, Robert J.; Park, Subok

2013-01-01

Purpose: Digital breast tomosynthesis (DBT) is a promising breast cancer screening tool that has already begun making inroads into clinical practice. However, there is ongoing debate over how to quantitatively evaluate and optimize these systems, because different definitions of image quality can lead to different optimal design strategies. Powerful and accurate tools are desired to extend our understanding of DBT system optimization and validate published design principles. Methods: The authors developed a virtual trial framework for task-specific DBT assessment that uses digital phantoms, open-source x-ray transport codes, and a projection-space, spatial-domain observer model for quantitative system evaluation. The authors considered evaluation of reconstruction algorithms as a separate problem and focused on the information content in the raw, unfiltered projection images. Specifically, the authors investigated the effects of scan angle and number of angular projections on detectability of a small (3 mm diameter) signal embedded in randomly-varying anatomical backgrounds. Detectability was measured by the area under the receiver-operating characteristic curve (AUC). Experiments were repeated for three test cases where the detectability-limiting factor was anatomical variability, quantum noise, or electronic noise. The authors also juxtaposed the virtual trial framework with other published studies to illustrate its advantages and disadvantages. Results: The large number of variables in a virtual DBT study make it difficult to directly compare different authors’ results, so each result must be interpreted within the context of the specific virtual trial framework. The following results apply to 25% density phantoms with 5.15 cm compressed thickness and 500 μm 3 voxels (larger 500 μm 2 detector pixels were used to avoid voxel-edge artifacts): 1. For raw, unfiltered projection images in the anatomical-variability-limited regime, AUC appeared to remain constant

Evolutionary pruning of transfer learned deep convolutional neural network for breast cancer diagnosis in digital breast tomosynthesis.

Science.gov (United States)

Samala, Ravi K; Chan, Heang-Ping; Hadjiiski, Lubomir M; Helvie, Mark A; Richter, Caleb; Cha, Kenny

2018-05-01

Deep learning models are highly parameterized, resulting in difficulty in inference and transfer learning for image recognition tasks. In this work, we propose a layered pathway evolution method to compress a deep convolutional neural network (DCNN) for classification of masses in digital breast tomosynthesis (DBT). The objective is to prune the number of tunable parameters while preserving the classification accuracy. In the first stage transfer learning, 19 632 augmented regions-of-interest (ROIs) from 2454 mass lesions on mammograms were used to train a pre-trained DCNN on ImageNet. In the second stage transfer learning, the DCNN was used as a feature extractor followed by feature selection and random forest classification. The pathway evolution was performed using genetic algorithm in an iterative approach with tournament selection driven by count-preserving crossover and mutation. The second stage was trained with 9120 DBT ROIs from 228 mass lesions using leave-one-case-out cross-validation. The DCNN was reduced by 87% in the number of neurons, 34% in the number of parameters, and 95% in the number of multiply-and-add operations required in the convolutional layers. The test AUC on 89 mass lesions from 94 independent DBT cases before and after pruning were 0.88 and 0.90, respectively, and the difference was not statistically significant (p  >  0.05). The proposed DCNN compression approach can reduce the number of required operations by 95% while maintaining the classification performance. The approach can be extended to other deep neural networks and imaging tasks where transfer learning is appropriate.

Evolutionary pruning of transfer learned deep convolutional neural network for breast cancer diagnosis in digital breast tomosynthesis

Science.gov (United States)

Samala, Ravi K.; Chan, Heang-Ping; Hadjiiski, Lubomir M.; Helvie, Mark A.; Richter, Caleb; Cha, Kenny

2018-05-01

Deep learning models are highly parameterized, resulting in difficulty in inference and transfer learning for image recognition tasks. In this work, we propose a layered pathway evolution method to compress a deep convolutional neural network (DCNN) for classification of masses in digital breast tomosynthesis (DBT). The objective is to prune the number of tunable parameters while preserving the classification accuracy. In the first stage transfer learning, 19 632 augmented regions-of-interest (ROIs) from 2454 mass lesions on mammograms were used to train a pre-trained DCNN on ImageNet. In the second stage transfer learning, the DCNN was used as a feature extractor followed by feature selection and random forest classification. The pathway evolution was performed using genetic algorithm in an iterative approach with tournament selection driven by count-preserving crossover and mutation. The second stage was trained with 9120 DBT ROIs from 228 mass lesions using leave-one-case-out cross-validation. The DCNN was reduced by 87% in the number of neurons, 34% in the number of parameters, and 95% in the number of multiply-and-add operations required in the convolutional layers. The test AUC on 89 mass lesions from 94 independent DBT cases before and after pruning were 0.88 and 0.90, respectively, and the difference was not statistically significant (p  >  0.05). The proposed DCNN compression approach can reduce the number of required operations by 95% while maintaining the classification performance. The approach can be extended to other deep neural networks and imaging tasks where transfer learning is appropriate.

Dosimetric characterization and organ dose assessment in digital breast tomosynthesis: Measurements and Monte Carlo simulations using voxel phantoms

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Baptista, Mariana, E-mail: marianabaptista@ctn.ist.utl.pt; Di Maria, Salvatore; Barros, Sílvia; Vaz, Pedro [Centro de Ciências e Tecnologias Nucleares, Instituto Superior Técnico, Universidade de Lisboa, Estrada Nacional 10, km 139,7, Bobadela LRS 2695-066 (Portugal); Figueira, Catarina [Centre for Plasma Physics, School of Mathematics and Physics, Queen’s University, Belfast BT7 1NN (United Kingdom); Sarmento, Marta; Orvalho, Lurdes [Serviço de Imagiologia, Hospital da Luz, Avenida Lusíada, 100, Lisboa 1500-650 (Portugal)

2015-07-15

Purpose: Due to its capability to more accurately detect deep lesions inside the breast by removing the effect of overlying anatomy, digital breast tomosynthesis (DBT) has the potential to replace the standard mammography technique in clinical screening exams. However, the European Guidelines for DBT dosimetry are still a work in progress and there are little data available on organ doses other than to the breast. It is, therefore, of great importance to assess the dosimetric performance of DBT with respect to the one obtained with standard digital mammography (DM) systems. The aim of this work is twofold: (i) to study the dosimetric properties of a combined DBT/DM system (MAMMOMAT Inspiration Siemens{sup ®}) for a tungsten/rhodium (W/Rh) anode/filter combination and (ii) to evaluate organs doses during a DBT examination. Methods: For the first task, measurements were performed in manual and automatic exposure control (AEC) modes, using two homogeneous breast phantoms: a PMMA slab phantom and a 4 cm thick breast-shaped rigid phantom, with 50% of glandular tissue in its composition. Monte Carlo (MC) simulations were performed using Monte Carlo N-Particle eXtended v.2.7.0. A MC model was implemented to mimic DM and DBT acquisitions for a wide range of x-ray spectra (24 –34 kV). This was used to calculate mean glandular dose (MGD) and to compute series of backscatter factors (BSFs) that could be inserted into the DBT dosimetric formalism proposed by Dance et al. Regarding the second aim of the study, the implemented MC model of the clinical equipment, together with a female voxel phantom (“Laura”), was used to calculate organ doses considering a typical DBT acquisition. Results were compared with a standard two-view mammography craniocaudal (CC) acquisition. Results: Considering the AEC mode, the acquisition of a single CC view results in a MGD ranging from 0.53 ± 0.07 mGy to 2.41 ± 0.31 mGy in DM mode and from 0.77 ± 0.11 mGy to 2.28 ± 0.32 mGy in DBT mode

Self-masking subtraction tomosynthesis

International Nuclear Information System (INIS)

Chakraborty, D.P.; Yester, M.V.; Barnes, G.T.; Lakshminarayanan, A.V.

1984-01-01

The authors tested the image quality and dose savings of self-masking subtraction tomosynthesis (SST), which combines digital tomosynthesis with subtraction of a blurred self-mask. High-quality images of the inner ear of a head phantom were obtained at moderate dose savings. Although they were taken with linear motion, they did not exhibit the streaking due to off-fulcrum objects that is characteristic of conventional linear tomography. SST could reduce patient dose by a factor of at least 12 in examinations of the inner ear, and the mechanical aspects can be implemented with moderate modifications of existing instrumentation

Practical applications of digital tomosynthesis of the chest.

Science.gov (United States)

Galea, A; Durran, A; Adlan, T; Gay, D; Riordan, R; Dubbins, P; Williams, M P

2014-04-01

Digital tomosynthesis is a radiographic technique that generates a number of coronal raw images of a patient from a single pass of the x-ray tube. Tomosynthesis provides some of the tomographic benefits of computed tomography (CT), but at a much lower dose of radiation and cost when compared to CT. This review illustrates the range of practical applications of digital tomosynthesis of the chest. Copyright © 2013 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

A simple method to retrospectively estimate patient dose-area product for chest tomosynthesis examinations performed using VolumeRAD.

Science.gov (United States)

Båth, Magnus; Söderman, Christina; Svalkvist, Angelica

2014-10-01

The purpose of the present work was to develop and validate a method of retrospectively estimating the dose-area product (DAP) of a chest tomosynthesis examination performed using the VolumeRAD system (GE Healthcare, Chalfont St. Giles, UK) from digital imaging and communications in medicine (DICOM) data available in the scout image. DICOM data were retrieved for 20 patients undergoing chest tomosynthesis using VolumeRAD. Using information about how the exposure parameters for the tomosynthesis examination are determined by the scout image, a correction factor for the adjustment in field size with projection angle was determined. The correction factor was used to estimate the DAP for 20 additional chest tomosynthesis examinations from DICOM data available in the scout images, which was compared with the actual DAP registered for the projection radiographs acquired during the tomosynthesis examination. A field size correction factor of 0.935 was determined. Applying the developed method using this factor, the average difference between the estimated DAP and the actual DAP was 0.2%, with a standard deviation of 0.8%. However, the difference was not normally distributed and the maximum error was only 1.0%. The validity and reliability of the presented method were thus very high. A method to estimate the DAP of a chest tomosynthesis examination performed using the VolumeRAD system from DICOM data in the scout image was developed and validated. As the scout image normally is the only image connected to the tomosynthesis examination stored in the picture archiving and communication system (PACS) containing dose data, the method may be of value for retrospectively estimating patient dose in clinical use of chest tomosynthesis.

A simple method to retrospectively estimate patient dose-area product for chest tomosynthesis examinations performed using VolumeRAD

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Båth, Magnus, E-mail: magnus.bath@vgregion.se; Svalkvist, Angelica [Department of Radiation Physics, Institute of Clinical Sciences, The Sahlgrenska Academy at University of Gothenburg, Gothenburg SE-413 45, Sweden and Department of Medical Physics and Biomedical Engineering, Sahlgrenska University Hospital, Gothenburg SE-413 45 (Sweden); Söderman, Christina [Department of Radiation Physics, Institute of Clinical Sciences, The Sahlgrenska Academy at University of Gothenburg, Gothenburg SE-413 45 (Sweden)

2014-10-15

Purpose: The purpose of the present work was to develop and validate a method of retrospectively estimating the dose-area product (DAP) of a chest tomosynthesis examination performed using the VolumeRAD system (GE Healthcare, Chalfont St. Giles, UK) from digital imaging and communications in medicine (DICOM) data available in the scout image. Methods: DICOM data were retrieved for 20 patients undergoing chest tomosynthesis using VolumeRAD. Using information about how the exposure parameters for the tomosynthesis examination are determined by the scout image, a correction factor for the adjustment in field size with projection angle was determined. The correction factor was used to estimate the DAP for 20 additional chest tomosynthesis examinations from DICOM data available in the scout images, which was compared with the actual DAP registered for the projection radiographs acquired during the tomosynthesis examination. Results: A field size correction factor of 0.935 was determined. Applying the developed method using this factor, the average difference between the estimated DAP and the actual DAP was 0.2%, with a standard deviation of 0.8%. However, the difference was not normally distributed and the maximum error was only 1.0%. The validity and reliability of the presented method were thus very high. Conclusions: A method to estimate the DAP of a chest tomosynthesis examination performed using the VolumeRAD system from DICOM data in the scout image was developed and validated. As the scout image normally is the only image connected to the tomosynthesis examination stored in the picture archiving and communication system (PACS) containing dose data, the method may be of value for retrospectively estimating patient dose in clinical use of chest tomosynthesis.

A simple method to retrospectively estimate patient dose-area product for chest tomosynthesis examinations performed using VolumeRAD

International Nuclear Information System (INIS)

Båth, Magnus; Svalkvist, Angelica; Söderman, Christina

2014-01-01

Purpose: The purpose of the present work was to develop and validate a method of retrospectively estimating the dose-area product (DAP) of a chest tomosynthesis examination performed using the VolumeRAD system (GE Healthcare, Chalfont St. Giles, UK) from digital imaging and communications in medicine (DICOM) data available in the scout image. Methods: DICOM data were retrieved for 20 patients undergoing chest tomosynthesis using VolumeRAD. Using information about how the exposure parameters for the tomosynthesis examination are determined by the scout image, a correction factor for the adjustment in field size with projection angle was determined. The correction factor was used to estimate the DAP for 20 additional chest tomosynthesis examinations from DICOM data available in the scout images, which was compared with the actual DAP registered for the projection radiographs acquired during the tomosynthesis examination. Results: A field size correction factor of 0.935 was determined. Applying the developed method using this factor, the average difference between the estimated DAP and the actual DAP was 0.2%, with a standard deviation of 0.8%. However, the difference was not normally distributed and the maximum error was only 1.0%. The validity and reliability of the presented method were thus very high. Conclusions: A method to estimate the DAP of a chest tomosynthesis examination performed using the VolumeRAD system from DICOM data in the scout image was developed and validated. As the scout image normally is the only image connected to the tomosynthesis examination stored in the picture archiving and communication system (PACS) containing dose data, the method may be of value for retrospectively estimating patient dose in clinical use of chest tomosynthesis

Prospective study aiming to compare 2D mammography and tomosynthesis + synthesized mammography in terms of cancer detection and recall. From double reading of 2D mammography to single reading of tomosynthesis.

Science.gov (United States)

Romero Martín, Sara; Raya Povedano, Jose Luis; Cara García, María; Santos Romero, Ana Luz; Pedrosa Garriguet, Margarita; Álvarez Benito, Marina

2018-06-01

To evaluate tomosynthesis compared with 2D-mammography in cancer detection and recalls in a screening-programme, and assess performing synthesized instead of 2D, and compare double reading of 2D with single reading of tomosynthesis. Women (age 50-69 years) participating in the screening-programme were included. 2D-mammography and tomosynthesis were performed. There were four reading models: 2D-mammography (first); 2D-mammography (second); tomosynthesis + synthesized (third); tomosynthesis + synthesized + 2D (fourth reading). Paired double reading of 2D (first+second) and tomosynthesis (third+fourth) were analysed. In 16,067 participants, there were 98 cancers and 1,196 recalls. Comparing double reading of 2D with single reading of tomosynthesis, there was an increase of 12.6 % in cancer detection with the third reading (p= 0.043) and 6.9 % with the fourth reading (p=0.210), and a decrease in recalls of 40.5 % (ptomosynthesis. Single reading of tomosynthesis plus synthesized increased cancer detection and decreased recalls compared with double reading 2D. 2D did not improve results when added to tomosynthesis. • Tomosynthesis increases cancer detection and decreases recall rates versus 2D mammography. • Synthesized-mammography avoids performing 2D, showing higher cancer detection. • Single reading of tomosynthesis + synthesized is feasible as a new practice.

Improving image quality for digital breast tomosynthesis: an automated detection and diffusion-based method for metal artifact reduction

Science.gov (United States)

Lu, Yao; Chan, Heang-Ping; Wei, Jun; Hadjiiski, Lubomir M.; Samala, Ravi K.

2017-10-01

In digital breast tomosynthesis (DBT), the high-attenuation metallic clips marking a previous biopsy site in the breast cause errors in the estimation of attenuation along the ray paths intersecting the markers during reconstruction, which result in interplane and inplane artifacts obscuring the visibility of subtle lesions. We proposed a new metal artifact reduction (MAR) method to improve image quality. Our method uses automatic detection and segmentation to generate a marker location map for each projection (PV). A voting technique based on the geometric correlation among different PVs is designed to reduce false positives (FPs) and to label the pixels on the PVs and the voxels in the imaged volume that represent the location and shape of the markers. An iterative diffusion method replaces the labeled pixels on the PVs with estimated tissue intensity from the neighboring regions while preserving the original pixel values in the neighboring regions. The inpainted PVs are then used for DBT reconstruction. The markers are repainted on the reconstructed DBT slices for radiologists’ information. The MAR method is independent of reconstruction techniques or acquisition geometry. For the training set, the method achieved 100% success rate with one FP in 19 views. For the test set, the success rate by view was 97.2% for core biopsy microclips and 66.7% for clusters of large post-lumpectomy markers with a total of 10 FPs in 58 views. All FPs were large dense benign calcifications that also generated artifacts if they were not corrected by MAR. For the views with successful detection, the metal artifacts were reduced to a level that was not visually apparent in the reconstructed slices. The visibility of breast lesions obscured by the reconstruction artifacts from the metallic markers was restored.

Lesion characterization in spectral photon-counting tomosynthesis

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Cederström, Björn; Fredenberg, Erik; Berggren, Karl; Erhard, Klaus; Danielsson, Mats; Wallis, Matthew

2017-03-01

It has previously been shown that 2D spectral mammography can be used to discriminate between (likely benign) cystic and (potentially malignant) solid lesions in order to reduce unnecessary recalls in mammography. One limitation of the technique is, however, that the composition of overlapping tissue needs to be interpolated from a region surrounding the lesion. The purpose of this investigation was to demonstrate that lesion characterization can be done with spectral tomosynthesis, and to investigate whether the 3D information available in tomosynthesis can reduce the uncertainty from the interpolation of surrounding tissue. A phantom experiment was designed to simulate a cyst and a tumor, where the tumor was overlaid with a structure that made it mimic a cyst. In 2D, the two targets appeared similar in composition, whereas spectral tomosynthesis revealed the exact compositional difference. However, the loss of discrimination signal due to spread from the plane of interest was of the same strength as the reduction of anatomical noise. Results from a preliminary investigation on clinical tomosynthesis images of solid lesions yielded results that were consistent with the phantom experiments, but were still to some extent inconclusive. We conclude that lesion characterization is feasible in spectral tomosynthesis, but more data, as well as refinement of the calibration and discrimination algorithms, are needed to draw final conclusions about the benefit compared to 2D.

Chest imaging with dual-energy substraction digital tomosynthesis

International Nuclear Information System (INIS)

Sone, S.; Kasuga, T.; Sakai, F.; Hirano, H.; Kubo, K.; Morimoto, M.; Takemura, K.; Hosoba, M.

1993-01-01

Dual-energy subtraction digital tomosynthesis with pulsed X-ray and rapid kV switching was used to examine calcifications in pulmonary lesions. The digital tomosynthesis system used included a conventional fluororadiographic TV unit with linear tomographic capabilities, a high resolution videocamera, and an image processing unit. Low-voltage, high voltage, and soft tissue subtracted or bone subtracted tomograms of any desired layer height were reconstructed from the image data acquired during a single tomographic swing. Calcifications, as well as their characteristics and distribution in pulmonary lesions, were clearly shown. The images also permitted discrimination of calcifications from dense fibrotic lesions. This technique was effective in demonstrating calcifications together with a solitary mass or disseminated nodules. (orig.)

Initial application of digital tomosynthesis for detection of pulmonary nodules

International Nuclear Information System (INIS)

Sun Zhiyuan; Su Hong; Zhao Yane; Ju Bing; Chang Shuanghui; Hu Qiuju; Lu Guangming

2010-01-01

Objective: To discuss the value of digital tomosynthesis for detection of pulmonary nodules. Methods: Thirty patients suspected of having pulmonary nodules underwent chest radiography, digital tomosynthesis and CT examination. Above image data were transferred to postprocessing work station and were reviewed by 2 radiologists with 3 years of chest-radiology diagnosis experience in a double-blind method. The number, location and size of nodules were recorded. Then, 2 radiologists reviewed the all images once more, and discuss in consensus. The sensitivities of chest radiography and digital tomosynthesis for detection of pulmonary nodules were respectively calculated according to the CT results. Chi-square test was used for radiography, digital tomosynthesis and CT examination. Results: Of 30 patients, 21 were detected having pulmonary nodules by X-ray radiography and 9 were negative, the total number of 40 nodules was detected, while 89 nodules in 26 patients were detected by digital tomosynthesis, and only 4 patients were negative. CT demonstrated 102 nodules in 27 patients, and 3 patients were negative. Taking CT as 'gold standard', the sensitivities of X-ray radiography and digital tomosynthesis were 27.4%(28/102)and 87.2%(89/102), X 2 =4.35, P<0.05, respectively. Conclusion: Digital tomosynthesis has a high sensitivity for detection of pulmonary nodules compared with X-ray radiography, and could be an excellent and necessary supplementary technique of X-ray radiography. (authors)

Suggestion of the manual exposure condition guideline for reducing patient dose in digital breast tomosynthesis

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Hong, Eun Ae [Dept. of Radiology, Korea University Guro Hospital, Seoul (Korea, Republic of); Lee, In Ja [Dept. of Radiologic Technology, Dongnam Health University, Suwon (Korea, Republic of)

2016-12-15

The conditions after exposure to digital mammography and digital breast tomosynthesis were analyzed. The examinations for the ACR phantom were done using manual exposure, not auto exposure, to examine image discrimination and patient dose. As a result, the following results were derived: In the CC exposure , the kVp was 2kVp higher while mAs decreased to 58.6% for the 3D tomography. Such result showed an approximate decrease of 60mAs. At that time, the patients Average Glandular Dose (AGD) was 1.65mGy in 2D and 1.87mGy in 3D; thus, AGD of 3D was shown to have about 1.13 times higher. The result of the manual exposure revealed a reduced mAs of up to 80%; there was no effect in the assessment standard in terms of image discrimination, resulting in more than 10 points. When mAs was reduced to 80% in the manual exposure for ACR phantom, AGD was decreased to 0.66mGy. The diagnostic values of images were maintained and patients dose was reduced in the manual exposure in the AEC condition for 3D. Since the use of 3D has recently increased, using the manual exposure has been recommended in this study to improve the diagnostic value, while, simultaneously reducing patients dose.

Inter-plane artifact suppression in tomosynthesis using 3D CT image data

Directory of Open Access Journals (Sweden)

Kim Jae G

2011-12-01

Full Text Available Abstract Background Despite its superb lateral resolution, flat-panel-detector (FPD based tomosynthesis suffers from low contrast and inter-plane artifacts caused by incomplete cancellation of the projection components stemming from outside the focal plane. The incomplete cancellation of the projection components, mostly due to the limited scan angle in the conventional tomosynthesis scan geometry, often makes the image contrast too low to differentiate the malignant tissues from the background tissues with confidence. Methods In this paper, we propose a new method to suppress the inter-plane artifacts in FPD-based tomosynthesis. If 3D whole volume CT images are available before the tomosynthesis scan, the CT image data can be incorporated into the tomosynthesis image reconstruction to suppress the inter-plane artifacts, hence, improving the image contrast. In the proposed technique, the projection components stemming from outside the region-of-interest (ROI are subtracted from the measured tomosynthesis projection data to suppress the inter-plane artifacts. The projection components stemming from outside the ROI are calculated from the 3D whole volume CT images which usually have lower lateral resolution than the tomosynthesis images. The tomosynthesis images are reconstructed from the subtracted projection data which account for the x-ray attenuation through the ROI. After verifying the proposed method by simulation, we have performed both CT scan and tomosynthesis scan on a phantom and a sacrificed rat using a FPD-based micro-CT. Results We have measured contrast-to-noise ratio (CNR from the tomosynthesis images which is an indicator of the residual inter-plane artifacts on the focal-plane image. In both cases of the simulation and experimental imaging studies of the contrast evaluating phantom, CNRs have been significantly improved by the proposed method. In the rat imaging also, we have observed better visual contrast from the tomosynthesis

Inter-plane artifact suppression in tomosynthesis using 3D CT image data

Science.gov (United States)

2011-01-01

Background Despite its superb lateral resolution, flat-panel-detector (FPD) based tomosynthesis suffers from low contrast and inter-plane artifacts caused by incomplete cancellation of the projection components stemming from outside the focal plane. The incomplete cancellation of the projection components, mostly due to the limited scan angle in the conventional tomosynthesis scan geometry, often makes the image contrast too low to differentiate the malignant tissues from the background tissues with confidence. Methods In this paper, we propose a new method to suppress the inter-plane artifacts in FPD-based tomosynthesis. If 3D whole volume CT images are available before the tomosynthesis scan, the CT image data can be incorporated into the tomosynthesis image reconstruction to suppress the inter-plane artifacts, hence, improving the image contrast. In the proposed technique, the projection components stemming from outside the region-of-interest (ROI) are subtracted from the measured tomosynthesis projection data to suppress the inter-plane artifacts. The projection components stemming from outside the ROI are calculated from the 3D whole volume CT images which usually have lower lateral resolution than the tomosynthesis images. The tomosynthesis images are reconstructed from the subtracted projection data which account for the x-ray attenuation through the ROI. After verifying the proposed method by simulation, we have performed both CT scan and tomosynthesis scan on a phantom and a sacrificed rat using a FPD-based micro-CT. Results We have measured contrast-to-noise ratio (CNR) from the tomosynthesis images which is an indicator of the residual inter-plane artifacts on the focal-plane image. In both cases of the simulation and experimental imaging studies of the contrast evaluating phantom, CNRs have been significantly improved by the proposed method. In the rat imaging also, we have observed better visual contrast from the tomosynthesis images reconstructed by

Grating-based phase contrast tomosynthesis imaging: Proof-of-concept experimental studies

International Nuclear Information System (INIS)

Li, Ke; Ge, Yongshuai; Garrett, John; Bevins, Nicholas; Zambelli, Joseph; Chen, Guang-Hong

2014-01-01

Purpose: This paper concerns the feasibility of x-ray differential phase contrast (DPC) tomosynthesis imaging using a grating-based DPC benchtop experimental system, which is equipped with a commercial digital flat-panel detector and a medical-grade rotating-anode x-ray tube. An extensive system characterization was performed to quantify its imaging performance. Methods: The major components of the benchtop system include a diagnostic x-ray tube with a 1.0 mm nominal focal spot size, a flat-panel detector with 96 μm pixel pitch, a sample stage that rotates within a limited angular span of ±30°, and a Talbot-Lau interferometer with three x-ray gratings. A total of 21 projection views acquired with 3° increments were used to reconstruct three sets of tomosynthetic image volumes, including the conventional absorption contrast tomosynthesis image volume (AC-tomo) reconstructed using the filtered-backprojection (FBP) algorithm with the ramp kernel, the phase contrast tomosynthesis image volume (PC-tomo) reconstructed using FBP with a Hilbert kernel, and the differential phase contrast tomosynthesis image volume (DPC-tomo) reconstructed using the shift-and-add algorithm. Three inhouse physical phantoms containing tissue-surrogate materials were used to characterize the signal linearity, the signal difference-to-noise ratio (SDNR), the three-dimensional noise power spectrum (3D NPS), and the through-plane artifact spread function (ASF). Results: While DPC-tomo highlights edges and interfaces in the image object, PC-tomo removes the differential nature of the DPC projection data and its pixel values are linearly related to the decrement of the real part of the x-ray refractive index. The SDNR values of polyoxymethylene in water and polystyrene in oil are 1.5 and 1.0, respectively, in AC-tomo, and the values were improved to 3.0 and 2.0, respectively, in PC-tomo. PC-tomo and AC-tomo demonstrate equivalent ASF, but their noise characteristics quantified by the 3D NPS

Grating-based phase contrast tomosynthesis imaging: Proof-of-concept experimental studies

Science.gov (United States)

Li, Ke; Ge, Yongshuai; Garrett, John; Bevins, Nicholas; Zambelli, Joseph; Chen, Guang-Hong

2014-01-01

Purpose: This paper concerns the feasibility of x-ray differential phase contrast (DPC) tomosynthesis imaging using a grating-based DPC benchtop experimental system, which is equipped with a commercial digital flat-panel detector and a medical-grade rotating-anode x-ray tube. An extensive system characterization was performed to quantify its imaging performance. Methods: The major components of the benchtop system include a diagnostic x-ray tube with a 1.0 mm nominal focal spot size, a flat-panel detector with 96 μm pixel pitch, a sample stage that rotates within a limited angular span of ±30°, and a Talbot-Lau interferometer with three x-ray gratings. A total of 21 projection views acquired with 3° increments were used to reconstruct three sets of tomosynthetic image volumes, including the conventional absorption contrast tomosynthesis image volume (AC-tomo) reconstructed using the filtered-backprojection (FBP) algorithm with the ramp kernel, the phase contrast tomosynthesis image volume (PC-tomo) reconstructed using FBP with a Hilbert kernel, and the differential phase contrast tomosynthesis image volume (DPC-tomo) reconstructed using the shift-and-add algorithm. Three inhouse physical phantoms containing tissue-surrogate materials were used to characterize the signal linearity, the signal difference-to-noise ratio (SDNR), the three-dimensional noise power spectrum (3D NPS), and the through-plane artifact spread function (ASF). Results: While DPC-tomo highlights edges and interfaces in the image object, PC-tomo removes the differential nature of the DPC projection data and its pixel values are linearly related to the decrement of the real part of the x-ray refractive index. The SDNR values of polyoxymethylene in water and polystyrene in oil are 1.5 and 1.0, respectively, in AC-tomo, and the values were improved to 3.0 and 2.0, respectively, in PC-tomo. PC-tomo and AC-tomo demonstrate equivalent ASF, but their noise characteristics quantified by the 3D NPS

Tomosynthesis of the thoracic spine: added value in diagnosing vertebral fractures in the elderly.

Science.gov (United States)

Geijer, Mats; Gunnlaugsson, Eirikur; Götestrand, Simon; Weber, Lars; Geijer, Håkan

2017-02-01

Thoracic spine radiography becomes more difficult with age. Tomosynthesis is a low-dose tomographic extension of radiography which may facilitate thoracic spine evaluation. This study assessed the added value of tomosynthesis in imaging of the thoracic spine in the elderly. Four observers compared the image quality of 50 consecutive thoracic spine radiography and tomosynthesis data sets from 48 patients (median age 67 years, range 55-92 years) on a number of image quality criteria. Observer variation was determined by free-marginal multirater kappa. The conversion factor and effective dose were determined from the dose-area product values. For all observers significantly more vertebrae were seen with tomosynthesis than with radiography (mean 12.4/9.3, P tomosynthesis was significantly higher than for radiography, for all evaluated structures. Tomosynthesis took longer to evaluate than radiography. Despite this, all observers scored a clear preference for tomosynthesis. Observer agreement was substantial (mean κ = 0.73, range 0.51-0.94). The calibration or conversion factor was 0.11 mSv/(Gy cm 2 ) for the combined examination. The resulting effective dose was 0.87 mSv. Tomosynthesis can increase the detection rate of thoracic vertebral fractures in the elderly, at low added radiation dose. • Tomosynthesis helps evaluate the thoracic spine in the elderly. • Observer agreement for thoracic spine tomosynthesis was substantial (mean κ = 0.73). • Significantly more vertebrae and significantly more fractures were seen with tomosynthesis. • Tomosynthesis took longer to evaluate than radiography. • There was a clear preference among all observers for tomosynthesis over radiography.

Selective photon counter for digital x-ray mammography tomosynthesis

Science.gov (United States)

Goldan, Amir H.; Karim, Karim S.; Rowlands, J. A.

2006-03-01

Photon counting is an emerging detection technique that is promising for mammography tomosynthesis imagers. In photon counting systems, the value of each image pixel is equal to the number of photons that interact with the detector. In this research, we introduce the design and implementation of a low noise, novel selective photon counting pixel for digital mammography tomosynthesis in crystalline silicon CMOS (complementary metal oxide semiconductor) 0.18 micron technology. The design comprises of a low noise charge amplifier (CA), two low offset voltage comparators, a decision-making unit (DMU), a mode selector, and a pseudo-random counter. Theoretical calculations and simulation results of linearity, gain, and noise of the photon counting pixel are presented.

Value of a Computer-aided Detection System Based on Chest Tomosynthesis Imaging for the Detection of Pulmonary Nodules.

Science.gov (United States)

Yamada, Yoshitake; Shiomi, Eisuke; Hashimoto, Masahiro; Abe, Takayuki; Matsusako, Masaki; Saida, Yukihisa; Ogawa, Kenji

2018-04-01

Purpose To assess the value of a computer-aided detection (CAD) system for the detection of pulmonary nodules on chest tomosynthesis images. Materials and Methods Fifty patients with and 50 without pulmonary nodules underwent both chest tomosynthesis and multidetector computed tomography (CT) on the same day. Fifteen observers (five interns and residents, five chest radiologists, and five abdominal radiologists) independently evaluated tomosynthesis images of 100 patients for the presence of pulmonary nodules in a blinded and randomized manner, first without CAD, then with the inclusion of CAD marks. Multidetector CT images served as the reference standard. Free-response receiver operating characteristic analysis was used for the statistical analysis. Results The pooled diagnostic performance of 15 observers was significantly better with CAD than without CAD (figure of merit [FOM], 0.74 vs 0.71, respectively; P = .02). The average true-positive fraction and false-positive rate per all cases with CAD were 0.56 and 0.26, respectively, whereas those without CAD were 0.47 and 0.20, respectively. Subanalysis showed that the diagnostic performance of interns and residents was significantly better with CAD than without CAD (FOM, 0.70 vs 0.62, respectively; P = .001), whereas for chest radiologists and abdominal radiologists, the FOM with CAD values were greater but not significantly: 0.80 versus 0.78 (P = .38) and 0.74 versus 0.73 (P = .65), respectively. Conclusion CAD significantly improved diagnostic performance in the detection of pulmonary nodules on chest tomosynthesis images for interns and residents, but provided minimal benefit for chest radiologists and abdominal radiologists. © RSNA, 2017 Online supplemental material is available for this article.

3D computer-aided detection for digital breast tomosynthesis: Comparison with 2D computer-aided detection for digital mammography in the detection of calcifications

Energy Technology Data Exchange (ETDEWEB)

Chu, A Jung; Cho, Nariya; Chang, Jung Min; Kim, Won Hwa; Lee, Su Hyun; Song, Sung Eun; Shin, Sung Ui; Moon, Woo Kyung [Dept. of Radiology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul (Korea, Republic of)

2017-08-15

To retrospectively evaluate the performance of 3D computer-aided detection (CAD) for digital breast tomosynthesis (DBT) in the detection of calcifications in comparison with 2D CAD for digital mammography (DM). Between 2012 and 2013, both 3D CAD and 2D CAD systems were retrospectively applied to the calcification data set including 69 calcifications (31 malignant calcifications and 38 benign calcifications) and the normal data set including 20 bilateral normal mammograms. Each data set consisted of paired DBT and DM images. Sensitivities for the detection of malignant calcifications were calculated from the calcification data set. False-positive mark rates were calculated from the normal data set. They were compared between the two systems. Sensitivities of 3D CAD [100% (31/31) at levels 2, 1, and 0] were same as those of the 2D CAD system [100% (31/31) at levels 2 and 1] (p = 1.0, respectively). The mean value of false-positive marks per view with 3D CAD was higher than that with 2D CAD at level 2 (0.52 marks ± 0.91 vs. 0.07 marks ± 0.26, p = 0.009). 3D CAD for DBT showed equivalent sensitivity, albeit with a higher false-positive mark rate, than 2D CAD for DM in the detection of calcifications.

Design and development of a phantom for tomosynthesis with potential for automated analysis via the cloud.

Science.gov (United States)

Goodenough, David; Levy, Josh; Olafsdottir, Hildur; Olafsson, Ingvi

2018-03-06

This paper describes Development of a Phantom for Tomosynthesis with Potential for Automated Analysis via the Cloud. Several studies are underway to investigate the effectiveness of Tomosynthesis Mammographic Image Screening, including the large TMIST project as funded by the National Cancer Institute https://www.cancer.gov/about-cancer/treatment/clinical-trials/nci-supported/tmist. The development of the phantom described in this paper follows initiatives from the FDA, the AAPM TG245 task group, and European Reference Organization (EUREF) for Quality Assured Breast Screening and Diagnostic Services Committee report noting, that no formal endorsement nor recommendation for use has been sought, or granted by any of these groups. This paper reports on the possibility of using this newly developed Tomosynthesis Phantom for Quality Assurance, field testing of image performance, including remote monitoring of DBT system performance, e.g., via transmission over the cloud. The phantom includes tests for: phantom positioning and alignment (important for remote analysis), scan geometry (x and y), chest wall offset, scan slice width and Slice Sensitivity Profile (SSP(z)) slice geometry (slice width), scan slice incrementation (z), z axis geometry bead, low contrast detectability using low contrast spheres, spatial resolution via Point Spread Function (PSF), Image uniformity, Signal to Noise Ratio (SNR), and Contrast to Noise Ratio (CNR) via readings over an Aluminum square. The phantom is designed for use with automated analysis via transmission of images over the cloud and the analysis package includes test of positioning accuracy (roll, pitch, and yaw). Data are shown from several commercial Tomosynthesis Scanners including Fuji, GE, Hologic, IMS-Giotti, and Siemens; however, the focus of this paper is on phantom design, and not in general aimed at direct commercial comparisons, and wherever possible the identity of the data is anonymized. Results of automated analysis of

Real-time tomosynthesis for radiation therapy guidance.

Science.gov (United States)

Hsieh, Scott S; Ng, Lydia W

2017-11-01

Fluoroscopy has been a tool of choice for monitoring treatments or interventions because of its extremely fast imaging times. However, the contrast obtained in fluoroscopy may be insufficient for certain clinical applications. In stereotactic ablative radiation therapy of the lung, fluoroscopy often lacks sufficient contrast for gating treatment. The purpose of this work is to describe and assess a real-time tomosynthesis design that can produce sufficient contrast for guidance of lung tumor treatment within a small field of view. Previous tomosynthesis designs in radiation oncology have temporal resolution on the order of seconds. The proposed system design uses parallel acquisition of multiple frames by simultaneously illuminating the field of view with multiple sources, enabling a temporal resolution of up to 30 frames per second. For a small field of view, a single flat-panel detector could be used if different sectors of the detector are assigned to specific sources. Simulated images were generated by forward projection of existing clinical datasets. The authors varied the number of tubes and the power of each tube in order to determine the impact on tumor visualization. Visualization of the tumor was much clearer in tomosynthesis than in fluoroscopy. Contrast generally improved with the number of sources used, and a minimum of four sources should be used. The high contrast of the lung allows very low system power, and in most cases, less than 1 mA was needed. More power is required in the lateral direction than the AP direction. The proposed system produces images adequate for real-time guidance of radiation therapy. The additional hardware requirements are modest, and the system is capable of imaging at high frame rates and low dose. Further development, including a prototype system and a dosimetry study, is needed to further evaluate the feasibility of this device for radiation therapy guidance. © 2017 American Association of Physicists in Medicine.

Digital Tomosynthesis to Evaluate Fracture Healing: Prospective Comparison With Radiography and CT.

Science.gov (United States)

Ha, Alice S; Lee, Amie Y; Hippe, Daniel S; Chou, Shinn-Huey S; Chew, Felix S

2015-07-01

Radiography, currently the standard for postoperative fracture imaging, is limited by overlapping bone and hardware. Tomosynthesis has the benefit of level-by-level imaging without the disadvantages of metal artifacts, increased radiation, and higher costs of CT, the current problem-solving tool. The purpose of this study was to compare tomosynthesis with radiography for evaluating fracture healing. In a prospective study, patients within 1 year of wrist hardware fixation underwent radiography, tomosynthesis, and CT, and the images were interpreted by three readers. The diagnostic accuracy of radiology and tomosynthesis was assessed with ROC curves, and interreader agreement was assessed with Cohen kappa. Fracture scores were correlated with Disabilities of the Arm, Shoulder, and Hand (DASH) and pain scores. The study participants were 49 patients with 51 fractures. The most common fracture sites were distal radius (43%), scaphoid (18%), and metacarpals (18%). Rates of cortex obscuration by hardware were 2% for CT, 8% for tomosynthesis, and 15% for radiography (p tomosynthesis than with radiography (AUC, 0.84 vs 0.76, p = 0.01). Inter-reader agreement was moderate for both radiography and tomosynthesis (κ = 0.44 vs 0.55, p = 0.051). There was no significant correlation between fracture scores and DASH scores. There was significant correlation between reported pain levels and both tomosynthesis (r = 0.28, p = 0.03) and CT (r = 0.29, p = 0.04) fracture scores. Tomosynthesis provides diagnostic information superior to that of ra diography in postoperative evaluation of wrist fractures with lower cost and radiation than CT and should be considered in fracture follow-up imaging of other bones.

Increased Cancer Detection Rate and Variations in the Recall Rate Resulting from Implementation of 3D Digital Breast Tomosynthesis into a Population-based Screening Program

Science.gov (United States)

Venkataraman, Shambavi; Phillips, Jordana; Dialani, Vandana; Fein-Zachary, Valerie J.; Prakash, Seema; Slanetz, Priscilla J.; Mehta, Tejas S.

2016-01-01

Purpose To compare the recall and cancer detection rates (CDRs) at screening with digital breast tomosynthesis (DBT) with those at screening with two-dimensional (2D) mammography and to evaluate variations in the recall rate (RR) according to patient age, risk factors, and breast density and among individual radiologists at a single U.S. academic medical center. Materials and Methods This institutional review board–approved, HIPAA-compliant prospective study with a retrospective cohort included 85 852 asymptomatic women who presented for breast cancer screening over a 3-year period beginning in 2011. A DBT unit was introduced into the existing 2D mammography screening program, and patients were assigned to the first available machine. Ten breast-subspecialized radiologists interpreted approximately 90% of the examinations. RRs were calculated overall and according to patient age, breast density, and individual radiologist. CDRs were calculated. Single and multiple mixed-effect logistic regression analyses, χ2 tests, and Bonferroni correction were utilized, as appropriate. Results The study included 5703 (6.6%) DBT examinations and 80 149 (93.4%) 2D mammography examinations. The DBT subgroup contained a higher proportion of patients with risk factors for breast cancer and baseline examinations. DBT was used to detect 54.3% more carcinomas (+1.9 per 1000, P < .0018) than 2D mammography. The RR was 7.51% for 2D mammography and 6.10% for DBT (absolute change, 1.41%; relative change, –18.8%; P < .0001). The DBT subgroup demonstrated a significantly lower RR for patients with extremely or heterogeneously dense breasts and for patients in their 5th and 7th decades. Conclusion Implementing DBT into a U.S. breast cancer screening program significantly decreased the screening RR overall and for certain patient subgroups, while significantly increasing the CDR. These findings may encourage more widespread adoption and reimbursement of DBT and facilitate improved patient

Effective dose to patients from thoracic spine examinations with tomosynthesis

International Nuclear Information System (INIS)

Svalkvist, Angelica; Baath, Magnus; Soederman, Christina

2016-01-01

The purposes of the present work were to calculate the average effective dose to patients from lateral tomosynthesis examinations of the thoracic spine, compare the results with the corresponding conventional examination and to determine a conversion factor between dose-area product (DAP) and effective dose for the tomosynthesis examination. Thoracic spine examinations from 17 patients were included in the study. The registered DAP and information about the field size for each projection radiograph were, together with patient height and mass, used to calculate the effective dose for each projection radiograph. The total effective doses for the tomosynthesis examinations were obtained by adding the effective doses from the 60 projection radiographs included in the examination. The mean effective dose was 0.47 mSv (range 0.24-0.81 mSv) for the tomosynthesis examinations and 0.20 mSv (range 0.07-0.29 mSv) for the corresponding conventional examinations (anteroposterior + left lateral projection). For the tomosynthesis examinations, a conversion factor between total DAP and effective dose of 0.092 mSv Gycm -2 was obtained. (authors)

Breast cancer screening controversies: who, when, why, and how?

Science.gov (United States)

Chetlen, Alison; Mack, Julie; Chan, Tiffany

2016-01-01

Mammographic screening is effective in reducing mortality from breast cancer. The issue is not whether mammography is effective, but whether the false positive rate and false negative rates can be reduced. This review will discuss controversies including the reduction in breast cancer mortality, overdiagnosis, the ideal screening candidate, and the optimal imaging modality for breast cancer screening. The article will compare and contrast screening mammography, tomosynthesis, whole-breast screening ultrasound, magnetic resonance imaging, and molecular breast imaging. Though supplemental imaging modalities are being utilized to improve breast cancer diagnosis, mammography still remains the gold standard for breast cancer screening. Copyright © 2015 Elsevier Inc. All rights reserved.

Boundary-enhancement in propagation-based x-ray phase-contrast tomosynthesis improves depth position characterization.

Science.gov (United States)

Guan, Huifeng; Xu, Qiaofeng; Garson, Alfred B; Anastasio, Mark A

2015-04-21

Propagation-based x-ray phase-contrast (PB XPC) tomosynthesis combines the concepts of tomosynthesis and XPC imaging to realize the advantages of both for biological imaging applications. Tomosynthesis permits reductions in acquisition times compared with full-view tomography, while XPC imaging provides the opportunity to resolve weakly absorbing structures. In this note, an investigation of the depth resolving properties of PB XPC tomosynthesis is conducted. The results demonstrate that in-plane structures display strong boundary-enhancement while out-of-plane structures do not. This effect can facilitate the identification of in-plane structures in PB XPC tomosynthesis that could normally not be distinguished from out-of-plane structures in absorption-based tomosynthesis.

Boundary-enhancement in propagation-based x-ray phase-contrast tomosynthesis improves depth position characterization

International Nuclear Information System (INIS)

Guan, Huifeng; Xu, Qiaofeng; Garson, Alfred B III; Anastasio, Mark A

2015-01-01

Propagation-based x-ray phase-contrast (PB XPC) tomosynthesis combines the concepts of tomosynthesis and XPC imaging to realize the advantages of both for biological imaging applications. Tomosynthesis permits reductions in acquisition times compared with full-view tomography, while XPC imaging provides the opportunity to resolve weakly absorbing structures. In this note, an investigation of the depth resolving properties of PB XPC tomosynthesis is conducted. The results demonstrate that in-plane structures display strong boundary-enhancement while out-of-plane structures do not. This effect can facilitate the identification of in-plane structures in PB XPC tomosynthesis that could normally not be distinguished from out-of-plane structures in absorption-based tomosynthesis. (note)

Dose to patient in tomosynthesis; Dosis a paciente en tomosintesis

Energy Technology Data Exchange (ETDEWEB)

Minambres Moro, A.; Fernandez Leton, P.; Garcia Rui-Zorrilla, J.; Perez Moreno, J. M.; Zucca Aparicio, D.

2013-07-01

They are beginning to implement digital mammography with the possibility of acquiring in tomosynthesis, whose biggest advantage is to distinguish structures without overlapping through of pseudotridimensionals images. With these modified mammograms can acquire a planar mammography, with fixed x-ray tube, or a tomosynthesis with tube by turning. For acquire tomosynthesis is necessary a detector of high efficiency together with tungsten white tubes. The objective of this study is to know the dose received by the patient with this new imaging. (Author)

Full-view 3D imaging system for functional and anatomical screening of the breast

Science.gov (United States)

Oraevsky, Alexander; Su, Richard; Nguyen, Ha; Moore, James; Lou, Yang; Bhadra, Sayantan; Forte, Luca; Anastasio, Mark; Yang, Wei

2018-04-01

Laser Optoacoustic Ultrasonic Imaging System Assembly (LOUISA-3D) was developed in response to demand of diagnostic radiologists for an advanced screening system for the breast to improve on low sensitivity of x-ray based modalities of mammography and tomosynthesis in the dense and heterogeneous breast and low specificity magnetic resonance imaging. It is our working hypothesis that co-registration of quantitatively accurate functional images of the breast vasculature and microvasculature, and anatomical images of breast morphological structures will provide a clinically viable solution for the breast cancer care. Functional imaging is LOUISA-3D is enabled by the full view 3D optoacoustic images acquired at two rapidly toggling laser wavelengths in the near-infrared spectral range. 3D images of the breast anatomical background is enabled in LOUISA-3D by a sequence of B-mode ultrasound slices acquired with a transducer array rotating around the breast. This creates the possibility to visualize distributions of the total hemoglobin and blood oxygen saturation within specific morphological structures such as tumor angiogenesis microvasculature and larger vasculature in proximity of the tumor. The system has four major components: (i) a pulsed dual wavelength laser with fiberoptic light delivery system, (ii) an imaging module with two arc shaped probes (optoacoustic and ultrasonic) placed in a transparent bowl that rotates around the breast, (iii) a multichannel electronic system with analog preamplifiers and digital data acquisition boards, and (iv) computer for the system control, data processing and image reconstruction. The most important advancement of this latest system design compared with previously reported systems is the full breast illumination accomplished for each rotational step of the optoacoustic transducer array using fiberoptic illuminator rotating around the breast independently from rotation of the detector probe. We report here a pilot case studies

The development of a pseudo-3D imaging system (tomosynthesis) for security screening of passenger baggage

International Nuclear Information System (INIS)

Reid, C.B.; Betcke, M.M.; Chana, D.; Speller, R.D.

2011-01-01

This paper describes a study investigating the potential of tomosynthesis as a post check-in baggage scanning system. A laboratory system has been constructed consisting of a moveable source and detector, arranged around a mini 90 o bend conveyor system, from which multiple projection images can be collected. Simulation code has been developed to allow the optimum source and detector positions to be determined. Reconstruction methods are being developed to modify the Shift-And-Add (SAA) algorithm to accommodate the non-typical imaging geometry.

The development of a pseudo-3D imaging system (tomosynthesis) for security screening of passenger baggage

Energy Technology Data Exchange (ETDEWEB)

Reid, C.B., E-mail: c.reid@medphys.ucl.ac.uk [Department of Medical Physics and Bioengineering, University College London, London WC1E 6BT (United Kingdom); Betcke, M.M. [Department of Computer Science, University College London, London WC1E 6BT (United Kingdom); Chana, D. [Department for Transport, London SW1E 6DT (United Kingdom); Speller, R.D. [Department of Medical Physics and Bioengineering, University College London, London WC1E 6BT (United Kingdom)

2011-10-01

This paper describes a study investigating the potential of tomosynthesis as a post check-in baggage scanning system. A laboratory system has been constructed consisting of a moveable source and detector, arranged around a mini 90{sup o} bend conveyor system, from which multiple projection images can be collected. Simulation code has been developed to allow the optimum source and detector positions to be determined. Reconstruction methods are being developed to modify the Shift-And-Add (SAA) algorithm to accommodate the non-typical imaging geometry.

EFFECTIVE DOSE TO PATIENTS FROM THORACIC SPINE EXAMINATIONS WITH TOMOSYNTHESIS.

Science.gov (United States)

Svalkvist, Angelica; Söderman, Christina; Båth, Magnus

2016-06-01

The purposes of the present work were to calculate the average effective dose to patients from lateral tomosynthesis examinations of the thoracic spine, compare the results with the corresponding conventional examination and to determine a conversion factor between dose-area product (DAP) and effective dose for the tomosynthesis examination. Thoracic spine examinations from 17 patients were included in the study. The registered DAP and information about the field size for each projection radiograph were, together with patient height and mass, used to calculate the effective dose for each projection radiograph. The total effective doses for the tomosynthesis examinations were obtained by adding the effective doses from the 60 projection radiographs included in the examination. The mean effective dose was 0.47 mSv (range 0.24-0.81 mSv) for the tomosynthesis examinations and 0.20 mSv (range 0.07-0.29 mSv) for the corresponding conventional examinations (anteroposterior + left lateral projection). For the tomosynthesis examinations, a conversion factor between total DAP and effective dose of 0.092 mSv Gycm(-2) was obtained. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Application of digital tomosynthesis to radiographic diagnosis of the temporal bone. Studies on visualization in normal subjects

International Nuclear Information System (INIS)

Kawai, Takashi

1995-01-01

To examine the usefulness of digital tomosynthesis for conducting radiographic diagnosis of the temporal bone, visualization of various aural structures such as the semicircular canals, cochlea, vestibular apparatus, ossicles of the ear and facial nerve canal was examined in 18 volunteers. The visualization of temporal bone specimens by digital tomosynthesis and CT images (slice thickness: 1.5 mm) was compared. The results showed that this system (Digital Tomosynthesis) produced clear images of bony labyrinthine structures such as the semicircular canals, cochlea, and vestibular apparatus. Visualization of the ossicles was also clear, and their continuity could be comprehended better than on CT images. This system also provided good visualization of the labyrinthine and tympanic parts of the facial nerve canal, although CT images had greater sharpness. Visualization of the lower half of the mastoid part was poor with this system. (author)

Evaluation of digital breast tomosynthesis reconstruction algorithms using synchrotron radiation in standard geometry

International Nuclear Information System (INIS)

Bliznakova, K.; Kolitsi, Z.; Speller, R. D.; Horrocks, J. A.; Tromba, G.; Pallikarakis, N.

2010-01-01

Purpose: In this article, the image quality of reconstructed volumes by four algorithms for digital tomosynthesis, applied in the case of breast, is investigated using synchrotron radiation. Methods: An angular data set of 21 images of a complex phantom with heterogeneous tissue-mimicking background was obtained using the SYRMEP beamline at ELETTRA Synchrotron Light Laboratory, Trieste, Italy. The irradiated part was reconstructed using the multiple projection algorithm (MPA) and the filtered backprojection with ramp followed by hamming windows (FBR-RH) and filtered backprojection with ramp (FBP-R). Additionally, an algorithm for reducing the noise in reconstructed planes based on noise mask subtraction from the planes of the originally reconstructed volume using MPA (MPA-NM) has been further developed. The reconstruction techniques were evaluated in terms of calculations and comparison of the contrast-to-noise ratio (CNR) and artifact spread function. Results: It was found that the MPA-NM resulted in higher CNR, comparable with the CNR of FBP-RH for high contrast details. Low contrast objects are well visualized and characterized by high CNR using the simple MPA and the MPA-NM. In addition, the image quality of the reconstructed features in terms of CNR and visual appearance as a function of the initial number of projection images and the reconstruction arc was carried out. Slices reconstructed with more input projection images result in less reconstruction artifacts and higher detail CNR, while those reconstructed from projection images acquired in reduced angular range causes pronounced streak artifacts. Conclusions: Of the reconstruction algorithms implemented, the MPA-NM and MPA are a good choice for detecting low contrast objects, while the FBP-RH, FBP-R, and MPA-NM provide high CNR and well outlined edges in case of microcalcifications.

Tomosynthesis: A new radiologic technique for rapid diagnosis of scaphoid fractures.

Science.gov (United States)

Compton, N; Murphy, L; Lyons, F; Jones, J; MacMahon, P; Cashman, J

2016-12-21

Scaphoid fractures constitute 71% of all carpal bone fractures. 1 Early diagnosis and treatment has significant bearing on fracture union rates and better clinical outcomes. While displaced fractures can be readily seen on plain radiograph, undisplaced fractures can require advanced imaging modalities to confirm that diagnosis. Advanced imaging such as Magnetic Resonance Imaging (MRI), Computerised tomography (CT) and bone scintigraphy are routinely used for the diagnosis of scaphoid fractures but require significant radiation exposure, increased cost and can be difficult to access. 2 Tomosynthesis is an emerging imaging modality which uses conventional x-ray systems to produce cross-sectional images. There has yet to be extensive research carried out investigating the diagnostic value of tomosynthesis in scaphoid fractures. The aim of this study is to optimise patient positioning for the diagnosis of scaphoid fractures in a cadaveric model and compare the diagnostic yield of tomography to conventional CT. Using four cadaveric specimens, three limb positions were examined in unfractured and fractured scaphoids to determine the optimal limb positions required for visualisation of the scaphoid. As a result of this study, the optimal position for visualisation of the scaphoid and diagnosis of scaphoid fractures has been determined. The results demonstrate that tomosynthesis is as effective as CT scanning in identifying scaphoid fractures in both sensitivity and specificity. By comparison to CT, tomosynthesis is cheaper, has lower radiation exposure, requires fewer hospital resources and can be performed quickly. Tomosynthesis is a valid diagnostic tool for the diagnosis of scaphoid fractures. Copyright © 2016 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved.

Filtered backprojection for modifying the impulse response of circular tomosynthesis

International Nuclear Information System (INIS)

Stevens, Grant M.; Fahrig, Rebecca; Pelc, Norbert J.

2001-01-01

A filtering technique has been developed to modify the three-dimensional impulse response of circular motion tomosynthesis to allow the generation of images whose appearance is like those of some other imaging geometries. In particular, this technique can reconstruct images with a blurring function which is more homogeneous for off-focal plane objects than that from circular tomosynthesis. In this paper, we describe the filtering process, and demonstrate the ability to alter the impulse response in circular motion tomosynthesis from a ring to a disk. This filtering may be desirable because the blurred out-of-plane objects appear less structured

Detection of osteophytes and subchondral cysts in the knee with use of tomosynthesis.

Science.gov (United States)

Hayashi, Daichi; Xu, Li; Roemer, Frank W; Hunter, David J; Li, Ling; Katur, Avinash M; Guermazi, Ali

2012-04-01

To evaluate the diagnostic performance of tomosynthesis in depicting osteophytes and subchondral cysts, with use of magnetic resonance (MR) imaging as the reference, and to test whether the lesions detected at radiography and tomosynthesis are associated with pain. The study was approved by local institutional review board, and all subjects gave written informed consent. Forty subjects (80 knees) older than 40 years were recruited irrespective of knee pain or radiographic osteoarthritis. Knees were imaged with radiography, tomosynthesis, and MR imaging. Presence of osteophytes and subchondral cysts in four locations of tibiofemoral joint (medial and lateral femur and tibia) was recorded. Knee pain was assessed by using the Western Ontario and McMaster University pain subscale. MR imaging depicted 171 osteophytes and 51 subchondral cysts. Tomosynthesis had a higher sensitivity for osteophyte detection in left and right lateral femur (0.96 vs 0.75, P = .025, and 1.00 vs 0.71, P = .008, respectively), right medial femur (0.94 vs 0.72, P = .046), and right lateral tibia (1.00 vs 0.83, P = .046). For subchondral cyst detection, the sensitivity of tomosynthesis was 0.14-1.00 and that of radiography was 0.00-0.56. Both modalities had similar specificity for both lesions. Subjects with tomosynthesis-depicted osteophytes (odds ratio, 4.2-6.4; P = .001-.011) and medially located subchondral cysts (odds ratio, 6.7-17.8; P = .004-.03) were more likely to feel pain than those without. However, radiography-depicted osteophytes were more strongly associated with pain than were tomosynthesis-depicted osteophytes. Tomosynthesis depicted more osteophytes and subchondral cysts than did radiography. Subjects with tomosynthesis-depicted osteophytes and subchondral cysts were more likely to feel pain than those without such lesions. © RSNA, 2012.

Motion compensated digital tomosynthesis

NARCIS (Netherlands)

van der Reijden, Anneke; van Herk, Marcel; Sonke, Jan-Jakob

2013-01-01

Digital tomosynthesis (DTS) is a limited angle image reconstruction method for cone beam projections that offers patient surveillance capabilities during VMAT based SBRT delivery. Motion compensation (MC) has the potential to mitigate motion artifacts caused by respiratory motion, such as blur. The

Semi-Automated Quantification of Finger Joint Space Narrowing Using Tomosynthesis in Patients with Rheumatoid Arthritis.

Science.gov (United States)

Ichikawa, Shota; Kamishima, Tamotsu; Sutherland, Kenneth; Kasahara, Hideki; Shimizu, Yuka; Fujimori, Motoshi; Yasojima, Nobutoshi; Ono, Yohei; Kaneda, Takahiko; Koike, Takao

2017-06-01

The purpose of the study is to validate the semi-automated method using tomosynthesis images for the assessment of finger joint space narrowing (JSN) in patients with rheumatoid arthritis (RA), by using the semi-quantitative scoring method as the reference standard. Twenty patients (14 females and 6 males) with RA were included in this retrospective study. All patients underwent radiography and tomosynthesis of the bilateral hand and wrist. Two rheumatologists and a radiologist independently scored JSN with two modalities according to the Sharp/van der Heijde score. Two observers independently measured joint space width on tomosynthesis images using an in-house semi-automated method. More joints with JSN were revealed with tomosynthesis score (243 joints) and the semi-automated method (215 joints) than with radiography (120 joints), and the associations between tomosynthesis scores and radiography scores were demonstrated (P tomosynthesis scores with r = -0.606 (P tomosynthesis images was in almost perfect agreement with intra-class correlation coefficient (ICC) values of 0.964 and 0.963, respectively. The semi-automated method using tomosynthesis images provided sensitive, quantitative, and reproducible measurement of finger joint space in patients with RA.

Overview of two years of clinical experience of chest tomo-synthesis at Sahlgrenska university hospital

International Nuclear Information System (INIS)

Johnsson, Aa. A.; Vikgren, J.; Svalkvist, A.; Zachrisson, S.; Flinck, A.; Boijsen, M.; Kheddache, S.; Maansson, L. G.; Baath, M.

2010-01-01

Since December 2006, ∼ 3800 clinical chest tomo-synthesis examinations have been performed at our department at Sahlgrenska Univ. Hospital. A subset of the examinations has been included in studies of the detectability of pulmonary nodules, using computed tomography (CT) as the gold standard. Visibility studies, in which chest tomo-synthesis and CT have been compared side-by side, have been used to determine the depiction potential of chest tomo-synthesis. Comparisons with conventional chest radiography have been made. In the clinical setting, chest tomo-synthesis has mostly been used as an additional examination. The most frequent indication for chest tomo-synthesis has been suspicion of a nodule or tumour. In visibility studies, tomo-synthesis has depicted over 90% of the nodules seen on the CT scan. The corresponding figure for chest radiography has been <30%. In the detection studies, the lesion-level sensitivity has been ∼ 60% for tomo-synthesis and 20% for chest radiography. In one of the detection studies, an analysis of all false-positive nodules was performed. This analysis showed that all findings had morphological correlates on the CT examinations. The majority of the false-positive nodules were localised in the immediate sub-pleural region. In conclusion, chest tomo-synthesis is an improved chest radiography method, which can be used to optimise the use of CT resources, thereby reducing the radiation dose to the patient population. However, there are some limitations with chest tomo-synthesis. For example, patients undergoing tomo-synthesis have to be able to stand still and hold their breath firmly for 10 s. Also, chest tomo-synthesis has a limited depth resolution, which may explain why pathology in the sub-pleural region is more difficult to interpret and artefacts from medical devices may occur. (authors)

Tomosynthesis of the thoracic spine: added value in diagnosing vertebral fractures in the elderly

Energy Technology Data Exchange (ETDEWEB)

Geijer, Mats [Oerebro University, Department of Radiology, Oerebro (Sweden); Lund University, Department of Clinical Sciences, Lund (Sweden); Gunnlaugsson, Eirikur; Goetestrand, Simon [Lund University and Skaane University Hospital, Department of Medical Imaging and Physiology, Lund (Sweden); Weber, Lars [Lund University, Department of Clinical Sciences, Lund (Sweden); Skaane University Hospital, Department of Radiation Physics, Lund (Sweden); Geijer, Haakan [Oerebro University, Department of Radiology, Faculty of Medicine and Health, Oerebro (Sweden)

2017-02-15

Thoracic spine radiography becomes more difficult with age. Tomosynthesis is a low-dose tomographic extension of radiography which may facilitate thoracic spine evaluation. This study assessed the added value of tomosynthesis in imaging of the thoracic spine in the elderly. Four observers compared the image quality of 50 consecutive thoracic spine radiography and tomosynthesis data sets from 48 patients (median age 67 years, range 55-92 years) on a number of image quality criteria. Observer variation was determined by free-marginal multirater kappa. The conversion factor and effective dose were determined from the dose-area product values. For all observers significantly more vertebrae were seen with tomosynthesis than with radiography (mean 12.4/9.3, P < 0.001) as well as significantly more fractures (mean 0.9/0.7, P = 0.017). The image quality score for tomosynthesis was significantly higher than for radiography, for all evaluated structures. Tomosynthesis took longer to evaluate than radiography. Despite this, all observers scored a clear preference for tomosynthesis. Observer agreement was substantial (mean κ = 0.73, range 0.51-0.94). The calibration or conversion factor was 0.11 mSv/(Gy cm{sup 2}) for the combined examination. The resulting effective dose was 0.87 mSv. Tomosynthesis can increase the detection rate of thoracic vertebral fractures in the elderly, at low added radiation dose. (orig.)

Tomosynthesis of the thoracic spine: added value in diagnosing vertebral fractures in the elderly

International Nuclear Information System (INIS)

Geijer, Mats; Gunnlaugsson, Eirikur; Goetestrand, Simon; Weber, Lars; Geijer, Haakan

2017-01-01

Thoracic spine radiography becomes more difficult with age. Tomosynthesis is a low-dose tomographic extension of radiography which may facilitate thoracic spine evaluation. This study assessed the added value of tomosynthesis in imaging of the thoracic spine in the elderly. Four observers compared the image quality of 50 consecutive thoracic spine radiography and tomosynthesis data sets from 48 patients (median age 67 years, range 55-92 years) on a number of image quality criteria. Observer variation was determined by free-marginal multirater kappa. The conversion factor and effective dose were determined from the dose-area product values. For all observers significantly more vertebrae were seen with tomosynthesis than with radiography (mean 12.4/9.3, P < 0.001) as well as significantly more fractures (mean 0.9/0.7, P = 0.017). The image quality score for tomosynthesis was significantly higher than for radiography, for all evaluated structures. Tomosynthesis took longer to evaluate than radiography. Despite this, all observers scored a clear preference for tomosynthesis. Observer agreement was substantial (mean κ = 0.73, range 0.51-0.94). The calibration or conversion factor was 0.11 mSv/(Gy cm 2 ) for the combined examination. The resulting effective dose was 0.87 mSv. Tomosynthesis can increase the detection rate of thoracic vertebral fractures in the elderly, at low added radiation dose. (orig.)

Value of tomosynthesis for lesion evaluation of small joints in osteoarthritic hands using the OARSI score.

Science.gov (United States)

Martini, K; Becker, A S; Guggenberger, R; Andreisek, G; Frauenfelder, T

2016-07-01

To determine the diagnostic performance of tomosynthesis in depicting osteoarthritic lesions in comparison to conventional radiographs, with use of computed tomography (CT) as standard-of-reference. Imaging of 12 cadaveric hands was performed with tomosynthesis in dorso-palmar (dp) projection, conventional radiographs (dp) and multi-detector CT. Distal interphalangeal joint (DIP)II, DIPIII, proximal interphalangeal joint (PIP)II, PIPIII, first carpometacarpal (CMC) and scaphotrapezotrapezoidal joint (STT) were graded by two independent readers using the Osteoarthritis Research Society International (OARSI) score. The mean score for each feature was calculated for all modalities. Additional wrists were evaluated for presence of calcium pyrophosphate disease (CPPD). CT served as reference-standard. Inter-reader agreement (ICC) was calculated. Comparing tomosynthesis and conventional radiographs to CT, the sensitivity for the presence of osteophytes was 95,7% vs 65,2%; for joint space narrowing 95,8% vs 52,1%; for subchondral sclerosis 61,5% vs 51,3%; for lateral deformity 83.3% vs 83,3%; and for subchondral cysts 45,8% vs 29,2%. Erosions were not present. While tomosynthesis showed no significant difference in OARSI score grading to CT (mean OARSI-score CT: 16.8, SD = 10.6; mean OARSI-score Tomosynthesis: 16.3, SD = 9.6; P = 0.84), conventional radiographs had significant lower mean OARSI scores (mean OARSI-score X-ray: 11.1, SD = 8.3; P = 0.04). Inter-reader agreement for OARSI scoring was excellent (ICC = 0.99). CPPD calcifications present in CT, were also visible with tomosynthesis, but not with conventional radiography. In conclusion, tomosynthesis depicts more osteoarthritic changes in the small joints of the hand than conventional radiography using the OARSI scoring system and CT as the standard of reference. Copyright © 2016 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

Real-time out-of-plane artifact subtraction tomosynthesis imaging using prior CT for scanning beam digital x-ray system

Energy Technology Data Exchange (ETDEWEB)

Wu, Meng, E-mail: mengwu@stanford.edu [Department of Electrical Engineering, Stanford University, Stanford, California 94305 (United States); Fahrig, Rebecca [Department of Radiology, Stanford University, Stanford, California 94305 (United States)

2014-11-01

Purpose: The scanning beam digital x-ray system (SBDX) is an inverse geometry fluoroscopic system with high dose efficiency and the ability to perform continuous real-time tomosynthesis in multiple planes. This system could be used for image guidance during lung nodule biopsy. However, the reconstructed images suffer from strong out-of-plane artifact due to the small tomographic angle of the system. Methods: The authors propose an out-of-plane artifact subtraction tomosynthesis (OPAST) algorithm that utilizes a prior CT volume to augment the run-time image processing. A blur-and-add (BAA) analytical model, derived from the project-to-backproject physical model, permits the generation of tomosynthesis images that are a good approximation to the shift-and-add (SAA) reconstructed image. A computationally practical algorithm is proposed to simulate images and out-of-plane artifacts from patient-specific prior CT volumes using the BAA model. A 3D image registration algorithm to align the simulated and reconstructed images is described. The accuracy of the BAA analytical model and the OPAST algorithm was evaluated using three lung cancer patients’ CT data. The OPAST and image registration algorithms were also tested with added nonrigid respiratory motions. Results: Image similarity measurements, including the correlation coefficient, mean squared error, and structural similarity index, indicated that the BAA model is very accurate in simulating the SAA images from the prior CT for the SBDX system. The shift-variant effect of the BAA model can be ignored when the shifts between SBDX images and CT volumes are within ±10 mm in the x and y directions. The nodule visibility and depth resolution are improved by subtracting simulated artifacts from the reconstructions. The image registration and OPAST are robust in the presence of added respiratory motions. The dominant artifacts in the subtraction images are caused by the mismatches between the real object and the prior CT

Retrospective estimation of patient dose-area product in thoracic spine tomosynthesis performed using VolumeRAD

International Nuclear Information System (INIS)

Baath, Magnus; Svalkvist, Angelica; Soederman, Christina

2016-01-01

The aim of this study was to evaluate the use of a recently developed method of retrospectively estimating the patient dose-area product (DAP) of a chest tomosynthesis examination, performed using VolumeRAD, in thoracic spine tomosynthesis and to determine the necessary field-size correction factor. Digital imaging and communications in medicine (DICOM) data for the projection radiographs acquired during a thoracic spine tomosynthesis examination were retrieved directly from the modality for 17 patients. Using the previously developed method, an estimated DAP for the tomosynthesis examination was determined from DICOM data in the scout image. By comparing the estimated DAP with the actual DAP registered for the projection radiographs, a field-size correction factor was determined. The field-size correction factor for thoracic spine tomosynthesis was determined to 0.92. Applying this factor to the DAP estimated retrospectively, the maximum difference between the estimated DAP and the actual DAP was <3 %. In conclusion, the previously developed method of retrospectively estimating the DAP in chest tomosynthesis can be applied to thoracic spine tomosynthesis. (authors)

Computer-aided detection of masses in digital tomosynthesis mammography: Comparison of three approaches

International Nuclear Information System (INIS)

Chan Heangping; Wei Jun; Zhang Yiheng; Helvie, Mark A.; Moore, Richard H.; Sahiner, Berkman; Hadjiiski, Lubomir; Kopans, Daniel B.

2008-01-01

The authors are developing a computer-aided detection (CAD) system for masses on digital breast tomosynthesis mammograms (DBT). Three approaches were evaluated in this study. In the first approach, mass candidate identification and feature analysis are performed in the reconstructed three-dimensional (3D) DBT volume. A mass likelihood score is estimated for each mass candidate using a linear discriminant analysis (LDA) classifier. Mass detection is determined by a decision threshold applied to the mass likelihood score. A free response receiver operating characteristic (FROC) curve that describes the detection sensitivity as a function of the number of false positives (FPs) per breast is generated by varying the decision threshold over a range. In the second approach, prescreening of mass candidate and feature analysis are first performed on the individual two-dimensional (2D) projection view (PV) images. A mass likelihood score is estimated for each mass candidate using an LDA classifier trained for the 2D features. The mass likelihood images derived from the PVs are backprojected to the breast volume to estimate the 3D spatial distribution of the mass likelihood scores. The FROC curve for mass detection can again be generated by varying the decision threshold on the 3D mass likelihood scores merged by backprojection. In the third approach, the mass likelihood scores estimated by the 3D and 2D approaches, described above, at the corresponding 3D location are combined and evaluated using FROC analysis. A data set of 100 DBT cases acquired with a GE prototype system at the Breast Imaging Laboratory in the Massachusetts General Hospital was used for comparison of the three approaches. The LDA classifiers with stepwise feature selection were designed with leave-one-case-out resampling. In FROC analysis, the CAD system for detection in the DBT volume alone achieved test sensitivities of 80% and 90% at average FP rates of 1.94 and 3.40 per breast, respectively. With the

The application of digital tomosynthesis to the diagnosis of the styloid process syndrome

International Nuclear Information System (INIS)

Ge Hequan; Zheng Kuihong; Wang Zijun; Huang Minhua; Ying Ligang

2011-01-01

Objective: To investigate the clinical value of digital tomosynthesis in the diagnosis of the styloid process syndrome. Methods: The thirty patients suspected of the styloid process syndrome underwent both multi-slice spiral CT scanning and digital tomosynthesis scanning. Two kinds of imaging were analyzed, and the length and angle of styloid on lateral and AP views were measured. Results: Both images could clearly show the styloid length, size, shape, direction and the relationship with surrounding structures. There was no significant difference in the length, medial angle in the AP position and anterior angle in the lateral position between multi-slice spiral CT scanning and digital tomosynthesis scanning (P>0.1). The styloid length on lateral digital tomosynthesis was significant smaller than that on multi-slice spiral CT scanning (P<0.01). Conclusions: The length of styloid measured should take the AP position as the standard using the digital tomosynthesis technique, which improve the image quality during the diagnosis of the styloid process syndrome and is less coitly and at a lower dose of radiation. Digital tomosynthesis could provide extensive clinical information and preoperative preparation of the very high referential value as CT canning. (authors)