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Sample records for digital tomosynthesis mammography

  1. Digital Mammography and Digital Breast Tomosynthesis.

    PubMed

    Moseley, Tanya W

    2016-06-01

    Breast imaging technology has advanced significantly from the 1930s until the present. American women have a 1 in 8 chance of developing breast cancer. Mammography has been proven in multiple clinical trials to reduce breast cancer mortality. Although a mainstay of breast imaging and improved from film-screen mammography, digital mammography is not a perfect examination. Overlapping obscuring breast tissue limits mammographic interpretation. Breast digital tomosynthesis reduces and/or eliminates overlapping obscuring breast tissue. Although there are some disadvantages with digital breast tomosynthesis, this relatively lost-cost technology may be used effectively in the screening and diagnostic settings.

  2. Breast cancer screening using tomosynthesis in combination with digital mammography.

    PubMed

    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 < .001); for biopsies, 18.1 (95% CI, 15.4-20.8) with digital mammography vs 19.3 (95% CI, 16.6-22.1) with digital mammography + 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

  3. Digital Mammography Imaging: Breast Tomosynthesis and Advanced Applications

    PubMed Central

    Helvie, Mark A.

    2011-01-01

    Synopsis This article discusses recent developments in advanced derivative technologies associated with digital mammography. Digital breast tomosynthesis – its principles, development, and early clinical trials are reviewed. Contrast enhanced digital mammography and combined imaging systems with digital mammography and ultrasound are also discussed. Although all these methods are currently research programs, they hold promise for improving cancer detection and characterization if early results are confirmed by clinical trials. PMID:20868894

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

    PubMed

    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 < .01). The addition of tomosynthesis reduced recall rates for all breast density and patient age groups, with significant differences (P < .05) found for scattered fibroglandular, heterogeneously dense, and extremely dense breasts and for patients younger than 40 years, those aged 40-49 years, those aged 50-59 years, and those aged 60-69 years. These findings persisted when multivariate logistic regression was used to control for differences in age, breast density, and elevated risk of breast cancer. The cancer detection rate was 5.7 per 1000 in patients receiving tomosynthesis versus 5.2 per 1000 in patients receiving conventional mammography alone (P = .70). Patients undergoing

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

    PubMed

    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 < 0.001; p for interaction = 0.21). The recall rate reduction for baseline screening was especially pronounced in women younger than 50 years (p = 0.005). DBT implementation resulted in an increase in cancer detection in the baseline subgroup of 40.5% versus an increase in the previously screened subgroup of 17.4%. DBT implementation resulted in an increase in PPV1 in the baseline subgroup of 85% versus 35.3% in the previously screened

  6. Comparison of digital mammography alone and digital mammography plus tomosynthesis in a population-based screening program.

    PubMed

    Skaane, Per; Bandos, Andriy I; Gullien, Randi; Eben, Ellen B; Ekseth, Ulrika; Haakenaasen, Unni; Izadi, Mina; Jebsen, Ingvild N; Jahr, Gunnar; Krager, Mona; Niklason, Loren T; Hofvind, Solveig; Gur, David

    2013-04-01

    To assess cancer detection rates, false-positive rates before arbitration, positive predictive values for women recalled after arbitration, and the type of cancers detected with use of digital mammography alone and combined with tomosynthesis in a large prospective screening trial. A prospective, reader- and modality-balanced screening study of participants undergoing combined mammography plus tomosynthesis, the results of which were read independently by four different radiologists, is under way. The study was approved by a regional ethics committee, and all participants provided written informed consent. The authors performed a preplanned interim analysis of results from 12,631 examinations interpreted by using mammography alone and mammography plus tomosynthesis from November 22, 2010, to December 31, 2011. Analyses were based on marginal log-linear models for binary data, accounting for correlated interpretations and adjusting for reader-specific performance levels by using a two-sided significance level of .0294. Detection rates, including those for invasive and in situ cancers, were 6.1 per 1000 examinations for mammography alone and 8.0 per 1000 examinations for mammography plus tomosynthesis (27% increase, adjusted for reader; P = .001). False-positive rates before arbitration were 61.1 per 1000 examinations with mammography alone and 53.1 per 1000 examinations with mammography plus tomosynthesis (15% decrease, adjusted for reader; P < .001). After arbitration, positive predictive values for recalled patients with cancers verified later were comparable (29.1% and 28.5%, respectively, with mammography alone and mammography plus tomosynthesis; P = .72). Twenty-five additional invasive cancers were detected with mammography plus tomosynthesis (40% increase, adjusted for reader; P < .001). The mean interpretation time was 45 seconds for mammography alone and 91 seconds for mammography plus tomosynthesis (P < .001). The use of mammography plus tomosynthesis in a

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

    PubMed

    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 < .0001). The mean interpretation time was 2.8 minutes ± 0.9 (range, 1.5-4.2 minutes) for combined 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 < .0001). With the increase in years of breast imaging experience, the overall additional time

  8. Diagnostic accuracy and recall rates for digital mammography and digital mammography combined with one-view and two-view tomosynthesis: results of an enriched reader study.

    PubMed

    Rafferty, Elizabeth A; Park, Jeong Mi; Philpotts, Liane E; Poplack, Steven P; Sumkin, Jules H; Halpern, Elkan F; Niklason, Loren T

    2014-02-01

    The purpose of this study was to compare two methods of combining tomosynthesis with digital mammography by assessing diagnostic accuracy and recall rates for digital mammography alone and digital mammography combined with one-view tomosynthesis and two-view tomosynthesis. Three hundred ten cases including biopsy-proven malignancies (51), biopsy-proven benign findings (47), recalled screening cases (138), and negative screening cases (74) were reviewed by 15 radiologists sequentially using digital mammography, adding one-view tomosynthesis, and then two-view tomosynthesis. Cases were assessed for recall and assigned a BI-RADS score and probability of malignancy for each imaging method. Diagnostic accuracy was assessed using receiver operating characteristic (ROC) analysis. Screening recall rates were compared using pooled logistical regression analysis. A p value of < 0.0167 was considered significant. The area under the ROC curve (AUC) for digital mammography (DM), DM plus one-view tomosynthesis, and DM plus two-view tomosynthesis was 0.828, 0.864, and 0.895, respectively. Both one-view and two-view tomosynthesis plus DM were significantly better than DM alone (Δ AUCs 0.036 [p = 0.009] and 0.068 [p < 0.001]). Average noncancer recall rates for digital mammography, DM plus one-view tomosynthesis, and DM plus two-view tomosynthesis were 44.2%, 27.2%, and 24.0%, respectively. Combined with DM, one-view and two-view tomosynthesis both showed significantly lower noncancer recall rates than digital mammography alone (p < 0.001). Digital mammography with two-view tomosynthesis showed a significantly lower recall rate than digital mammography with one-view tomosynthesis (p < 0.001). Diagnostic accuracy for dense (Δ AUC, 0.091%; p < 0.001) and nondense (Δ AUC, 0.035%; p = 0.001) breasts improved with DM plus two-view tomosynthesis compared with digital mammography alone. Compared with digital mammography, diagnostic sensitivity for invasive cancers increased with the

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

    PubMed

    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 < .001). Simultaneous increase in invasive 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 < .001) was observed. Addition of tomosynthesis to digital mammography increased invasive 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.

  10. Comparative Effectiveness of Combined Digital Mammography and Tomosynthesis Screening for Women with Dense Breasts

    PubMed Central

    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.

    2015-01-01

    Purpose To evaluate the effectiveness of combined biennial digital mammography and tomosynthesis screening, compared with biennial digital mammography screening alone, among women with dense breasts. Materials and Methods 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. Results 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. Conclusion 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. © RSNA, 2014 Online

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

    PubMed

    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.

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

    PubMed

    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.

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

    PubMed

    Gennaro, Gisella; Bernardi, D; Houssami, N

    2017-08-17

    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: MGDFFDM=1.366 mGy, MGDDBT=1.858 mGy; p<0.0001; MLO: MGDFFDM=1.374 mGy, MGDDBT=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. • 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.

  14. Assessing radiologist performance using combined digital mammography and breast tomosynthesis compared with digital mammography alone: results of a multicenter, multireader trial.

    PubMed

    Rafferty, Elizabeth A; Park, Jeong Mi; Philpotts, Liane E; Poplack, Steven P; Sumkin, Jules H; Halpern, Elkan F; Niklason, Loren T

    2013-01-01

    To compare radiologists' diagnostic accuracy and recall rates for breast tomosynthesis combined with digital mammography versus digital mammography alone. Institutional review board approval was obtained at each accruing institution. Participating women gave written informed consent. Mediolateral oblique and craniocaudal digital mammographic and tomosynthesis images of both breasts were obtained from 1192 subjects. Two enriched reader studies were performed to compare digital mammography with tomosynthesis against digital mammography alone. Study 1 comprised 312 cases (48 cancer cases) with images read by 12 radiologists; study 2, 312 cases (51 cancer cases) with 15 radiologists. Study 1 readers recorded only that an abnormality requiring recall was present; study 2 readers had additional training and recorded both lesion type and location. Diagnostic accuracy was compared with receiver operating characteristic analysis. Recall rates of noncancer cases, sensitivity, specificity, and positive and negative predictive values determined by analyzing Breast Imaging Reporting and Data System scores were compared for the two methods. Diagnostic accuracy for combined tomosynthesis and digital mammography was superior to that of digital mammography alone. Average difference in area under the curve in study 1 was 7.2% (95% confidence interval [CI]: 3.7%, 10.8%; P < .001) and in study 2 was 6.8% (95% CI: 4.1%, 9.5%; P < .001). All 27 radiologists increased diagnostic accuracy with addition of tomosynthesis. Recall rates for noncancer cases for all readers significantly decreased with addition of tomosynthesis (range, 6%-67%; P < .001 for 25 readers, P < .03 for all readers). Increased sensitivity was largest for invasive cancers: 15% and 22% in studies 1 and 2 versus 3% for in situ cancers in both studies. Addition of tomosynthesis to digital mammography offers the dual benefit of significantly increased diagnostic accuracy and significantly reduced recall rates for noncancer

  15. Assessing Radiologist Performance Using Combined Digital Mammography and Breast Tomosynthesis Compared with Digital Mammography Alone: Results of a Multicenter, Multireader Trial

    PubMed Central

    Park, Jeong Mi; Philpotts, Liane E.; Poplack, Steven P.; Sumkin, Jules H.; Halpern, Elkan F.; Niklason, Loren T.

    2013-01-01

    Purpose To compare radiologists’ diagnostic accuracy and recall rates for breast tomosynthesis combined with digital mammography versus digital mammography alone. Materials and Methods Institutional review board approval was obtained at each accruing institution. Participating women gave written informed consent. Mediolateral oblique and craniocaudal digital mammographic and tomosynthesis images of both breasts were obtained from 1192 subjects. Two enriched reader studies were performed to compare digital mammography with tomosynthesis against digital mammography alone. Study 1 comprised 312 cases (48 cancer cases) with images read by 12 radiologists; study 2, 312 cases (51 cancer cases) with 15 radiologists. Study 1 readers recorded only that an abnormality requiring recall was present; study 2 readers had additional training and recorded both lesion type and location. Diagnostic accuracy was compared with receiver operating characteristic analysis. Recall rates of noncancer cases, sensitivity, specificity, and positive and negative predictive values determined by analyzing Breast Imaging Reporting and Data System scores were compared for the two methods. Results Diagnostic accuracy for combined tomosynthesis and digital mammography was superior to that of digital mammography alone. Average difference in area under the curve in study 1 was 7.2% (95% confidence interval [CI]: 3.7%, 10.8%; P < .001) and in study 2 was 6.8% (95% CI: 4.1%, 9.5%; P < .001). All 27 radiologists increased diagnostic accuracy with addition of tomosynthesis. Recall rates for noncancer cases for all readers significantly decreased with addition of tomosynthesis (range, 6%–67%; P < .001 for 25 readers, P < .03 for all readers). Increased sensitivity was largest for invasive cancers: 15% and 22% in studies 1 and 2 versus 3% for in situ cancers in both studies. Conclusion Addition of tomosynthesis to digital mammography offers the dual benefit of significantly increased diagnostic accuracy

  16. Breast positioning system for full field digital mammography and digital breast tomosynthesis system

    NASA Astrophysics Data System (ADS)

    Varjonen, Mari; Pamilo, Martti; Hokka, Pirjo; Hokkanen, Riina; Strömmer, Pekka

    2007-03-01

    This paper will present a new breast positioning system for amorphous selenium (a-Se) based full field digital mammography (FFDM) system, which is also a platform of tomosynthesis prototype. Clinical images demonstrate that this method is capable extending the breast away from the chest wall, and maximizing the breast volume. Breast positioning system consists of two transparent moving sheets that apply traction of the breast controlled by motor. Sheets are under and above the compressed breast. Breast positioning sheets pull the breast into the imaging area during the compression. Digital mammography system is based on amorphous selenium flat panel detector (FPD) technology where the overall thickness of the selenium structure is 200 μm, and the pixel size on this detector is 85 μm. Preliminary results will be presented. Clinical study showed increment of the breast volume imaged, and it brought up to 1.0 cm - 2.0 cm more breast tissue. New breast position system also holds a promise of slight decrement of compression force used in the examination. Maximizing the exposured breast tissue is complicated, but important aspect in the breast cancer detection and diagnosis. Increasing the field of view with an additional volume of breast tissue imaged is a key point in digital mammography and digital breast tomosynthesis (DBT).

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

    PubMed

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

    2017-07-14

    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 < .001; specificity remained high (>.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.

  18. Diagnostic accuracy of digital mammography versus tomosynthesis: effect of radiologists' experience

    NASA Astrophysics Data System (ADS)

    Zanca, F.; Wallis, M.; Moa, E.; Leifland, K.; Danielsson, M.; Oyen, R.; Bosmans, H.

    2012-02-01

    Purpose: To investigate whether readers' experience affects performance in a study comparing 2D digital mammography (2D) with 2-view (CC and MLO) or 1-view (MLO) tomosynthesis. Materials and Methods: One-hundred-thirty 2D cases were collected from screening assessment and referral clinics; 64 of the cases had verified abnormalities and the remaining were confirmed normal. Two-view tomosynthesis images were obtained from the same patients. Ten accredited readers (5 with >= 10 years experience in mammography and 5 with < 10 years) classified the cases in terms of malignancy (rate 0-5), and recall (yes/no), for both modalities. A second experiment was performed with the same cases, with 10 other readers (again 5 experienced / 5 less experienced), but using 2D and 1-view tomosynthesis as the two modalities. The multi-reader-multi-case ROC method was applied and the significance of diagnostic accuracy difference of 2D vs tomosynthesis was calculated, as a function of experience and for each experiment. Recall rate (RR) on malignant and benign cases was also calculated, along with reading time. Results: No significant difference was reached between 2D and 2-view tomosynthesis for experienced readers (pvalue= 0.25); for less experienced readers the p-value was significant (0.03). No significant difference was found between 2D and 1-view tomosynthesis, independent of readers' experience. RR for benign cases decreased for tomosynthesis (for booth 1- and 2-view), independent of experience. Average reading time per case was 79 s (range 65- 91 s) and 134 s (range 119-158 s) for experienced readers; 56 s (range 46-67 s) and 115s (range 97-142 s) for nonexperienced, for 2D and 2-view tomosynthesis respectively. Reading time was 74 s (range 43-98 s) and 99 s (range 73- 117 s) for experienced readers; 74 s (range 62-85 s) and 94 s (range 82-137 s) for non-experienced, for 2D and 1-view tomosynthesis respectively. Conclusions: For experienced readers, there is no evidence of

  19. [Digital breast tomosynthesis].

    PubMed

    Preibsch, H; Siegmann-Luz, K C

    2015-01-01

    In digital breast tomosynthesis several low dose mammograms are acquired from different angles to calculate thin slices of synthetic mammograms from algorithms. Similar to computed tomography and magnetic resonance imaging, breast tomosynthesis provides breast images which are virtually free from superimposition. This is in particular important in cases of high mammographic density to differentiate real masses and architectural distortions from the overlying parenchyma. In comparison to full field digital mammography tomosynthesis can improve the cancer detection rate and reduce the recall rate. The limitations of tomosynthesis are the higher radiation dose and the longer reporting time compared to full field digital mammography. Until the radiation dose can be significantly reduced it is advisable to use tomosynthesis in addition to full field digital mammography primarily for the assessment of suspicious mammographic findings and not for breast cancer screening.

  20. Breast MRI, digital mammography and breast tomosynthesis: comparison of three methods for early detection of breast cancer.

    PubMed

    Roganovic, Dragana; Djilas, Dragana; Vujnovic, Sasa; Pavic, Dag; Stojanov, Dragan

    2015-11-16

    Breast cancer is the most common malignancy in women and early detection is important for its successful treatment. The aim of this study was to investigate the sensitivity and specificity of three methods for early detection of breast cancer: breast magnetic resonance imaging (MRI), digital mammography, and breast tomosynthesis in comparison to histopathology, as well as to investigate the intraindividual variability between these modalities. We included 57 breast lesions, each detected by three diagnostic modalities: digital mammography, breast MRI, and breast tomosynthesis, and subsequently confirmed by histopathology. Breast Imaging-Reporting and Data System (BI-RADS) was used for characterizing the lesions. One experienced radiologist interpreted all three diagnostic modalities. Twenty-nine of the breast lesions were malignant while 28 were benign. The sensitivity for digital mammography, breast MRI, and breast tomosynthesis, was 72.4%, 93.1%, and 100%, respectively; while the specificity was 46.4%, 60.7%, and 75%, respectively. Receiver operating characteristics (ROC) curve analysis showed an overall diagnostic advantage of breast tomosynthesis over both breast MRI and digital mammography. The difference in performance between breast tomosynthesis and digital mammography was significant (p <0.001), while the difference between breast tomosynthesis and breast MRI was not significant (p=0.20).

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

    PubMed

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

    2013-09-01

    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. • Digital breast tomosynthesis is a new adjunct to mammography and breast ultrasound. • We compared the diagnostic performance of these investigations in an experimental observer study. • Single-view breast tomosynthesis was confirmed as non-inferior to dual-view mammography. • None of the investigations (or combinations) tested outperformed the others. • Further prospective studies are needed to clarify precise role of tomosynthesis for diagnostic application.

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

    SciTech Connect

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

    2011-12-15

    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

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

    PubMed

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

    2011-12-01

    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. 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. 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 lesions (p > 0.05). Agreement

  4. Development and Clinical Evaluation of Tomosynthesis for Digital Mammography

    DTIC Science & Technology

    2000-10-01

    Tomosynthesis holds the promise of detecting breast cancer earlier, at a smaller size, with fewer false-positive outcomes. Progress toward this goal...automatic motorized tomosynthesis system has been delivered, installed and acceptance tested at MGH. A physics report on the imaging characteristics is...complete. We are now in position to evaluate tomosynthesis in the clinical setting. This will permit an understanding of it’s clinical potential, and if warranted, the design of a clinical trial.

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

    PubMed

    Zhao, Bo; Zhao, Wei

    2008-05-01

    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 degrees 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 microm. The detector can be read out in full resolution or 2 x 1 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

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

    PubMed Central

    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° 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 2×1 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

  7. Research in digital mammography and tomosynthesis at the University of Toronto.

    PubMed

    Yaffe, Martin J

    2014-07-01

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

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

    SciTech Connect

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

    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

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

    PubMed

    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

  10. Optimal photon energy comparison between digital breast tomosynthesis and mammography: a case study.

    PubMed

    Di Maria, S; Baptista, M; Felix, M; Oliveira, N; Matela, N; Janeiro, L; Vaz, P; Orvalho, L; Silva, A

    2014-06-01

    A comparison, in terms of the optimal energy that maximizes the image quality between digital breast tomosynthesis (DBT) and digital mammography (DM) was performed in a MAMMOMAT Inspiration system (Siemens) based on amorphous selenium flat panel detector. In this paper we measured the image quality by the signal difference-to-noise ratio (SDNR), and the patient risk by the mean glandular dose (MGD). Using these quantities we compared the optimal voltage that maximizes the image quality both in breast tomosynthesis and standard mammography acquisition mode. The comparison for the two acquisition modes was performed for a W/Rh anode filter combinations by using a 4.5 cm tissue equivalent mammography phantom. Moreover, in order to check if the used equipment was quantum noise limited, the relation of the relative noise with respect to the detector dose was evaluated. Results showed that in the tomosynthesis acquisition mode the optimal voltage is 28 kV, whereas in standard mammography the optimal voltage is 30 kV. The automatic exposure control (AEC) of the system selects 28 kV as optimal voltage both for DBT and DM. Monte Carlo simulations showed a qualitative agreement with the AEC selection system, since an optimal monochromatic energy of 20 keV was found both for DBT and DM. Moreover, the check about the noise showed that the system is not completely quantum noise limited, and this issue could explain the experimental slight difference in terms of optimal voltage between DBT and DM. According to these results, the use of higher voltage settings is not justified for the improvement of the image quality during a DBT examination.

  11. Comparison of digital breast tomosynthesis and 2D digital mammography using a hybrid performance test

    NASA Astrophysics Data System (ADS)

    Cockmartin, Lesley; Marshall, Nicholas W.; Van Ongeval, Chantal; Aerts, Gwen; Stalmans, Davina; Zanca, Federica; Shaheen, Eman; De Keyzer, Frederik; Dance, David R.; Young, Kenneth C.; Bosmans, Hilde

    2015-05-01

    This paper introduces a hybrid method for performing detection studies in projection image based modalities, based on image acquisitions of target objects and patients. The method was used to compare 2D mammography and digital breast tomosynthesis (DBT) in terms of the detection performance of spherical densities and microcalcifications. The method starts with the acquisition of spheres of different glandular equivalent densities and microcalcifications of different sizes immersed in a homogeneous breast tissue simulating medium. These target objects are then segmented and the subsequent templates are fused in projection images of patients and processed or reconstructed. This results in hybrid images with true mammographic anatomy and clinically relevant target objects, ready for use in observer studies. The detection study of spherical densities used 108 normal and 178 hybrid 2D and DBT images; 156 normal and 321 hybrid images were used for the microcalcifications. Seven observers scored the presence/absence of the spheres/microcalcifications in a square region via a 5-point confidence rating scale. Detection performance in 2D and DBT was compared via ROC analysis with sub-analyses for the density of the spheres, microcalcification size, breast thickness and z-position. The study was performed on a Siemens Inspiration tomosynthesis system using patient acquisitions with an average age of 58 years and an average breast thickness of 53 mm providing mean glandular doses of 1.06 mGy (2D) and 2.39 mGy (DBT). Study results showed that breast tomosynthesis (AUC = 0.973) outperformed 2D (AUC = 0.831) for the detection of spheres (p  <  0.0001) and this applied for all spherical densities and breast thicknesses. By way of contrast, DBT was worse than 2D for microcalcification detection (AUC2D = 0.974, AUCDBT = 0.838, p  <  0.0001), with significant differences found for all sizes (150-354 µm), for breast thicknesses above 40 mm and for heights

  12. Comparison of digital breast tomosynthesis and 2D digital mammography using a hybrid performance test.

    PubMed

    Cockmartin, Lesley; Marshall, Nicholas W; Van Ongeval, Chantal; Aerts, Gwen; Stalmans, Davina; Zanca, Federica; Shaheen, Eman; De Keyzer, Frederik; Dance, David R; Young, Kenneth C; Bosmans, Hilde

    2015-05-21

    This paper introduces a hybrid method for performing detection studies in projection image based modalities, based on image acquisitions of target objects and patients. The method was used to compare 2D mammography and digital breast tomosynthesis (DBT) in terms of the detection performance of spherical densities and microcalcifications. The method starts with the acquisition of spheres of different glandular equivalent densities and microcalcifications of different sizes immersed in a homogeneous breast tissue simulating medium. These target objects are then segmented and the subsequent templates are fused in projection images of patients and processed or reconstructed. This results in hybrid images with true mammographic anatomy and clinically relevant target objects, ready for use in observer studies. The detection study of spherical densities used 108 normal and 178 hybrid 2D and DBT images; 156 normal and 321 hybrid images were used for the microcalcifications. Seven observers scored the presence/absence of the spheres/microcalcifications in a square region via a 5-point confidence rating scale. Detection performance in 2D and DBT was compared via ROC analysis with sub-analyses for the density of the spheres, microcalcification size, breast thickness and z-position. The study was performed on a Siemens Inspiration tomosynthesis system using patient acquisitions with an average age of 58 years and an average breast thickness of 53 mm providing mean glandular doses of 1.06 mGy (2D) and 2.39 mGy (DBT). Study results showed that breast tomosynthesis (AUC = 0.973) outperformed 2D (AUC = 0.831) for the detection of spheres (p  <  0.0001) and this applied for all spherical densities and breast thicknesses. By way of contrast, DBT was worse than 2D for microcalcification detection (AUC2D = 0.974, AUCDBT = 0.838, p  <  0.0001), with significant differences found for all sizes (150-354 µm), for breast thicknesses above 40 mm and for heights

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

    PubMed

    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 p<0.05). No significant differences were found in AUC between DCE-MRI, CET and CEDM (all p>0.05). 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.

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

    PubMed

    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

  15. Impact of prior mammograms on combined reading of digital mammography and digital breast tomosynthesis.

    PubMed

    Kim, Won Hwa; Chang, Jung Min; Koo, Hye Ryoung; Seo, Mirinae; Bae, Min Sun; Lee, Joongyub; Moon, Woo Kyung

    2017-02-01

    Background Although digital breast tomosynthesis (DBT) is an emerging technique yielding higher sensitivity and specificity compared to digital mammography (DM) alone, relative contribution of prior mammograms on the interpretation of DBT combined with DM has not been investigated. Purpose To retrospectively compare the diagnostic performances of DM, DM + DBT, and DM + DBT with prior mammograms. Material and Methods Three breast radiologists independently reviewed images of 116 patients with 24 cancers in the sequential order of DM, DM + DBT, and DM + DBT with prior mammograms using Breast Imaging Reporting and Data System (BI-RADS) assessment categories. Results The average areas under the receiver operating characteristic curve (AUC) of DM, DM + DBT, and DM + DBT with prior mammograms were 0.712, 0.777, and 0.816, respectively. Adding prior mammograms did not significantly affect the AUC of DM + DBT ( P = 0.108), whereas adding DBT significantly increased the AUC of DM ( P = 0.009). Sensitivity for DM, DM + DBT, and DM + DBT with prior mammograms was 58.3%, 69.4%, and 69.4%, and specificities were 84.1%, 85.9%, and 93.8%, respectively. Addition of DBT significantly increased the sensitivity ( P = 0.0090) of DM. Prior mammograms significantly improved the specificity of DM + DBT ( P = 0.0004), whereas adding prior mammogram did not affect sensitivity of DM + DBT ( P = 1.000). Conclusion DBT significantly increases the overall sensitivity and diagnostic performance of DM. Prior mammograms significantly increase the specificity of DM + DBT but have no significant effect on sensitivity and overall diagnostic performance.

  16. Pipeline for effective denoising of digital mammography and digital breast tomosynthesis

    NASA Astrophysics Data System (ADS)

    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.

  17. Radiation dose differences between digital mammography and digital breast tomosynthesis are dependent on breast thickness

    NASA Astrophysics Data System (ADS)

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

    2016-03-01

    Purpose To evaluate the radiation dose derived from digital mammography (DM) and digital breast tomosynthesis (DBT) at different tube current-exposure time product (mAs) and at 6 phantom thicknesses from 10 to 60 mm. Materials and Methods A total of 240 DM and DBT cranio-caudal (CC) phantom images were acquired at each thickness and at four exposure levels (the baseline mAs, 50%, 25% and 12.5% the baseline mAs). The incident Air Kerma (K) at the surface of the phantoms was measured using a solid state dosimeter. Mean Glandular Doses (MGD) were calculated for both modalities (DM and DBT). Results DBT dose was greater than that of DM for all mAs at each phantom thickness. For a breast thickness of 50 mm (close to average sized breast), the dose for DBT (2.32 mGy) was 13% higher than that for DM (2.05 mGy). The results also show that the difference in MGD between DM and DBT was less for the thicker compared with the thinner phantom, this difference being approximately a factor of 2.58 at 10 mm compared with a factor of 1.08 at 60 mm. While the MGD increased with increasing phantom thickness for both modalities, the dose increase with DBT was less than for DM, with the difference between 10 and 60 mm being a factor of 7 for DM and 3 for DBT. Conclusion The radiation dose from DBT was higher than that of DM and the difference in dose between DM and DBT decreases as phantom thickness increases.

  18. Comparison of computer-aided detection of clustered microcalcifications in digital mammography and digital breast tomosynthesis

    NASA Astrophysics Data System (ADS)

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

    2015-03-01

    Digital breast tomosynthesis (DBT) has the potential to replace digital mammography (DM) for breast cancer screening. An effective computer-aided detection (CAD) system for microcalcification clusters (MCs) on DBT will facilitate the transition. In this study, we collected a data set with corresponding DBT and DM for the same breasts. DBT was acquired with IRB approval and informed consent using a GE GEN2 DBT prototype system. The DM acquired with a GE Essential system for the patient's clinical care was collected retrospectively from patient files. DM-based CAD (CADDM) and DBT-based CAD (CADDBT) were previously developed by our group. The major differences between the CAD systems include: (a) CADDBT uses two parallel processes whereas CADDM uses a single process for enhancing MCs and removing the structured background, (b) CADDBT has additional processing steps to reduce the false positives (FPs), including ranking of candidates of cluster seeds and cluster members and the use of adaptive CNR and size thresholds at clustering and FP reduction, (c) CADDM uses convolution neural network (CNN) and linear discriminant analysis (LDA) to differentiate true microcalcifications from FPs based on their morphological and CNN features. The performance difference is assessed by FROC analysis using test set (100 views with MCs and 74 views without MCs) independent of their respective training sets. At sensitivities of 70% and 80%, CADDBT achieved FP rates of 0.78 and 1.57 per view compared to 0.66 and 2.10 per image for the CADDM. JAFROC showed no significant difference between MC detection on DM and DBT by the two CAD systems.

  19. A comparison of image interpretation times in full field digital mammography and digital breast tomosynthesis

    NASA Astrophysics Data System (ADS)

    Astley, Susan; Connor, Sophie; Lim, Yit; Tate, Catriona; Entwistle, Helen; Morris, Julie; Whiteside, Sigrid; Sergeant, Jamie; Wilson, Mary; Beetles, Ursula; Boggis, Caroline; Gilbert, Fiona

    2013-03-01

    Digital Breast Tomosynthesis (DBT) provides three-dimensional images of the breast that enable radiologists to discern whether densities are due to overlapping structures or lesions. To aid assessment of the cost-effectiveness of DBT for screening, we have compared the time taken to interpret DBT images and the corresponding two-dimensional Full Field Digital Mammography (FFDM) images. Four Consultant Radiologists experienced in reading FFDM images (4 years 8 months to 8 years) with training in DBT interpretation but more limited experience (137-407 cases in the past 6 months) were timed reading between 24 and 32 two view FFDM and DBT cases. The images were of women recalled from screening for further assessment and women under surveillance because of a family history of breast cancer. FFDM images were read before DBT, according to local practice. The median time for readers to interpret FFDM images was 17.0 seconds, with an interquartile range of 12.3-23.6 seconds. For DBT, the median time was 66.0 seconds, and the interquartile range was 51.1-80.5 seconds. The difference was statistically significant (p<0.001). Reading times were significantly longer in family history clinics (p<0.01). Although it took approximately four times as long to interpret DBT than FFDM images, the cases were more complex than would be expected for routine screening, and with higher mammographic density. The readers were relatively inexperienced in DBT interpretation and may increase their speed over time. The difference in times between clinics may be due to increased throughput at assessment, or decreased density.

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

    PubMed

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

    2016-06-01

    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. • Digital breast tomosynthesis (DBT) plus mammography was compared with MRI plus mammography. • DBT had lower sensitivity and higher PPV than MRI. • DBT had higher diagnostic performance than mammography.

  1. Clinical implementation of synthesized mammography with digital breast tomosynthesis in a routine clinical practice.

    PubMed

    Freer, Phoebe E; Riegert, Joanna; Eisenmenger, Laura; Ose, Dominik; Winkler, Nicole; Stein, Matthew A; Stoddard, Gregory J; Hess, Rachel

    2017-08-05

    Most published studies evaluating digital breast tomosynthesis (DBT) included a separate 2-dimensional full-field digital mammogram (FFDM) for DBT screening protocols, increasing radiation from screening mammography. Synthesized mammography (SM) creates a 2-dimensional image from the DBT source data, and if used in place of FFDM, it reduces radiation of DBT screening. This study evaluated the implementation of SM + DBT in routine screening practice in terms of recall rates, cancer detection rates (CDR), % of minimal cancers, % of node-positive cancers, and positive predictive values (PPV). A multivariate retrospective institutional analysis was performed on 31,979 women who obtained screening mammography (10/2013-12/2015) with cohorts divided by modality (SM + DBT, FFDM + DBT, and FFDM). We adjusted for comparison mammograms, age, breast density, and the interpreting radiologist. Recall type was analyzed for differences (focal asymmetry, asymmetry, masses, calcifications, architectural distortion). SM + DBT significantly decreased the recall rate compared to FFDM (5.52 vs. 7.83%, p < 0.001) with no differences in overall CDR (p = 0.66), invasive and/or in situ CDR, or percentages of minimal and node-negative cancers. PPV1 significantly increased with SM + DBT relative to FFDM (9.1 vs. 6.2%, p = 0.02). SM + DBT did not differ significantly in recall rate or overall CDR compared to FFDM + DBT. There were statistically significant differences in certain findings recalled by screening modality (e.g., focal asymmetries). SM + DBT reduces false positives compared to FFDM, while maintaining the CDR and other desirable audit outcome data. SM + DBT is more accurate than FFDM alone, and is a desirable alternative to FFDM + DBT, given the added benefit of radiation reduction.

  2. Does Reader Performance with Digital Breast Tomosynthesis Vary according to Experience with Two-dimensional Mammography?

    PubMed

    Tucker, Lorraine; Gilbert, Fiona J; Astley, Susan M; Dibden, Amanda; Seth, Archana; Morel, Juliet; Bundred, Sara; Litherland, Janet; Klassen, Herman; Lip, Gerald; Purushothaman, Hema; Dobson, Hilary M; McClure, Linda; Skippage, Philippa; Stoner, Katherine; Kissin, Caroline; Beetles, Ursula; Lim, Yit Yoong; Hurley, Emma; Goligher, Jane; Rahim, Rumana; Gagliardi, Tanja J; Suaris, Tamara; Duffy, Stephen W

    2017-05-01

    Purpose To assess whether individual reader performance with digital breast tomosynthesis (DBT) and two-dimensional (2D) mammography varies with number of years of experience or volume of 2D mammograms read. Materials and Methods After written informed consent was obtained, 8869 women (age range, 29-85 years; mean age, 56 years) were recruited into the TOMMY trial (A Comparison of Tomosynthesis with Digital Mammography in the UK National Health Service Breast Screening Program), an ethically approved, multicenter, multireader, retrospective reading study, between July 2011 and March 2013. Each case was read prospectively for clinical assessment and to establish ground truth. A retrospective reading data set of 7060 cases was created and randomly allocated for independent blinded review of (a) 2D mammograms, (b) DBT images and 2D mammograms, and (c) synthetic 2D mammograms and DBT images, without access to previous examinations. Readers (19 radiologists, three advanced practitioner radiographers, and two breast clinicians) who had 3-25 (median, 10) years of experience in the U.K. National Health Service Breast Screening Program and read 5000-13 000 (median, 8000) cases per annum were included in this study. Specificity was analyzed according to reader type and years and volume of experience, and then both specificity and sensitivity were analyzed by matched inference. The median duration of experience (10 years) was used as the cutoff point for comparison of reader performance. Results Specificity improved with the addition of DBT for all readers. This was significant for all staff groups (56% vs 68% and 49% vs 67% [P < .0001] for radiologists and advanced practitioner radiographers, respectively; 46% vs 55% [P = .02] for breast clinicians). Sensitivity was improved for 19 of 24 (79%) readers and was significantly higher for those with less than 10 years of experience (91% vs 86%; P = .03) and those with total mammographic experience of fewer than 80 000 cases (88

  3. Ultra-Fast Image Reconstruction of Tomosynthesis Mammography Using GPU.

    PubMed

    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).

  4. Mass detection in breast tomosynthesis and digital mammography: a model observer study

    NASA Astrophysics Data System (ADS)

    Castella, C.; Ruschin, M.; Eckstein, M. P.; Abbey, C. K.; Kinkel, K.; Verdun, F. R.; Tingberg, A.; Bochud, F. O.

    2009-02-01

    In this study, we adapt and apply model observers within the framework of realistic detection tasks in breast tomosynthesis (BT). We use images consisting of realistic masses digitally embedded in real patient anatomical backgrounds, and we adapt specific model observers that have been previously applied to digital mammography (DM). We design alternative forced-choice experiments (AFC) studies for DM and BT tasks in the signal known exactly but variable (SKEV) framework. We compare performance of various linear model observers (non-prewhitening matched filter with an eye filter, and several channelized Hotelling observers (CHO) against human. A good agreement in performance between human and model observers can be obtained when an appropriate internal noise level is adopted. Models achieve the same detection performance across BT and DM with about three times less projected signal intensity in BT than in DM (humans: 3.8), due to the anatomical noise reduction in BT. We suggest that, in the future, model observers can potentially be used as an objective tool for automating the optimization of BT acquisition parameters or reconstruction algorithms, or narrowing a wide span of possible parameter combinations, without requiring human observers studies.

  5. Accuracy of mammography, digital breast tomosynthesis, ultrasound and MR imaging in preoperative assessment of breast cancer.

    PubMed

    Mariscotti, Giovanna; Houssami, Nehmat; Durando, Manuela; Bergamasco, Laura; Campanino, Pier Paolo; Ruggieri, Chiara; Regini, Elisa; Luparia, Andrea; Bussone, Riccardo; Sapino, Anna; Fonio, Paolo; Gandini, Giovanni

    2014-03-01

    To define the accuracy of digital breast tomosynthesis (DBT) and magnetic resonance imaging (MRI) added to digital mammography (DM) and ultrasound (US) in the preoperative assessment of breast cancer. We performed a prospective study of 200 consecutive women with histologically-proven breast cancer using the above imaging techniques. Accuracy measurements were estimated using a lesion-by-lesion analysis for unifocal, multifocal/multicentric, bilateral and all carcinomas. We also calculated sensitivity according to breast density. DBT had higher sensitivity than DM (90.7% vs. 85.2%). Combined DM and DBT with US yielded a 97.7% sensitivity; despite high sensitivity of MRI (98.8%), the addition of MRI to combined DM with DBT and US did not significantly improve sensitivity. Overall accuracy did not significantly differ between MRI and DM with DBT and US (92.3% vs. 93.7%). Breast density affected sensitivity of DM and DBT (statistically significant difference for DM), not MRI. There is little gain in sensitivity and no gain in overall accuracy, by performing MRI for patients who have been evaluated with DM with DBT and US.

  6. Analysis of Parenchymal Texture with Digital Breast Tomosynthesis: Comparison with Digital Mammography and Implications for Cancer Risk Assessment

    PubMed Central

    Ikejimba, Lynda C.; Bakic, Predrag R.; Troxel, Andrea B.; Conant, Emily F.; Maidment, Andrew D. A.

    2011-01-01

    Purpose: To correlate the parenchymal texture features at digital breast tomosynthesis (DBT) and digital mammography with breast percent density (PD), an established breast cancer risk factor, in a screening population of women. Materials and Methods: This HIPAA-compliant study was approved by the institutional review board. Bilateral DBT images and digital mammograms from 71 women (mean age, 54 years; age range, 34–75 years) with negative or benign findings at screening mammography were retrospectively collected from a separate institutional review board–approved DBT screening trial (performed from July 2007 to March 2008) in which all women had given written informed consent. Parenchymal texture features of skewness, coarseness, contrast, energy, homogeneity, and fractal dimension were computed from the retroareolar region. Principal component analysis (PCA) was applied to obtain orthogonal texture components. Mammographic PD was estimated with software. Correlation analysis and multiple linear regression with generalized estimating equations were performed to determine the association between texture features and breast PD. Regression was adjusted for age to determine the independent association of texture to breast PD when age was also considered as a predictor variable. Results: Texture feature correlations to breast PD were stronger with DBT than with digital mammography. Statistically significant correlations (P < .001) were observed for contrast (r = 0.48), energy (r = −0.47), and homogeneity (r = −0.56) at DBT and for contrast (r = 0.26), energy (r = −0.26), and homogeneity (r = −0.33) at digital mammography. Multiple linear regression analysis of PCA texture components as predictors of PD also demonstrated significantly stronger associations with DBT. The association was strongest when age was also considered as a predictor of PD (R2 = 0.41 for DBT and 0.28 for digital mammography; P < .001). Conclusion: Parenchymal texture features are more

  7. Implementation of Synthesized Two-dimensional Mammography in a Population-based Digital Breast Tomosynthesis Screening Program.

    PubMed

    Zuckerman, Samantha P; Conant, Emily F; Keller, Brad M; Maidment, Andrew D A; Barufaldi, Bruno; Weinstein, Susan P; Synnestvedt, Marie; McDonald, Elizabeth S

    2016-12-01

    Purpose To evaluate the early implementation of synthesized two-dimensional (s2D) mammography in a population screened entirely with s2D and digital breast tomosynthesis (DBT) (referred to as s2D/DBT) and compare recall rates and cancer detection rates to historic outcomes of digital mammography combined with DBT (referred to as digital mammography/DBT) screening. Materials and Methods This was an institutional review board-approved and HIPAA-compliant retrospective interpretation of prospectively acquired data with waiver of informed consent. Compared were recall rates, biopsy rates, cancer detection rates, and radiation dose for 15 571 women screened with digital mammography/DBT from October 1, 2011, to February 28, 2013, and 5366 women screened with s2D/DBT from January 7, 2015, to June 30, 2015. Two-sample z tests of equal proportions were used to determine statistical significance. Results Recall rate for s2D/DBT versus digital mammography/DBT was 7.1% versus 8.8%, respectively (P < .001). Biopsy rate for s2D/DBT versus digital mammography/DBT decreased (1.3% vs 2.0%, respectively; P = .001). There was no significant difference in cancer detection rate for s2D/DBT versus digital mammography/DBT (5.03 of 1000 vs 5.45 of 1000, respectively; P = .72). The average glandular dose was 39% lower in s2D/DBT versus digital mammography/DBT (4.88 mGy vs 7.97 mGy, respectively; P < .001). Conclusion Screening with s2D/DBT in a large urban practice resulted in similar outcomes compared with digital mammography/DBT imaging. Screening with s2D/DBT allowed for the benefits of DBT with a decrease in radiation dose compared with digital mammography/DBT. (©) RSNA, 2016 An earlier incorrect version of this article appeared online. This article was corrected on August 11, 2016.

  8. Digital breast tomosynthesis and breast ultrasound: Additional roles in dense breasts with category 0 at conventional digital mammography.

    PubMed

    Lee, Won Kyung; Chung, Jin; Cha, Eun-Suk; Lee, Jee Eun; Kim, Jeoung Hyun

    2016-01-01

    To compare the diagnostic performances of digital breast tomosynthesis (DBT) and ultrasound for the dense breasts with category 0 at conventional digital mammography. This retrospective study was approved by the institutional review board, and informed consent was waived. Among the 1103 patients who underwent screening digital mammography at our institution, 769 (69.7%) patients had dense breasts. Of the 769 patients, 229 (29.8%) lesions were categorized as 0. DBT, breast ultrasound and digital mammography were performed in 108 (47.2%) patients. BI-RADS final assessments for DBT and ultrasound were recorded. Categories 1-3 were clinically considered as benign, and categories 4 and 5 were clinically considered as malignant. The diagnostic performances of breast ultrasound and DBT were correlated with final pathologic reports or follow-up images. Among 108 lesions, 17 (15.7%) were malignant and 91 (84.3%) were benign. Sensitivity was 100% for both ultrasound (17/17) and DBT (17/17) and negative predictive value was also 100% for both ultrasound (49/49) and DBT (74/74). Specificity and positive predictive value for ultrasound were 53.9% (49/91) and 28.8% (17/59), respectively. Specificity and positive predictive value for DBT were 81.3% (74/91) and 50% (17/34), respectively. DBT showed higher diagnostic accuracy than that of breast ultrasound (DBT: 84.3%, 91/108; ultrasound: 61.1%, 66/108; p<0.001). The benign biopsy rate of DBT (50%, 17/34) was lower than that of ultrasound (71.2%, 42/59). DBT showed better diagnostic performance than breast ultrasound for dense breasts with category 0. DBT may reduce the benign biopsy rate and short term follow-up. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  9. Characterization of invisible breast cancers in digital mammography and tomosynthesis: radio-pathological correlation.

    PubMed

    Aguilar Angulo, P M; Romero Castellano, C; Ruiz Martín, J; Sánchez-Camacho González-Carrato, M P; Cruz Hernández, L M

    2017-09-21

    To review the radio-pathologic features of symptomatic breast cancers not detected at digital mammography (DM) and digital breast tomosynthesis (DBT). Retrospective analysis of 169 lesions from symptomatic patients with breast cancer that were studied with DM, DBT, ultrasound (US) and magnetic resonance (MR). We identified occult lesions (true false negatives) in DM and DBT. Clinical data, density, US and MR findings were analyzed as well as histopathological results. We identified seven occult lesions in DM and DBT. 57% (4/7) of the lesions were identified in high-density breasts (type c and d), and the rest of them in breasts of density type b. Six carcinomas were identified at US and MR (BI-RADS 4 masses); the remaining lesion was only identified at MR. The tumor size was larger than 3cm at MRI in 57% of the lesions. All tumors were ductal infiltrating carcinomas, six of them with high stromal proportion. According to molecular classification, we found only one triple-negative breast cancer, the other lesions were luminal-type. We analyzed the tumor margins of two resected carcinomas that were not treated with neoadjuvant chemotherapy, both lesions presented margins that displaced the adjacent parenchyma without infiltrating it. Occult breast carcinomas in DM and DBT accounted for 4% of lesions detected in patients with symptoms. They were mostly masses, all of them presented the diagnosis of infiltrating ductal carcinoma (with predominance of the luminal immunophenotype) and were detected in breasts of density type b, c and d. Copyright © 2017 SERAM. Publicado por Elsevier España, S.L.U. All rights reserved.

  10. Pathologic Outcomes of Architectural Distortion on Digital 2D Versus Tomosynthesis Mammography.

    PubMed

    Bahl, Manisha; Lamb, Leslie R; Lehman, Constance D

    2017-08-23

    The purpose of this study is to compare the risk of malignancy associated with architectural distortion detected on 2D digital mammography (DM) versus digital breast tomosynthesis (DBT). We performed a retrospective review of architectural distortion cases recommended for biopsy from September 2007 to February 2011, the period before DBT integration (hereafter known as the DM group), and from January 2013 to June 2016, the period after DBT integration (hereafter known as the DBT group). Medical records were reviewed for imaging findings and pathology results. Architectural distortion was more commonly detected in the DBT group than the DM group (0.14% [274/202,438 examinations] vs 0.07% [121/166,661 examinations]; p < 0.001). The positive predictive value of architectural distortion for malignancy was significantly lower in the DBT group than the DM group (50.7% [139/274 cases] vs 73.6% [89/121 cases]; p < 0.001). Radial scar was the most common nonmalignant finding in both groups, but it was more common in the DBT group (33.2% [91/274] vs 11.6% [14/121]; p < 0.001). In the DBT group, architectural distortion without correlative findings on ultrasound was less likely to represent malignancy than was architectural distortion with correlative findings on ultrasound (29.2% [31/106] vs 66.5% [105/158]; p < 0.001). Architectural distortion is more commonly detected on DBT than DM and is less likely to represent malignancy on DBT. Architectural distortion on DBT is less likely to represent malignancy if there is no sonographic correlate; however, biopsy is warranted even in the absence of a sonographic correlate, given the nearly 30% risk of malignancy in this setting.

  11. The TOMMY trial: a comparison of TOMosynthesis with digital MammographY in the UK NHS Breast Screening Programme--a multicentre retrospective reading study comparing the diagnostic performance of digital breast tomosynthesis and digital mammography with digital mammography alone.

    PubMed

    Gilbert, Fiona J; Tucker, Lorraine; Gillan, Maureen Gc; Willsher, Paula; Cooke, Julie; Duncan, Karen A; Michell, Michael J; Dobson, Hilary M; Lim, Yit Yoong; Purushothaman, Hema; Strudley, Celia; Astley, Susan M; Morrish, Oliver; Young, Kenneth C; Duffy, Stephen W

    2015-01-01

    Digital breast tomosynthesis (DBT) is a three-dimensional mammography technique with the potential to improve accuracy by improving differentiation between malignant and non-malignant lesions. The objectives of the study were to compare the diagnostic accuracy of DBT in conjunction with two-dimensional (2D) mammography or synthetic 2D mammography, against standard 2D mammography and to determine if DBT improves the accuracy of detection of different types of lesions. Women (aged 47-73 years) recalled for further assessment after routine breast screening and women (aged 40-49 years) with moderate/high of risk of developing breast cancer attending annual mammography screening were recruited after giving written informed consent. All participants underwent a two-view 2D mammography of both breasts and two-view DBT imaging. Image-processing software generated a synthetic 2D mammogram from the DBT data sets. In an independent blinded retrospective study, readers reviewed (1) 2D or (2) 2D + DBT or (3) synthetic 2D + DBT images for each case without access to original screening mammograms or prior examinations. Sensitivities and specificities were calculated for each reading arm and by subgroup analyses. Data were available for 7060 subjects comprising 6020 (1158 cancers) assessment cases and 1040 (two cancers) family history screening cases. Overall sensitivity was 87% [95% confidence interval (CI) 85% to 89%] for 2D only, 89% (95% CI 87% to 91%) for 2D + DBT and 88% (95% CI 86% to 90%) for synthetic 2D + DBT. The difference in sensitivity between 2D and 2D + DBT was of borderline significance (p = 0.07) and for synthetic 2D + DBT there was no significant difference (p = 0.6). Specificity was 58% (95% CI 56% to 60%) for 2D, 69% (95% CI 67% to 71%) for 2D + DBT and 71% (95% CI 69% to 73%) for synthetic 2D + DBT. Specificity was significantly higher in both DBT reading arms for all subgroups of age, density and dominant radiological

  12. Two-view and single-view tomosynthesis versus full-field digital mammography: high-resolution X-ray imaging observer study.

    PubMed

    Wallis, Matthew G; Moa, Elin; Zanca, Federica; Leifland, Karin; Danielsson, Mats

    2012-03-01

    To compare the diagnostic accuracy of two-dimensional (2D) full-field digital mammography with that of two-view (mediolateral and craniocaudal) and single-view (mediolateral oblique) tomosynthesis in an observer study involving two institutions. Ethical committee approval was obtained. All participating women gave informed consent. Two hundred twenty women (mean age, 56.3; range, 40-80 years) with breast density of 2-4 according to American College of Radiology criteria were recruited between November 2008 and September 2009 and underwent standard treatment plus tomosynthesis with a prototype photon-counting machine. After exclusion criteria were met, this resulted in a final test set of 130 women. Ten accredited readers classified the 130 cases (40 cancers, 24 benign lesions, and 66 normal images) using 2D mammography and two-view tomosynthesis. Another 10 readers reviewed the same cases using 2D mammography but single-view tomosynthesis. The multireader, multicase receiver operating characteristic (ROC) method was applied. The significance of the observed difference in accuracy between 2D mammography and tomosynthesis was calculated. For diagnostic accuracy, 2D mammography performed significantly worse than two-view tomosynthesis (average area under ROC curve [AUC] = 0.772 for 2D, AUC = 0.851 for tomosynthesis, P = .021). Significant differences were found for both masses and microcalcification (P = .037 and .049). The difference in AUC between the two modalities of -0.110 was significant (P = .03) only for the five readers with the least experience (<10 years of reading); with AUC of -0.047 for the five readers with 10 years or more experience (P = .25). No significant difference (P = .79) in reader performance was seen when 2D mammography (average AUC = 0.774) was compared with single-view tomosynthesis (average AUC = 0.775). Two-view tomosynthesis outperforms 2D mammography but only for readers with the least experience. The benefits were seen for both masses

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

    PubMed

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

    2017-08-17

    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.

  14. Detection of microcalcification clusters by 2D-mammography and narrow and wide angle digital breast tomosynthesis

    NASA Astrophysics Data System (ADS)

    Hadjipanteli, Andria; Elangovan, Premkumar; Looney, Padraig T.; Mackenzie, Alistair; Wells, Kevin; Dance, David R.; Young, Kenneth C.

    2016-03-01

    The aim of this study was to compare the detection of microcalcification clusters by human observers in breast images using 2D-mammography and narrow (15°/15 projections) and wide (50°/25 projections) angle digital breast tomosynthesis (DBT). Simulated microcalcification clusters with a range of microcalcification diameters (125 μm-275 μm) were inserted into 6 cm thick simulated compressed breasts. Breast images were produced with and without inserted microcalcification clusters using a set of image modelling tools, which were developed to represent clinical imaging by mammography and tomosynthesis. Commercially available software was used for image processing and image reconstruction. The images were then used in a series of 4-alternative forced choice (4AFC) human observer experiments conducted for signal detection with the microcalcification clusters as targets. The minimum detectable calcification diameter was found for each imaging modality: (i) 2D-mammography: 164+/-5 μm (ii) narrow angle DBT: 210+/-5 μm, (iii) wide angle DBT: 255+/-4 μm. A statistically significant difference was found between the minimum detectable calcification diameters that can be detected by the three imaging modalities. Furthermore, it was found that there was not a statistically significant difference between the results of the five observers that participated in this study. In conclusion, this study presents a method that quantifies the threshold diameter required for microcalcification detection, using high resolution, realistic images with observers, for the comparison of DBT geometries with 2D-mammography. 2Dmammography can visualise smaller detail diameter than both DBT imaging modalities and narrow-angle DBT can visualise a smaller detail diameter than wide-angle DBT.

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

    PubMed

    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

  16. Radiation exposure of digital breast tomosynthesis using an antiscatter grid compared with full-field digital mammography.

    PubMed

    Paulis, Leonie E; Lobbes, Marc B I; Lalji, Ulrich C; Gelissen, Nicky; Bouwman, Ramona W; Wildberger, Joachim E; Jeukens, Cécile R L P N

    2015-10-01

    Our study aim was to assess the radiation dose of digital breast tomosynthesis (DBT) in comparison to full-field digital mammography (FFDM) in a clinical setting. Two-hundred four patients were consecutively included, of which 236 complementary DBT and FFDM examinations were available. All acquisitions were performed on a single commercially available mammography system capable of FFDM and DBT acquisitions using an antiscatter grid. The average glandular dose (AGD) was calculated for each examination using the Dance method. For this, tube output and half-value layer were measured, and the required exposure parameters (target/filter material, tube voltage, tube load, compressed breast thickness) were retrieved from the DICOM metadata. The DBT and FFDM AGD values were pairwise tested, and a subanalysis with respect to breast thickness was performed. The mean (SD) AGD values for a single-view DBT and FFDM were 1.49 (0.36) mGy and 1.62 (0.55) mGy, respectively, which are small but statistically significant differences. This difference may be partially attributed to the small difference in the mean breast thickness between FFDM and DBT (3 mm). In this patient population, the AGD was lower for DBT than for FFDM in 61% of the patients. When patients were categorized according to breast thickness, the AGD of DBT was only significantly smaller than the AGD of FFDM for breast thickness categories larger than 50 mm, indicating that the dose reduction for DBT compared with FFDM was more pronounced in thick breasts. The radiation dose of patients undergoing a single-view DBT was comparable to a single-view FFDM. For patients with thicker breasts, the radiation dose of DBT was slightly lower than FFDM.

  17. 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

    PubMed Central

    Cavagnetto, F; Calabrese, M; Houssami, N

    2013-01-01

    Objective: 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. Methods: 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. Results: 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 (p<0.0001). There was a good correlation between the BI-RADS categories and the density evaluated using 2D FFDM and DBT (r=0.56, p<0.01 and r=0.48, p<0.01, respectively). Conclusion: Using DBT, breast density values were lower than those obtained using 2D FFDM, with a non-linear relationship across the BI-RADS categories. These data are relevant for clinical practice and research studies using density in determining the risk. Advances in knowledge: On DBT, breast density values were lower than with 2D FFDM, with a non-linear relationship across the classical BI-RADS categories. PMID:24029631

  18. Digital breast tomosynthesis: application of 2D digital mammography CAD to detection of microcalcification clusters on planar projection image

    NASA Astrophysics Data System (ADS)

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

    2015-03-01

    Computer-aided detection (CAD) has the potential to aid radiologists in detection of microcalcification clusters (MCs). CAD for digital breast tomosynthesis (DBT) can be developed by using the reconstructed volume, the projection views or other derivatives as input. We have developed a novel method of generating a single planar projection (PPJ) image from a regularized DBT volume to emphasize the high contrast objects such as microcalcifications while removing the anatomical background and noise. In this work, we adapted a CAD system developed for digital mammography (CADDM) to the PPJ image and compared its performance with our CAD system developed for DBT volumes (CADDBT) in the same set of cases. For microcalcification detection in the PPJ image using the CADDM system, the background removal preprocessing step designed for DM was not needed. The other methods and processing steps in the CADDM system were kept without modification while the parameters were optimized with a training set. The linear discriminant analysis classifier using cluster based features was retrained to generate a discriminant score to be used as decision variable. For view-based FROC analysis, at 80% sensitivity, an FP rate of 1.95/volume and 1.54/image were achieved, respectively, for CADDBT and CADDM in an independent test set. At a threshold of 1.2 FPs per image or per DBT volume, the nonparametric analysis of the area under the FROC curve shows that the optimized CADDM for PPJ is significantly better than CADDBT. However, the performance of CADDM drops at higher sensitivity or FP rate, resulting in similar overall performance between the two CAD systems. The higher sensitivity of the CADDM in the low FP rate region and vice versa for the CADDBT indicate that a joint CAD system combining detection in the DBT volume and the PPJ image has the potential to increase the sensitivity and reduce the FP rate.

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

    PubMed

    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 < 0.05) of most parameters. The volumetric and area breast 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.

  20. Addition of Digital Breast Tomosynthesis to Full-Field Digital Mammography in the Diagnostic Setting: Additional Value and Cancer Detectability

    PubMed Central

    Seo, Mirinae; Kim, Sun Ah; Kim, Won Hwa; Lim, Ji He; Lee, Su Hyun; Bae, Min Sun; Koo, Hye Ryoung; Cho, Nariya; Moon, Woo Kyung

    2016-01-01

    Purpose The purpose of this study was to assess the value of adding digital breast tomosynthesis (DBT) to full-field digital mammography (FFDM) in the diagnostic workup of breast cancer and to determine which lesion variables affect cancer detectability in the combined modality. Methods Between March and May 2012, paired FFDM and DBT images were obtained from 203 women as part of a diagnostic workup for breast cancer. Images from FFDM alone, DBT alone, and DBT combined with FFDM were reviewed in separate sessions by six blinded readers. Jackknife alternative free-response receiver operating characteristic (JAFROC) figure of merit (FOM), sensitivity, and specificity were compared between the modalities. Lesion characteristics affecting the cancer detection rate when using the combined modality were also analyzed. Results Among the 203 women, 126 women had a total of 129 malignancies and 77 women had total of 77 benign lesions. The overall JAFROC FOM of the combined modality was higher than that of FFDM alone (0.827 vs. 0.775, p<0.001) and that of DBT alone was higher than that of FFDM alone (0.807 vs. 0.775, p=0.027). The overall sensitivity of the combined modality was higher than that of FFDM alone (80.0% vs. 73.2%, p<0.001) and that of DBT alone was higher than that of FFDM alone (78.3% vs. 73.2%, p=0.007). Compared to FFDM alone, the combined modality detected an additional 48 cancers. Using the combined modality, the presence of masses or microcalcifications was significantly associated with the cancer detection rate (p<0.001). Conclusion The combination of DBT with FFDM results in a higher diagnostic yield than FFDM alone. Additionally, DBT alone performs better than FFDM alone. However, even when DBT is combined with FFDM, breast cancers with no discernible masses and those lacking calcifications are difficult to detect. PMID:28053633

  1. Breast cancer screening using tomosynthesis in combination with digital mammography compared to digital mammography alone: a cohort study within the PROSPR consortium.

    PubMed

    Conant, Emily F; Beaber, Elisabeth F; Sprague, Brian L; Herschorn, Sally D; Weaver, Donald L; Onega, Tracy; Tosteson, Anna N A; McCarthy, Anne Marie; Poplack, Steven P; Haas, Jennifer S; Armstrong, Katrina; Schnall, Mitchell D; Barlow, William E

    2016-02-01

    Digital breast tomosynthesis (DBT) is emerging as the new standard of care for breast cancer screening based on improved cancer detection coupled with reductions in recall compared to screening with digital mammography (DM) alone. However, many prior studies lack follow-up data to assess false negatives examinations. The purpose of this study is to assess if DBT is associated with improved screening outcomes based on follow-up data from tumor registries or pathology. Retrospective analysis of prospective cohort data from three research centers performing DBT screening in the PROSPR consortium from 2011 to 2014 was performed. Recall and biopsy rates were assessed from 198,881 women age 40-74 years undergoing screening (142,883 DM and 55,998 DBT examinations). Cancer, cancer detection, and false negative rates and positive predictive values were assessed on examinations with one year of follow-up. Logistic regression was used to compare DBT to DM adjusting for research center, age, prior breast imaging, and breast density. There was a reduction in recall with DBT compared to DM (8.7 vs. 10.4 %, p < 0.0001), with adjusted OR = 0.68 (95 % CI = 0.65-0.71). DBT demonstrated a statistically significant increase in cancer detection over DM (5.9 vs. 4.4/1000 screened, adjusted OR = 1.45, 95 % CI = 1.12-1.88), an improvement in PPV1 (6.4 % for DBT vs. 4.1 % for DM, adjusted OR = 2.02, 95 % CI = 1.54-2.65), and no significant difference in false negative rates for DBT compared to DM (0.46 vs. 0.60/1000 screened, p = 0.347). Our data support implementation of DBT screening based on increased cancer detection, reduced recall, and no difference in false negative screening examinations.

  2. Quantitative Digital Tomosynthesis Mammography for Improved Breast Cancer Detection and Diagnosis

    DTIC Science & Technology

    2008-04-01

    fixed angular range, but strongly affected by tomo -angle such that the depth resolution improves with increasing total tomosynthesis angle. The SART...directions on all tomo - synthesized slices with reduced intensity. These artifacts also appear at the breast boundary in which the pixel intensity changes...breast boundary artifacts and detector boundary ar- tifacts, from the reconstructed DTM slices. II . MATERIALS AND METHODS II.A. Breast tomosynthesis

  3. Breast cancer screening with digital breast tomosynthesis.

    PubMed

    Skaane, Per

    2017-01-01

    To give an overview of studies comparing full-field digital mammography (FFDM) and digital breast tomosynthesis (DBT) in breast cancer screening. The implementation of tomosynthesis in breast imaging is rapidly increasing world-wide. Experimental clinical studies of relevance for DBT screening have shown that tomosynthesis might have a great potential in breast cancer screening, although most of these retrospective reading studies are based on small populations, so that final conclusions are difficult to draw from individual reports. Several retrospective studies and three prospective trials on tomosynthesis in breast cancer screening have been published so far, confirming the great potential of DBT in mammography screening. The main results of these screening studies are presented. The retrospective screening studies from USA have all shown a significant decrease in the recall rate using DBT as adjunct to mammography. Most of these studies have also shown an increase in the cancer detection rate, and the non-significant results in some studies might be explained by a lack of statistical power. All the three prospective European trials have shown a significant increase in the cancer detection rate. The retrospective and the prospective screening studies comparing FFDM and DBT have all demonstrated that tomosynthesis has a great potential for improving breast cancer screening. DBT should be regarded as a better mammogram that could improve or overcome limitations of the conventional mammography, and tomosynthesis might be considered as the new technique in the next future of breast cancer screening.

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

    PubMed

    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

  5. Computer-aided detection of masses in digital tomosynthesis mammography: Comparison of three approaches

    SciTech Connect

    Chan Heangping; Wei Jun; Zhang Yiheng; Helvie, Mark A.; Moore, Richard H.; Sahiner, Berkman; Hadjiiski, Lubomir; Kopans, Daniel B.

    2008-09-15

    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

  6. Can digital breast tomosynthesis replace conventional diagnostic mammography views for screening recalls without calcifications? A comparison study in a simulated clinical setting.

    PubMed

    Brandt, Kathleen R; Craig, Daniel A; Hoskins, Tanya L; Henrichsen, Tara L; Bendel, Emily C; Brandt, Stephanie R; Mandrekar, Jay

    2013-02-01

    This study evaluated digital breast tomosynthesis (DBT) as an alternative to conventional diagnostic mammography in the workup of noncalcified findings recalled from screening mammography in a simulated clinical setting that incorporated comparison mammograms and breast ultrasound results. One hundred forty-six women, with 158 abnormalities, underwent diagnostic mammography and two-view DBT. Three radiologists viewed the abnormal screening mammograms, comparison mammograms, and DBT images and recorded a DBT BI-RADS category and confidence score for each finding. Readers did not view the diagnostic mammograms. A final DBT BI-RADS category, incorporating ultrasound results in some cases, was determined and compared with the diagnostic mammography BI-RADS category using kappa statistics. Sensitivity and specificity were calculated for DBT and diagnostic mammography. Agreement between DBT and diagnostic mammography BI-RADS categories was excellent for readers 1 and 2 (κ = 0.91 and κ = 0.84) and good for reader 3 (κ = 0.68). For readers 1, 2, and 3, sensitivity and specificity of DBT for breast abnormalities were 100%, 100%, and 88% and 94%, 93%, and 89%, respectively. The clinical workup averaged three diagnostic views per abnormality and ultrasound was requested in 49% of the cases. DBT was adequate mammographic evaluation for 93-99% of the findings and ultrasound was requested in 33-55% of the cases. The results of this study suggest that DBT can replace conventional diagnostic mammography views for the evaluation of noncalcified findings recalled from screening mammography and achieve similar sensitivity and specificity. Two-view DBT was considered adequate mammographic evaluation for more than 90% of the findings. There was minimal change in the use of ultrasound with DBT compared with diagnostic mammography.

  7. Mutual information-based template matching scheme for detection of breast masses: from mammography to digital breast tomosynthesis.

    PubMed

    Mazurowski, Maciej A; Lo, Joseph Y; Harrawood, Brian P; Tourassi, Georgia D

    2011-10-01

    Development of a computational decision aid for a new medical imaging modality typically is a long and complicated process. It consists of collecting data in the form of images and annotations, development of image processing and pattern recognition algorithms for analysis of the new images and finally testing of the resulting system. Since new imaging modalities are developed more rapidly than ever before, any effort for decreasing the time and cost of this development process could result in maximizing the benefit of the new imaging modality to patients by making the computer aids quickly available to radiologists that interpret the images. In this paper, we make a step in this direction and investigate the possibility of translating the knowledge about the detection problem from one imaging modality to another. Specifically, we present a computer-aided detection (CAD) system for mammographic masses that uses a mutual information-based template matching scheme with intelligently selected templates. We presented principles of template matching with mutual information for mammography before. In this paper, we present an implementation of those principles in a complete computer-aided detection system. The proposed system, through an automatic optimization process, chooses the most useful templates (mammographic regions of interest) using a large database of previously collected and annotated mammograms. Through this process, the knowledge about the task of detecting masses in mammograms is incorporated in the system. Then, we evaluate whether our system developed for screen-film mammograms can be successfully applied not only to other mammograms but also to digital breast tomosynthesis (DBT) reconstructed slices without adding any DBT cases for training. Our rationale is that since mutual information is known to be a robust inter-modality image similarity measure, it has high potential of transferring knowledge between modalities in the context of the mass detection

  8. The effect of system geometry and dose on the threshold detectable calcification diameter in 2D-mammography and digital breast tomosynthesis

    NASA Astrophysics Data System (ADS)

    Hadjipanteli, Andria; Elangovan, Premkumar; Mackenzie, Alistair; Looney, Padraig T.; Wells, Kevin; Dance, David R.; Young, Kenneth C.

    2017-02-01

    Digital breast tomosynthesis (DBT) is under consideration to replace or to be used in combination with 2D-mammography in breast screening. The aim of this study was the comparison of the detection of microcalcification clusters by human observers in simulated breast images using 2D-mammography, narrow angle (15°/15 projections) and wide angle (50°/25 projections) DBT. The effects of the cluster height in the breast and the dose to the breast on calcification detection were also tested. Simulated images of 6 cm thick compressed breasts were produced with and without microcalcification clusters inserted, using a set of image modelling tools for 2D-mammography and DBT. Image processing and reconstruction were performed using commercial software. A series of 4-alternative forced choice (4AFC) experiments was conducted for signal detection with the microcalcification clusters as targets. Threshold detectable calcification diameter was found for each imaging modality with standard dose: 2D-mammography: 2D-mammography (165  ±  9 µm), narrow angle DBT (211  ±  11 µm) and wide angle DBT (257  ±  14 µm). Statistically significant differences were found when using different doses, but different geometries had a greater effect. No differences were found between the threshold detectable calcification diameters at different heights in the breast. Calcification clusters may have a lower detectability using DBT than 2D imaging.

  9. Cost-Effectiveness of Tomosynthesis in Annual Screening Mammography.

    PubMed

    Kalra, Vivek B; Wu, Xiao; Haas, Brian M; Forman, Howard P; Philpotts, Liane E

    2016-11-01

    The purpose of this study was to evaluate the cost-effectiveness of the addition of annual screening tomosynthesis to 2D digital mammography alone for women beginning at 40 years old and to determine differences for age decade subgroups. Decision-tree analysis comparing annual tomosynthesis versus 2D mammography alone from a federal payer perspective and lifetime horizon was created from published multiinstitutional data, published institutional data, literature values, and Medicare reimbursement rates. Cost-effectiveness was calculated through incremental cost-effectiveness ratios and net monetary benefit calculations. Sensitivity analyses were performed to determine the implication of different variables including changes in recall rate and disutility for false-positives. Base-case analysis showed an incremental cost per quality-adjusted life year gained for tomosynthesis over 2D alone for all ages (≥ 40 years old) of $20,230, 40- to 49-year-old subgroup of $20,976, 50- to 59-year-old subgroup of $49,725, 60- to 69-year-old subgroup of $44,641, and ≥ 70-year-old subgroup of $82,500. Net monetary benefit per decade in the 40- to 49-year-old subgroup was $1,598, 50- to 59-year-old subgroup of $546, 60- to 69-year-old subgroup of $535, and ≥ 70-year-old subgroup of $501. Tomosynthesis was the better strategy in 63.2% of the iterations according to probabilistic sensitivity analysis. Addition of annual screening tomosynthesis to 2D mammography beginning at the age of 40 years was cost-effective compared with 2D mammography alone in our analysis. Three times greater net monetary benefits were found in women 40-49 years old compared with those 50-59 years old.

  10. Comparison of visibility of circumscribed masses on Digital Breast Tomosynthesis (DBT) and 2D mammography: are circumscribed masses better visualized and assured of being benign on DBT?

    PubMed

    Nakashima, Kazuaki; Uematsu, Takayoshi; Itoh, Takahiro; Takahashi, Kaoru; Nishimura, Seiichirou; Hayashi, Tomomi; Sugino, Takashi

    2017-02-01

    To compare the visibility of circumscribed masses on digital breast tomosynthesis (DBT) images and 2D mammograms and determine the usefulness of DBT for differentiation between benign and malignant circumscribed masses. Seventy-one (19 malignant and 52 benign) mammographic well-circumscribed masses were included. Visibility of the masses and halo signs on DBT images were retrospectively compared with 2D mammograms. The effects of mammographic breast density on mass visibility were also evaluated. For DBT, 83% were superior and 17% were equivalent in visibility of the masses to that of 2D, and superiority of DBT was significantly enhanced in the high breast density group compared with the low breast density group (91% vs 68%, respectively, p = 0.016). Three lesions were only detected on DBT. There was no significant difference in the superiority of DBT for lesion visibility between malignant and benign masses. The halo sign was detected in 58% lesions on DBT and in 4% on 2D (p < 0.001). Circumscribed masses were better visualized on DBT than on 2D mammograms, particularly in high-density breasts. The halo sign often appeared on DBT and gave a clearer mass margin. However, circumscribed masses on DBT are not assured of being benign. • Circumscribed masses were better visualized on breast tomosynthesis than on 2D mammography. • Tomosynthesis visualized circumscribed masses better than 2D for all breast density categories. • Halo signs often appeared on tomosynthesis and contributed to detect circumscribed margins. • Circumscribed masses on tomosynthesis images are not assured of being benign lesions.

  11. Targeted Gold Nanoparticle Contrast Agent for Digital Breast Tomosynthesis and Computed Tomography

    DTIC Science & Technology

    2010-03-01

    TITLE: Targeted Gold Nanoparticle Contrast Agent for Digital Breast Tomosynthesis and Computed Tomography PRINCIPAL INVESTIGATOR: Roshan...2009 – Feb 14, 2010 4. TITLE AND SUBTITLE Targeted Gold Nanoparticle Contrast Agent for Digital Breast 5a. CONTRACT NUMBER Tomosynthesis and...of all breast cancers [2, 3]. The combination of such contrast agents with temporal subtraction breast tomosynthesis (DBT) or digital mammography

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

    PubMed

    Cockmartin, Lesley; Marshall, Nicholas; Zhang, Guozhi; Lemmens, Kim; Shaheen, Eman; Van Ongeval, Chantal; Fredenberg, Erik; Dance, David; Salvagnini, Elena; Michielsen, Koen; Bosmans, Hilde

    2016-12-15

    This paper introduces and applies a structured phantom with target objects for the comparison of detection performance of digital breast tomosynthesis (DBT) against 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 (AEC). 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 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 differences between FFDM and DBT modes for five

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

    NASA Astrophysics Data System (ADS)

    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

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

    PubMed

    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

    2017-01-10

    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

  15. Analysis of computer-aided detection techniques and signal characteristics for clustered microcalcifications on digital mammography and digital breast tomosynthesis

    NASA Astrophysics Data System (ADS)

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

    2016-10-01

    With IRB approval, digital breast tomosynthesis (DBT) images of human subjects were collected using a GE GEN2 DBT prototype system. Corresponding digital mammograms (DMs) of the same subjects were collected retrospectively from patient files. The data set contained a total of 237 views of DBT and equal number of DM views from 120 human subjects, each included 163 views with microcalcification clusters (MCs) and 74 views without MCs. The data set was separated into training and independent test sets. The pre-processing, object prescreening and segmentation, false positive reduction and clustering strategies for MC detection by three computer-aided detection (CADe) systems designed for DM, DBT, and a planar projection image generated from DBT were analyzed. Receiver operating characteristic (ROC) curves based on features extracted from microcalcifications and free-response ROC (FROC) curves based on scores from MCs were used to quantify the performance of the systems. Jackknife FROC (JAFROC) and non-parametric analysis methods were used to determine the statistical difference between the FROC curves. The difference between the CADDM and CADDBT systems when the false positive rate was estimated from cases without MCs did not reach statistical significance. The study indicates that the large search space in DBT may not be a limiting factor for CADe to achieve similar performance as that observed in DM.

  16. Diagnostic performance of digital breast tomosynthesis with a wide scan angle compared to full-field digital mammography for the detection and characterization of microcalcifications.

    PubMed

    Clauser, Paola; Nagl, Georg; Helbich, Thomas H; Pinker-Domenig, Katja; Weber, Michael; Kapetas, Panagiotis; Bernathova, Maria; Baltzer, Pascal A T

    2016-12-01

    To assess the diagnostic performance of digital breast tomosynthesis (DBT), with a wide scan-angle, compared to full-field digital mammography (FFDM), for the detection and characterization of microcalcifications. IRB approval was obtained for this retrospective study. We selected 150 FFDM and DBT (50 benign and 50 malignant histologically verified microcalcifications, 50 cases classified as BI-RADS 1). Four radiologists evaluated, in separate sessions and blinded to patients' history and histology, the presence of microcalcifications. Cases with microcalcifications were assessed for visibility, characteristics, and grade of suspicion using BI-RADS categories. Detection rate and diagnostic performance were calculated. Visibility, lesions' characteristics and reading time were analysed. Detection rate and visibility were good for both FFDM and DBT, without intra-reader differences (P=0.510). Inter-reader differences were detected (P<0.018). Only two lesions were not detected by any reader on either FFDM or DBT. Diagnostic performance with DBT was as good as that of FFDM, but a significant inter-reader difference was found (P=0.041). High inter-reader variability in the use of the descriptors was found. Reading time for DBT was almost twice that for FFDM (44 and 25s, respectively). Wide scan-angle DBT enabled the detection and characterization of microcalcifications with no significant differences from FFDM. Inter-reader variability was seen. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  17. Digital breast tomosynthesis as an adjunct to digital mammography for detecting and characterising invasive lobular cancers: a multi-reader study.

    PubMed

    Mariscotti, G; Durando, M; Houssami, N; Zuiani, C; Martincich, L; Londero, V; Caramia, E; Clauser, P; Campanino, P P; Regini, E; Luparia, A; Castellano, I; Bergamasco, L; Sapino, A; Fonio, P; Bazzocchi, M; Gandini, G

    2016-09-01

    To examine the interpretive performance of digital breast tomosynthesis (DBT) as an adjunct to digital mammography (DM) compared to DM alone in a series of invasive lobular carcinomas (ILCs) and to assess whether DBT can be used to characterise ILC. A retrospective, multi-reader study was conducted of 83 mammographic examinations of women with 107 newly diagnosed ILCs ascertained at histology. Consenting women underwent both DM and DBT acquisitions. Twelve radiologists, with varying mammography experience, interpreted DM images alone, reporting lesion location, mammographic features, and malignancy probability using the Breast Imaging-Reporting and Data System (BI-RADS) categories 1-5; they then reviewed DBT images in addition to DM, and reported the same parameters. Statistical analyses compared sensitivity, false-positive rates (FPR), and interpretive performance using the receiver operating characteristics (ROC) curve and the area under the curve (AUC), for reading with DM versus DM plus DBT. Multi-reader pooled ROC analysis for DM plus DBT yielded AUC=0.89 (95% confidence interval [CI]: 0.88-0.91), which was significantly higher (p<0.0001) than DM alone with AUC=0.84 (95% CI: 0.82-0.86). DBT plus DM significantly increased pooled sensitivity (85%) compared to DM alone (70%; p<0.0001). FPR did not vary significantly with the addition of DBT to DM. Interpreting with DBT (compared to DM alone) increased the correct identification of ILCs depicted as architectural distortions (84% versus 65%, respectively) or as masses (89% versus 70%), increasing interpretive performance for both experienced and less-experienced readers; larger gains in AUC were shown for less-experienced radiologists. Multifocal and/or multicentric and bilateral disease was more frequently identified on DM with DBT. Adding DBT to DM significantly improved the accuracy of mammographic interpretation for ILCs and contributed to characterising disease extent. Copyright © 2016 The Royal College of

  18. Full Field Digital Mammography (FFDM) versus CMOS Technology, Specimen Radiography System (SRS) and Tomosynthesis (DBT) - Which System Can Optimise Surgical Therapy?

    PubMed

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

    2013-05-01

    Aim: This prospective clinical study aimed to evaluate whether it would be possible to reduce the rate of re-excisions using CMOS technology, a specimen radiography system (SRS) or digital breast tomosynthesis (DBT) compared to a conventional full field digital mammography (FFDM) system. Material and Method: Between 12/2012 and 2/2013 50 patients were diagnosed with invasive breast cancer (BI-RADS™ 5). After histological verification, all patients underwent breast-conserving therapy with intraoperative imaging using 4 different systems and differing magnifications: 1. Inspiration™ (Siemens, Erlangen, Germany), amorphous selenium, tungsten source, focus 0.1 mm, resolution 85 µm pixel pitch, 8 lp/mm; 2. BioVision™ (Bioptics, Tucson, AZ, USA), CMOS technology, photodiode array, flat panel, tungsten source, focus 0.05, resolution 50 µm pixel pitch, 12 lp/mm; 3. the Trident™ specimen radiography system (SRS) (Hologic, Bedford, MA, USA), amorphous selenium, tungsten source, focus 0.05, resolution 70 µm pixel pitch, 7.1 lp/mm; 4. tomosynthesis (Siemens, Erlangen, Germany), amorphous selenium, tungsten source, focus 0.1 mm, resolution 85 µm pixel pitch, 8 lp/mm, angular range 50 degrees, 25 projections, scan time > 20 s, geometry: uniform scanning, reconstruction: filtered back projection. The 600 radiographs were prospectively shown to 3 radiologists. Results: Of the 50 patients with histologically proven breast cancer (BI-RADS™ 6), 39 patients required no further surgical therapy (re-excision) after breast-conserving surgery. A retrospective analysis (n = 11) showed a significant (p < 0.05) increase of sensitivity with the BioVision™, the Trident™ and tomosynthesis compared to the Inspiration™ at a magnification of 1.0 : 2.0 or 1.0 : 1.0 (tomosynthesis) (2.6, 3.3 or 3.6 %), i.e. re-excision would not have been necessary in 2, 3 or 4 patients, respectively, compared to findings obtained with a standard

  19. Digital Breast Tomosynthesis guided Near Infrared Spectroscopy: Volumetric estimates of fibroglandular fraction and breast density from tomosynthesis reconstructions.

    PubMed

    Vedantham, Srinivasan; Shi, Linxi; Michaelsen, Kelly E; Krishnaswamy, Venkataramanan; Pogue, Brian W; Poplack, Steven P; Karellas, Andrew; Paulsen, Keith D

    A multimodality system combining a clinical prototype digital breast tomosynthesis with its imaging geometry modified to facilitate near-infrared spectroscopic imaging has been developed. The accuracy of parameters recovered from near-infrared spectroscopy is dependent on fibroglandular tissue content. Hence, in this study, volumetric estimates of fibroglandular tissue from tomosynthesis reconstructions were determined. A kernel-based fuzzy c-means algorithm was implemented to segment tomosynthesis reconstructed slices in order to estimate fibroglandular content and to provide anatomic priors for near-infrared spectroscopy. This algorithm was used to determine volumetric breast density (VBD), defined as the ratio of fibroglandular tissue volume to the total breast volume, expressed as percentage, from 62 tomosynthesis reconstructions of 34 study participants. For a subset of study participants who subsequently underwent mammography, VBD from mammography matched for subject, breast laterality and mammographic view was quantified using commercial software and statistically analyzed to determine if it differed from tomosynthesis. Summary statistics of the VBD from all study participants were compared with prior independent studies. The fibroglandular volume from tomosynthesis and mammography were not statistically different (p=0.211, paired t-test). After accounting for the compressed breast thickness, which were different between tomosynthesis and mammography, the VBD from tomosynthesis was correlated with (r =0.809, p<0.001), did not statistically differ from (p>0.99, paired t-test), and was linearly related to, the VBD from mammography. Summary statistics of the VBD from tomosynthesis were not statistically different from prior studies using high-resolution dedicated breast computed tomography. The observation of correlation and linear association in VBD between mammography and tomosynthesis suggests that breast density associated risk measures determined for

  20. Full Field Digital Mammography (FFDM) versus CMOS Technology versus Tomosynthesis (DBT) - Which System Increases the Quality of Intraoperative Imaging?

    PubMed

    Schulz-Wendtland, R; Dilbat, G; Bani, M; Fasching, P A; Lux, M P; Wenkel, E; Schwab, S; Loehberg, C R; Jud, S M; Rauh, C; Bayer, C M; Beckmann, M W; Uder, M; Meier-Meitinger, M

    2012-06-01

    Aim: The aim of this prospective clinical study was to assess whether it would be possible to reduce the rate of re-excisions and improve the quality using CMOS technology or digital breast tomosynthesis (DBT) compared to a conventional FFDM system. Material and Methods: An invasive breast cancer (BI-RADS 5) was diagnosed in 200 patients in the period from 5/2011 to 1/2012. After histological verification, a breast-conserving therapy was performed with intraoperative imaging. Three different imaging systems were used: 1) Inspiration™ (Siemens, Erlangen, Germany), amorphous selenium, tungsten source, focus 0.1 mm, resolution 85 µm pixel pitch, 8 l/mm as the standard; 2) BioVision™ (Bioptics, Tucson, USA), flat panel photodiode array, tungsten source, focus 0.05, resolution 50 µm pixel pitch, 12 l/mm; 3) Tomosynthesis (Siemens, Erlangen, Germany), amorphous selenium, tungsten source, focus 0.1 mm, resolution 85 µm pixel pitch, 8 l/mm, range: 50°, 25 projections, scan time > 20 s, geometry: uniform scanning, reconstruction: filtered back projection. The 600 radiograms were prospectively shown to 3 radiologists. Results: Out of a total of 200 patients with histologically confirmed breast cancer (BI-RADS 6) 156 patients required no further operative therapy (re-excision) after breast-conserving therapy. A retrospective analysis (n = 44) showed an increase in sensitivity with tomosynthesis compared to the BioVision™ (CMOS technology) and the Inspiration™ at a magnification of 1.0 : 1.0 of 8 % (p < 0.05), i.e. re-excision would not have been necessary in 16 patients with tomosynthesis. Conclusions: The sensitivity of tomosynthesis for intraoperative radiography is significantly (p < 0.05) higher compared to both CMOS technology and an FFDM system with a conventional detector. Additional studies using higher magnification, e.g. 2.0 : 1.0, but no zooming will be necessary to evaluate the method further.

  1. Full Field Digital Mammography (FFDM) versus CMOS Technology versus Tomosynthesis (DBT) – Which System Increases the Quality of Intraoperative Imaging?

    PubMed Central

    Schulz-Wendtland, R.; Dilbat, G.; Bani, M.; Fasching, P. A.; Lux, M. P.; Wenkel, E.; Schwab, S.; Loehberg, C. R.; Jud, S. M.; Rauh, C.; Bayer, C. M.; Beckmann, M. W.; Uder, M.; Meier-Meitinger, M.

    2012-01-01

    Aim: The aim of this prospective clinical study was to assess whether it would be possible to reduce the rate of re-excisions and improve the quality using CMOS technology or digital breast tomosynthesis (DBT) compared to a conventional FFDM system. Material and Methods: An invasive breast cancer (BI-RADS 5) was diagnosed in 200 patients in the period from 5/2011 to 1/2012. After histological verification, a breast-conserving therapy was performed with intraoperative imaging. Three different imaging systems were used: 1) Inspiration™ (Siemens, Erlangen, Germany), amorphous selenium, tungsten source, focus 0.1 mm, resolution 85 µm pixel pitch, 8 l/mm as the standard; 2) BioVision™ (Bioptics, Tucson, USA), flat panel photodiode array, tungsten source, focus 0.05, resolution 50 µm pixel pitch, 12 l/mm; 3) Tomosynthesis (Siemens, Erlangen, Germany), amorphous selenium, tungsten source, focus 0.1 mm, resolution 85 µm pixel pitch, 8 l/mm, range: 50°, 25 projections, scan time > 20 s, geometry: uniform scanning, reconstruction: filtered back projection. The 600 radiograms were prospectively shown to 3 radiologists. Results: Out of a total of 200 patients with histologically confirmed breast cancer (BI-RADS 6) 156 patients required no further operative therapy (re-excision) after breast-conserving therapy. A retrospective analysis (n = 44) showed an increase in sensitivity with tomosynthesis compared to the BioVision™ (CMOS technology) and the Inspiration™ at a magnification of 1.0 : 1.0 of 8 % (p < 0.05), i.e. re-excision would not have been necessary in 16 patients with tomosynthesis. Conclusions: The sensitivity of tomosynthesis for intraoperative radiography is significantly (p < 0.05) higher compared to both CMOS technology and an FFDM system with a conventional detector. Additional studies using higher magnification, e.g. 2.0 : 1.0, but no zooming will be necessary to evaluate the method further. PMID:26640287

  2. Fully Automated Quantitative Estimation of Volumetric Breast Density from Digital Breast Tomosynthesis Images: Preliminary Results and Comparison with Digital Mammography and MR Imaging

    PubMed Central

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

    2016-01-01

    Purpose To assess a fully automated method for volumetric breast density (VBD) estimation in digital breast tomosynthesis (DBT) and to compare the findings with those of full-field digital mammography (FFDM) and magnetic resonance (MR) imaging. Materials and Methods Bilateral DBT images, FFDM images, and sagittal breast MR images were retrospectively collected from 68 women who underwent breast cancer screening from October 2011 to September 2012 with institutional review board–approved, HIPAA-compliant protocols. A fully automated computer algorithm was developed for quantitative estimation of VBD from DBT images. FFDM images were processed with U.S. Food and Drug Administration–cleared software, and the MR images were processed with a previously validated automated algorithm to obtain corresponding VBD estimates. Pearson correlation and analysis of variance with Tukey-Kramer post hoc correction were used to compare the multimodality VBD estimates. Results Estimates of VBD from DBT were significantly correlated with FFDM-based and MR imaging–based estimates with r = 0.83 (95% confidence interval [CI]: 0.74, 0.90) and r = 0.88 (95% CI: 0.82, 0.93), respectively (P < .001). The corresponding correlation between FFDM and MR imaging was r = 0.84 (95% CI: 0.76, 0.90). However, statistically significant differences after post hoc correction (α = 0.05) were found among VBD estimates from FFDM (mean ± standard deviation, 11.1% ± 7.0) relative to MR imaging (16.6% ± 11.2) and DBT (19.8% ± 16.2). Differences between VDB estimates from DBT and MR imaging were not significant (P = .26). Conclusion Fully automated VBD estimates from DBT, FFDM, and MR imaging are strongly correlated but show statistically significant differences. Therefore, absolute differences in VBD between FFDM, DBT, and MR imaging should be considered in breast cancer risk assessment. © RSNA, 2015 Online supplemental material is available for this article. PMID:26491909

  3. X-Ray Induced Formation of γ-H2AX Foci after Full-Field Digital Mammography and Digital Breast-Tomosynthesis

    PubMed Central

    Schwab, Siegfried A.; Brand, Michael; Schlude, Ina-Kristin; Wuest, Wolfgang; Meier-Meitinger, Martina; Distel, Luitpold; Schulz-Wendtland, Ruediger; Uder, Michael; Kuefner, Michael A.

    2013-01-01

    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. PMID:23936236

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

    PubMed

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

    2017-03-02

    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.

  5. Digital Longitudinal Tomosynthesis

    NASA Astrophysics Data System (ADS)

    Rimkus, Daniel Steven

    1985-12-01

    The purpose of this dissertation was to investigate the clinical utility of digital longitudinal tomosynthesis in radiology. By acquiring a finite group of digital images during a longitudinal tomographic exposure, and processing these images, tomographic planes, other than the fulcrum plane, can be reconstructed. This process is now termed "tomosynthesis". A prototype system utilizing this technique was developed. Both phantom and patient studies were done with this system. The phantom studies were evaluated by subjective, visual criterion and by quantitative analysis of edge sharpness and noise in the reconstructions. Two groups of patients and one volunteer were studied. The first patient group consisted of 8 patients undergoing intravenous urography (IVU). These patients had digital tomography and film tomography of the abdomen. The second patient group consisted of 4 patients with lung cancer admitted to the hospital for laser resection of endobronchial tumor. These patients had mediastinal digital tomograms to evaluate the trachea and mainstem bronchi. The knee of one volunteer was imaged by film tomography and digital tomography. The results of the phantom studies showed that the digital reconstructions accurately produced images of the desired planes. The edge sharpness of the reconstructions approached that of the acquired images. Adequate reconstructions were achieved with as few as 5 images acquired during the exposure, with the quality of the reconstructions improving as the number of images acquired increased. The IVU patients' digital studies had less contrast and spatial resolution than the film tomograms. The single renal lesion visible on the film tomograms was also visible in the digital images. The digital mediastinal studies were felt by several radiologists to be superior to a standard chest xray in evaluating the airways. The digital images of the volunteer's knee showed many of the same anatomic features as the film tomogram, but the digital

  6. Replacing single-view mediolateral oblique (MLO) digital mammography (DM) with synthesized mammography (SM) with digital breast tomosynthesis (DBT) images: Comparison of the diagnostic performance and radiation dose with two-view DM with or without MLO-DBT.

    PubMed

    Kang, Hyo-Jin; Chang, Jung Min; Lee, Joongyub; Song, Sung Eun; Shin, Sung Ui; Kim, Won Hwa; Bae, Min Sun; Moon, Woo Kyung

    2016-11-01

    To evaluate the diagnostic performance and radiation dose of single view cranio-caudal (CC) digital mammography (DM) plus mediolateral oblique (MLO) digital breast tomosynthesis (DBT) combined with synthesized mammography (SM) in comparison with two-view DM with or without DBT. This study was approved by our institutional review board, and informed consent was obtained from 130 women. Paired two-view DM and single MLO-DBT with SM images were acquired, and four independent retrospective reading sessions of different combinations of DM, SM and DBT were performed for the presence of malignant tumors using jackknife alternative free-response receiver operator curve (JAFROC) methods. The diagnostic performances and average glandular dose (AGD) were compared between different combinations of DM, SM and DBT. Of 159 lesions in 130 patients, 27 were malignant. When using MLO-DBT with SM instead of MLO-DM, a significantly higher sensitivity (P=0.016) and specificity (P=0.012) were noted than with two-view DM, and comparable figure of merit (FOM), sensitivity, and specificity to two-view DM with DBT were noted. The mean AGD of CC-DM plus MLO-DBT with SM was 5.78mGy±1.06 per patient, which was significantly lower than that with two-view DM with MLO-DBT (8.45mGy±1.32; P <0.001) and slightly higher than that with two-view DM (5.30mGy±0.63). The combined use of CC-DM plus MLO-DBT with SM showed higher sensitivity and specificity to two-view DM with a smaller AGD increment and comparable diagnostic performance to that of two-view DM with MLO-DBT with a significantly lower mean AGD. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  7. Digital tomosynthesis in breast cancer: A systematic review.

    PubMed

    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.

  8. Effect of the Availability of Prior Full-Field Digital Mammography and Digital Breast Tomosynthesis Images on the Interpretation of Mammograms

    PubMed Central

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

    2015-01-01

    Purpose To assess the effect of and interaction between the availability of prior images and digital breast tomosynthesis (DBT) images in decisions to recall women during mammogram interpretation. Materials and Methods Verbal informed consent was obtained for this HIPAA-compliant institutional review board–approved protocol. Eight radiologists independently interpreted twice deidentified mammograms obtained in 153 women (age range, 37–83 years; mean age, 53.7 years ± 9.3 [standard deviation]) in a mode by reader by case-balanced fully crossed study. Each study consisted of current and prior full-field digital mammography (FFDM) images and DBT images that were acquired in our facility between June 2009 and January 2013. For one reading, sequential ratings were provided by using (a) current FFDM images only, (b) current FFDM and DBT images, and (c) current FFDM, DBT, and prior FFDM images. The other reading consisted of (a) current FFDM images only, (b) current and prior FFDM images, and (c) current FFDM, prior FFDM, and DBT images. Fifty verified cancer cases, 60 negative and benign cases (clinically not recalled), and 43 benign cases (clinically recalled) were included. Recall recommendations and interaction between the effect of prior FFDM and DBT images were assessed by using a generalized linear model accounting for case and reader variability. Results Average recall rates in noncancer cases were significantly reduced with the addition of prior FFDM images by 34% (145 of 421) and 32% (106 of 333) without and with DBT images, respectively (P < .001). However, this recall reduction was achieved at the cost of a corresponding 7% (23 of 345) and 4% (14 of 353) reduction in sensitivity (P = .006). In contrast, availability of DBT images resulted in a smaller reduction in recall rates (false-positive interpretations) of 19% (76 of 409) and 26% (71 of 276) without and with prior FFDM images, respectively (P = .001). Availability of DBT images resulted in 4% (15 of

  9. Effect of the Availability of Prior Full-Field Digital Mammography and Digital Breast Tomosynthesis Images on the Interpretation of Mammograms.

    PubMed

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

    2015-07-01

    To assess the effect of and interaction between the availability of prior images and digital breast tomosynthesis (DBT) images in decisions to recall women during mammogram interpretation. Verbal informed consent was obtained for this HIPAA-compliant institutional review board-approved protocol. Eight radiologists independently interpreted twice deidentified mammograms obtained in 153 women (age range, 37-83 years; mean age, 53.7 years ± 9.3 [standard deviation]) in a mode by reader by case-balanced fully crossed study. Each study consisted of current and prior full-field digital mammography (FFDM) images and DBT images that were acquired in our facility between June 2009 and January 2013. For one reading, sequential ratings were provided by using (a) current FFDM images only, (b) current FFDM and DBT images, and (c) current FFDM, DBT, and prior FFDM images. The other reading consisted of (a) current FFDM images only, (b) current and prior FFDM images, and (c) current FFDM, prior FFDM, and DBT images. Fifty verified cancer cases, 60 negative and benign cases (clinically not recalled), and 43 benign cases (clinically recalled) were included. Recall recommendations and interaction between the effect of prior FFDM and DBT images were assessed by using a generalized linear model accounting for case and reader variability. Average recall rates in noncancer cases were significantly reduced with the addition of prior FFDM images by 34% (145 of 421) and 32% (106 of 333) without and with DBT images, respectively (P < .001). However, this recall reduction was achieved at the cost of a corresponding 7% (23 of 345) and 4% (14 of 353) reduction in sensitivity (P = .006). In contrast, availability of DBT images resulted in a smaller reduction in recall rates (false-positive interpretations) of 19% (76 of 409) and 26% (71 of 276) without and with prior FFDM images, respectively (P = .001). Availability of DBT images resulted in 4% (15 of 338) and 8% (25 of 322) increases in

  10. Towards standardization of x-ray beam filters in digital mammography and digital breast tomosynthesis: Monte Carlo simulations and analytical modelling

    NASA Astrophysics Data System (ADS)

    Shrestha, Suman; Vedantham, Srinivasan; Karellas, Andrew

    2017-03-01

    In digital breast tomosynthesis and digital mammography, the x-ray beam filter material and thickness vary between systems. Replacing K-edge filters with Al was investigated with the intent to reduce exposure duration and to simplify system design. Tungsten target x-ray spectra were simulated with K-edge filters (50 µm Rh; 50 µm Ag) and Al filters of varying thickness. Monte Carlo simulations were conducted to quantify the x-ray scatter from various filters alone, scatter-to-primary ratio (SPR) with compressed breasts, and to determine the radiation dose to the breast. These data were used to analytically compute the signal-difference-to-noise ratio (SDNR) at unit (1 mGy) mean glandular dose (MGD) for W/Rh and W/Ag spectra. At SDNR matched between K-edge and Al filtered spectra, the reductions in exposure duration and MGD were quantified for three strategies: (i) fixed Al thickness and matched tube potential in kilovolts (kV); (ii) fixed Al thickness and varying the kV to match the half-value layer (HVL) between Al and K-edge filtered spectra; and, (iii) matched kV and varying the Al thickness to match the HVL between Al and K-edge filtered spectra. Monte Carlo simulations indicate that the SPR with and without the breast were not different between Al and K-edge filters. Modelling for fixed Al thickness (700 µm) and kV matched to K-edge filtered spectra, identical SDNR was achieved with 37–57% reduction in exposure duration and with 2–20% reduction in MGD, depending on breast thickness. Modelling for fixed Al thickness (700 µm) and HVL matched by increasing the kV over (0,4) range, identical SDNR was achieved with 62–65% decrease in exposure duration and with 2–24% reduction in MGD, depending on breast thickness. For kV and HVL matched to K-edge filtered spectra by varying Al filter thickness over (700, 880) µm range, identical SDNR was achieved with 23–56% reduction in exposure duration and 2–20% reduction in MGD, depending on breast thickness

  11. Towards standardization of x-ray beam filters in digital mammography and digital breast tomosynthesis: Monte Carlo simulations and analytical modelling.

    PubMed

    Shrestha, Suman; Vedantham, Srinivasan; Karellas, Andrew

    2017-03-07

    In digital breast tomosynthesis and digital mammography, the x-ray beam filter material and thickness vary between systems. Replacing K-edge filters with Al was investigated with the intent to reduce exposure duration and to simplify system design. Tungsten target x-ray spectra were simulated with K-edge filters (50 µm Rh; 50 µm Ag) and Al filters of varying thickness. Monte Carlo simulations were conducted to quantify the x-ray scatter from various filters alone, scatter-to-primary ratio (SPR) with compressed breasts, and to determine the radiation dose to the breast. These data were used to analytically compute the signal-difference-to-noise ratio (SDNR) at unit (1 mGy) mean glandular dose (MGD) for W/Rh and W/Ag spectra. At SDNR matched between K-edge and Al filtered spectra, the reductions in exposure duration and MGD were quantified for three strategies: (i) fixed Al thickness and matched tube potential in kilovolts (kV); (ii) fixed Al thickness and varying the kV to match the half-value layer (HVL) between Al and K-edge filtered spectra; and, (iii) matched kV and varying the Al thickness to match the HVL between Al and K-edge filtered spectra. Monte Carlo simulations indicate that the SPR with and without the breast were not different between Al and K-edge filters. Modelling for fixed Al thickness (700 µm) and kV matched to K-edge filtered spectra, identical SDNR was achieved with 37-57% reduction in exposure duration and with 2-20% reduction in MGD, depending on breast thickness. Modelling for fixed Al thickness (700 µm) and HVL matched by increasing the kV over (0,4) range, identical SDNR was achieved with 62-65% decrease in exposure duration and with 2-24% reduction in MGD, depending on breast thickness. For kV and HVL matched to K-edge filtered spectra by varying Al filter thickness over (700, 880) µm range, identical SDNR was achieved with 23-56% reduction in exposure duration and 2-20% reduction in MGD, depending on breast thickness. These

  12. Breast tomosynthesis and digital mammography: a comparison of breast cancer visibility and BIRADS classification in a population of cancers with subtle mammographic findings.

    PubMed

    Andersson, Ingvar; Ikeda, Debra M; Zackrisson, Sophia; Ruschin, Mark; Svahn, Tony; Timberg, Pontus; Tingberg, Anders

    2008-12-01

    The main purpose was to compare breast cancer visibility in one-view breast tomosynthesis (BT) to cancer visibility in one- or two-view digital mammography (DM). Thirty-six patients were selected on the basis of subtle signs of breast cancer on DM. One-view BT was performed with the same compression angle as the DM image in which the finding was least/not visible. On BT, 25 projections images were acquired over an angular range of 50 degrees, with double the dose of one-view DM. Two expert breast imagers classified one- and two-view DM, and BT findings for cancer visibility and BIRADS cancer probability in a non-blinded consensus study. Forty breast cancers were found in 37 breasts. The cancers were rated more visible on BT compared to one-view and two-view DM in 22 and 11 cases, respectively, (p < 0.01 for both comparisons). Comparing one-view DM to one-view BT, 21 patients were upgraded on BIRADS classification (p < 0.01). Comparing two-view DM to one-view BT, 12 patients were upgraded on BIRADS classification (p < 0.01). The results indicate that the cancer visibility on BT is superior to DM, which suggests that BT may have a higher sensitivity for breast cancer detection.

  13. Computer-aided detection of masses in digital tomosynthesis mammography: combination of 3D and 2D detection information

    NASA Astrophysics Data System (ADS)

    Chan, Heang-Ping; Wei, Jun; Zhang, Yiheng; Moore, Richard H.; Kopans, Daniel B.; Hadjiiski, Lubomir; Sahiner, Berkman; Roubidoux, Marilyn A.; Helvie, Mark A.

    2007-03-01

    We are developing a computer-aided detection (CAD) system for masses on digital breast tomosynthesis mammograms (DBTs). The CAD system includes two parallel processes. In the first process, mass detection and feature analysis are performed in the reconstructed 3D DBT volume. A mass likelihood score is estimated for each mass candidate using a linear discriminant (LDA) classifier. In the second process, mass detection and feature analysis are applied to the individual projection view (PV) images. A mass likelihood score is estimated for each mass candidate using another LDA classifier. The mass likelihood images derived from the PVs are back-projected to the breast volume to estimate the 3D spatial distribution of the mass likelihood scores. The mass likelihood scores estimated by the two processes at the corresponding 3D location are then merged and evaluated using FROC analysis. In this preliminary study, a data set of 52 DBT cases acquired with a GE prototype system at the Massachusetts General Hospital was used. The LDA classifiers with stepwise feature selection were designed with leave-one-case-out resampling. In an FROC analysis, the CAD system for detection in the DBT volume alone achieved test sensitivities of 80% and 90% at an average FP rate of 1.6 and 3.0 per breast, respectively. In comparison, the average FP rates of the combined system were 1.2 and 2.3 per breast, respectively, at the same sensitivities. The combined system is a promising approach to improving mass detection on DBTs.

  14. Targeted Gold Nanoparticle Contrast Agent for Digital Breast Tomosynthesis and Computed Tomography

    DTIC Science & Technology

    2011-03-01

    injections. All imaging was performed on Hologic Selenia Dimensions digital breast tomosynthesis unit at 25 kVp, 50 mAs and 35 µm of rhodium filtration...to the techniques involved with in vivo imaging such as: animal handling, administration of anesthesia, imaging mice with a digital tomosynthesis ...transmission x-ray tomography (computed tomography (CT); these principles are however easily transferable to mammography or breast tomosynthesis

  15. Digital Breast Tomosynthesis: State of the Art

    PubMed Central

    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

  16. Imaging With Synthesized 2D Mammography: Differences, Advantages, and Pitfalls Compared With Digital Mammography.

    PubMed

    Zuckerman, Samantha P; Maidment, Andrew D A; Weinstein, Susan P; McDonald, Elizabeth S; Conant, Emily F

    2017-07-01

    Synthesized 2D (s2D) mammography is rapidly replacing digital mammography in breast imaging with digital breast tomosynthesis (DBT) to reduce radiation dose and maintain screening outcomes. We illustrate variations in the appearance of s2D and digital mammograms to aid in implementation of this technology. Despite subjective differences in the appearance of s2D and digital mammograms, early outcomes of screening using s2D mammography and DBT are not inferior to those achieved with digital mammography and DBT. Understanding these variations may aid in implementing this technique and improving patient outcomes.

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

    NASA Astrophysics Data System (ADS)

    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.

  18. Dynamic Contrast-Enhanced Digital Breast Tomosynthesis

    DTIC Science & Technology

    2012-03-01

    11-1-0229 TITLE: Dynamic Contrast-Enhanced Digital Breast Tomosynthesis PRINCIPAL INVESTIGATOR: Dr. Andrew Maidment...5 Introduction We propose a new technique for obtaining 4D dynamic contrast-enhanced (DCE) digital breast tomosynthesis (DBT) im...seconds. One com plete tomosynthesis projection series consists of a set of projection im ages acquired at distinct angles. In the proposed m ethod

  19. Clinical performance of Siemens digital breast tomosynthesis versus standard supplementary mammography for the assessment of screen-detected soft-tissue abnormalities: a multi-reader study.

    PubMed

    Whelehan, P; Heywang-Köbrunner, S H; Vinnicombe, S J; Hacker, A; Jänsch, A; Hapca, A; Gray, R; Jenkin, M; Lowry, K; Oeppen, R; Reilly, M; Stahnke, M; Evans, A

    2017-01-01

    To compare the diagnostic accuracy of standard screening images plus single-view digital breast tomosynthesis (DBT), using Siemens DBT equipment, with standard screening images plus supplementary mammographic views in non-calcific, screen-detected mammographic abnormalities. Participants were unselected women aged 50-69 years recalled within a population-based European breast screening programme for assessment of soft-tissue mammographic abnormalities. Supplementary mammographic views (SMVs) and DBT were performed in all cases. A range of equipment was used for screening and supplementary mammography, but all DBT examinations were performed using the Siemens Mammomat Inspiration. A retrospective multi-reader study including 238 cases for whom either histology or at least 2 years' follow-up was available was performed with eight suitably accredited UK breast screening personnel reading all cases under both conditions, with temporal separation. Readers were blinded to case outcomes and findings from other examinations. Diagnostic accuracy using receiver operating characteristic (ROC) analysis was compared between screening plus SMV images and screening plus DBT images. The study was powered to detect a 3% inferiority margin in diagnostic accuracy between methods. The final sample with complete data available for analysis included 195 benign cases (1,560 reads) and 35 malignant cases (280 reads). The DBT method yielded a slightly higher area under the curve (AUC) value than the SMV method (0.870 versus 0.857), but the difference was not statistically significant (p=0.4890), indicating that the methods have equivalent accuracy. Siemens DBT demonstrates equivalent diagnostic accuracy according to ROC curve analysis when used in place of SMVs in screen-detected soft-tissue mammographic abnormalities. Copyright © 2016 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

  20. Motion compensated digital tomosynthesis.

    PubMed

    van der Reijden, Anneke; van Herk, Marcel; Sonke, Jan-Jakob

    2013-12-01

    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 purpose of this feasibility study was therefore to develop and evaluate motion-compensated DTS (MC-DTS). MC-DTS images were reconstructed by back projection of X-ray projection images acquired over 30° arcs. Back projection lines were deformed according to an a priori motion model derived from the 4D planning CT. MC-DTS was evaluated on a respiratory motion phantom and 3 lung cancer patients. Respiratory artifact reduction was assessed visually and quantified by fitting a cumulative Gaussian function to profiles along the background-GTV transition in the CC direction. MC reconstruction was fast enough to keep up with image acquisition and considerably reduced motion blur visually. Quantitatively, MC reduced the background-GTV transition distance by 49%. Motion compensation considerably improved the image quality of DTS images of lung cancer patients, giving an opportunity for more accurate DTS guidance and intra-fraction monitoring concurrent with VMAT delivery. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  1. Optimization and Comparison of Different Digital Mammographic Tomosynthesis Reconstruction Methods

    DTIC Science & Technology

    2007-04-01

    likelihood iterative algorithm (MLEM) by Wu et al. [4,5], tuned-aperture computed tomography (TACT) reconstruction methods developed by Webber and...A. Karellas, S. Vedantham, S. J. Glick, C. J. D’Orsi, S. P. Baker, and R. L. Webber , “Comparison of tomosynthesis methods used with digital...L. Webber , “Evaluation of linear and nonlinear tomosynthetic reconstruction methods in digital mammography,” Acad. Radiol. 8, 219-224 (2001). 8. L

  2. Clinical Digital Breast Tomosynthesis System: Dosimetric Characterization

    PubMed Central

    Feng, Steve Si Jia

    2012-01-01

    Purpose: To comprehensively characterize the dosimetric properties of a clinical digital breast tomosynthesis (DBT) system for the acquisition of mammographic and tomosynthesis images. Materials and Methods: Compressible water-oil mixture phantoms were created and imaged by using the automatic exposure control (AEC) of the Selenia Dimensions system (Hologic, Bedford, Mass) in both DBT and full-field digital mammography (FFDM) mode. Empirical measurements of the x-ray tube output were performed with a dosimeter to measure the air kerma for the range of tube current–exposure time product settings and to develop models of the automatically selected x-ray spectra. A Monte Carlo simulation of the system was developed and used in conjunction with the AEC-chosen settings and spectra models to compute and compare the mean glandular dose (MGD) resulting from both imaging modalities for breasts of varying sizes and glandular compositions. Results: Acquisition of a single craniocaudal view resulted in an MGD ranging from 0.309 to 5.26 mGy in FFDM mode and from 0.657 to 3.52 mGy in DBT mode. For a breast with a compressed thickness of 5.0 cm and a 50% glandular fraction, a DBT acquisition resulted in an only 8% higher MGD than an FFDM acquisition (1.30 and 1.20 mGy, respectively). For a breast with a compressed thickness of 6.0 cm and a 14.3% glandular fraction, a DBT acquisition resulted in an 83% higher MGD than an FFDM acquisition (2.12 and 1.16 mGy, respectively). Conclusion: For two-dimensional–three-dimensional fusion imaging with the Selenia Dimensions system, the MGD for a 5-cm-thick 50% glandular breast is 2.50 mGy, which is less than the Mammography Quality Standards Act limit for a two-view screening mammography study. © RSNA, 2012 PMID:22332070

  3. Scatter radiation in digital tomosynthesis of the breast

    PubMed Central

    Sechopoulos, Ioannis; Suryanarayanan, Sankararaman; Vedantham, Srinivasan; D’Orsi, Carl J.; Karellas, Andrew

    2008-01-01

    Digital tomosynthesis of the breast is being investigated as one possible solution to the problem of tissue superposition present in planar mammography. This imaging technique presents various advantages that would make it a feasible replacement for planar mammography, among them similar, if not lower, radiation glandular dose to the breast; implementation on conventional digital mammography technology via relatively simple modifications; and fast acquisition time. One significant problem that tomosynthesis of the breast must overcome, however, is the reduction of x-ray scatter inclusion in the projection images. In tomosynthesis, due to the projection geometry and radiation dose considerations, the use of an antiscatter grid presents several challenges. Therefore, the use of postacquisition software-based scatter reduction algorithms seems well justified, requiring a comprehensive evaluation of x-ray scatter content in the tomosynthesis projections. This study aims to gain insight into the behavior of x-ray scatter in tomosynthesis by characterizing the scatter point spread functions (PSFs) and the scatter to primary ratio (SPR) maps found in tomosynthesis of the breast. This characterization was performed using Monte Carlo simulations, based on the Geant4 toolkit, that simulate the conditions present in a digital tomosynthesis system, including the simulation of the compressed breast in both the cranio-caudal (CC) and the medio-lateral oblique (MLO) views. The variation of the scatter PSF with varying tomosynthesis projection angle, as well as the effects of varying breast glandular fraction and x-ray spectrum, was analyzed. The behavior of the SPR for different projection angle, breast size, thickness, glandular fraction, and x-ray spectrum was also analyzed, and computer fit equations for the magnitude of the SPR at the center of mass for both the CC and the MLO views were found. Within mammographic energies, the x-ray spectrum was found to have no appreciable

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

    PubMed

    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.

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

    PubMed

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

    2017-01-01

    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.

  6. TU-E-217BCD-03: Characterization of Anatomical Noise in Mammography, Tomosynthesis and Breast CT.

    PubMed

    Boone, J; Chen, L; Nosratieh, A; Abbey, C; Lindfors, K; Aminololama-Shakeri, S; Seibert, J

    2012-06-01

    The role of breast density in cancer detection has been well characterized, and newer modalities such as breast tomosynthesis and breast CT (bCT) were developed to improve cancer detection in the dense breast by reducing anatomical complexity. Anatomical noise was characterized on a small cohort of patient images and compared across digital mammography, tomosynthesis, and bCT images. An IRB-approved and HIPPA-compliant clinical study was performed on women undergoing breast biopsy, and mammography, tomosynthesis, and bCT were performed on both breasts immediately prior to biopsy. A total of 23 women participated in this study, and the unaffected breast (no lesion) was evaluated. A total of 1000 regions of interest were sampled on each image data set, and the 2D noise power spectrum (NPS) was evaluated. This was radially averaged to produce a 1D NPS, and the NPS was fit to a power law: ln{NPS(f)} = alpha+betaxln(f), over an anatomically-relevant range of spatial frequencies. The slope, beta, was averaged across patients and compared between modalities and projections. The value of beta was determined for bCT data sets, and they were 1.75 (0.424), 1.83 (0.352), and 1.79 (0.397), for the coronal, sagittal and axial views, respectively. For tomosynthesis, beta was 3.06 (0.361) and 3.10 (0.315) for the CC and MLO views, respectively. For mammography, these values were 3.17 (0.226) and 3.30 (0.236), for the CC and MLO views, respectively. The values of beta for breast CT were significantly different than those for tomosynthesis and mammography (p<0.001, all 12 comparisons). The results of this investigation demonstrate that the anatomical complexity of the breast, as characterized by the parameter beta, is statistically similar between mammography and tomosynthesis, a somewhat surprising finding. The breast CT image data, however, demonstrate a statistically-significant reduction in beta across all projections. Funded in part by Hologic Corporation and by a grant from

  7. Initial Clinical Experience with Contrast-Enhanced Digital Breast Tomosynthesis

    PubMed Central

    Chen, Sara C.; Carton, Ann-Katherine; Albert, Michael; Conant, Emily F.; Schnall, Mitchell D.; Maidment, Andrew D. A.

    2007-01-01

    RATIONALE and OBJECTIVES Contrast-enhanced digital mammography and digital breast tomosynthesis are 2 imaging techniques that attempt to increase malignant breast lesion conspicuity. The combination of these into a single technique, contrast-enhanced digital breast tomosynthesis (CE-DBT), could potentially integrate the strengths of both. The objectives of this study were to assess the clinical feasibility of CE-DBT as an adjunct to digital mammography, and to correlate lesion enhancement characteristics and morphology obtained with CE-DBT to digital mammography, ultrasound, and magnetic resonance (MR). MATERIALS and METHODS CE-DBT (GE Senographe 2000D, Milwaukee, WI) was performed as a pilot study in an ongoing NCI-funded grant (P01 CA85484) studying multimodality breast imaging. 13 patients with ACR BI-RADS category 4 or 5 breast lesions underwent imaging with digital mammography, ultrasound, MR, and CE-DBT. CE-DBT was performed at 45-49 kVp with a rhodium target and a 0.27 mm copper (Alfa Aesar, Ward Hill, MA) filter. Pre- and post-injection DBT image sets were acquired in the MLO projection with slight compression. Each image set consists of 9 images acquired over a 50° arc and was obtained with a mean glandular x-ray dose comparable to two conventional mammographic views. Between the pre- and post-contrast DBT image sets, a single bolus of iodinated contrast agent (1 ml/kg at 2 ml/s; Omnipaque-300, Amersham Health Inc., Princeton, NJ) was administered. Images were reconstructed using filtered-backprojection in 1 mm increments, and transmitted to a clinical PACS workstation. RESULTS Initial experience suggests that CE-DBT provides morphologic and vascular characteristics of breast lesions qualitatively concordant with that of digital mammography and MR. CONCLUSION As an adjunct to digital mammography, CE-DBT may be a potential alternative tool for breast lesion morphologic and vascular characterization. PMID:17236995

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

    SciTech Connect

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

    2014-06-15

    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{sup ′}, 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{sup ′} 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{sup ′}, while dual energy techniques for both modalities demonstrated the next best performance. Unsubtracted imaging resulted in the lowest d{sup ′} 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

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

    PubMed Central

    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

  10. Gold Nanoparticle Contrast Agents in Mammography: A Feasibility Study

    DTIC Science & Technology

    2008-08-01

    The successful translation of molecular imaging to mammography and digital breast tomosynthesis would allow clinical molecular imaging of the breast...nanoparticle (NP) imaging agents, used in conjunction with digital mammography and breast tomosynthesis , should provide improved lesion conspicuity. Au-NP...used in conjunction with digital mammography and breast tomosynthesis , should result in significantly improved lesion conspicuity. Molecular

  11. NPS comparison of anatomical noise characteristics in mammography, tomosynthesis, and breast CT images using power law metrics

    NASA Astrophysics Data System (ADS)

    Chen, Lin; Boone, John M.; Nosratieh, Anita; Abbey, Craig K.

    2011-03-01

    Digital mammography is the current standard for breast cancer screening, however breast tomosynthesis and breast CT (bCT) have been studied in clinical trials. At our institution, 30 women (BIRADS 4 and 5) underwent IRB-approved imaging by mammography, breast tomosynthesis, and bCT on the same day. Twenty three data sets were used for analysis. The 2D noise power spectrum (NPS) was computed and averaged for each data set. The NPS was computed for different slice thicknesses of dx × N, where dx ~ 0.3 mm and N=1-64, on the bCT data. Each 2D NPS was radially averaged, and the 1D data were fit using a power law function as proposed by Burgess: NPS(f) = αf-β. The value of β was determined over a range of frequencies corresponding to anatomical noise, for each patient and each modality. Averaged over the 30 women (26 for bCT, 28 for tomosynthesis, 28 for mammography), for mammography β=3.06 (0.25), for CC tomosynthesis β=2.91 (0.35), and for axial bCT β=1.72 (0.47). For sagittal bCT β=1.77 (0.36) and for coronal bCT, β=1.88 (0.45). The computation of β versus slice thickness on the coronal bCT data set led to β~1.7 for N=1, asymptotically reaching β ~ 3 for larger slice thickness. These results suggest that there is a fundamental difference in breast anatomic noise as characterized by β, between thin slices (<2 mm) and thicker slices. Tomosynthesis was found to have anatomic noise properties closer to mammography than breast CT, most likely due to the relatively thick slice sensitivity profile of tomosynthesis.

  12. Radiation dosimetry in digital breast tomosynthesis: report of AAPM Tomosynthesis Subcommittee Task Group 223.

    PubMed

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

    2014-09-01

    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.

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

    SciTech Connect

    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; 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.

  14. Impact of the Addition of Digital Breast Tomosynthesis (DBT) to Standard 2D Digital Screening Mammography on the Rates of Patient Recall, Cancer Detection, and Recommendations for Short-term Follow-up.

    PubMed

    Powell, Jaclynn L; Hawley, Jeffrey R; Lipari, Adele M; Yildiz, Vedat O; Erdal, B Selnur; Carkaci, Selin

    2017-03-01

    The addition of digital breast tomosynthesis (DBT) to digital screening mammography (DM) has been shown to decrease recall rates and improve cancer detection rates, but there is a lack of data regarding the impact of DBT on rates of short-term follow-up. We assessed possible changes in performance measures with the introduction of DBT at our facility. In our observational study, databases were used to compare rates of recall, short-term follow-up, biopsy, and cancer detection between women undergoing DM without (n = 10,477) and women undergoing DM with (n = 2304) the addition of DBT. Regression analysis was performed to determine associations with patient age, breast density, and availability of comparison examinations. The addition of DBT resulted in significantly lower recall rates (16%-14%, P = .017), higher rates of biopsy (12.7%-19.1%, P < .01), and increased detection of ductal carcinoma in situ, with a difference of 2.3 cases per 1000 screens (P = .044). A 33% increase in cancer detection rates was observed with DBT, which did not reach statistical significance. Short-term follow-up of probably benign findings was 80% higher in the DBT group (odds ratio = 1.80, 95% confidence interval = 1.38-2.36, P < .001). To our knowledge, we are the first to study the impact of DBT on rates of short-term follow-up, and observed an 80% increase over the DM group. Further research is needed to determine the malignancy rate of Breast Imaging Reporting and Data System 3 lesions detected with DBT, and establish appropriate follow-up to maximize cancer detection while minimizing expense and patient anxiety. Copyright © 2017 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

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

    PubMed

    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.

  16. Quantitative image quality measurements of a digital breast tomosynthesis system.

    PubMed

    Olgar, T; Kahn, T; Gosch, D

    2013-12-01

    The aim of this study was to measure the image quality of a digital breast tomosynthesis (DBT) system quantitatively. The signal transfer property (STP), modulation transfer function (MTF), noise power spectrum (NPS), and detective quantum efficiency (DQE) of the Hologic Selenia Dimensions breast tomosynthesis system were measured according to established methods. The NPS was calculated from two-dimensional (2 D) fast Fourier transform (FFT) of flat field images. The presampling MTF of the system was determined for 2 D standard projection mammography and 3 D breast tomosynthesis mode using the edge method. The DQE was derived for different detector air kerma (DAK) values from NPS and MTF measurements. The detector response function was linear for both two-dimensional (2 D) standard projection mammography and three-dimensional (3 D) breast tomosynthesis modes. The gradient of the detector response in the 3 D imaging mode was higher than the gradient in the 2 D imaging mode by a factor of 3.1. The MTF values measured at the Nyquist frequency were 32 % and 39 % in 2 D and 3 D imaging modes, respectively. The DQE was saturated at an air kerma value approximately 3.5 times lower in 3 D mode than in 2 D mode. The measured maximum DQE value was 54 %. The measured DQE values were comparable with breast tomosynthesis systems from other companies (Siemens, GE). © Georg Thieme Verlag KG Stuttgart · New York.

  17. Breast Cancers Found with Digital Breast Tomosynthesis: A Comparison of Pathology and Histologic Grade.

    PubMed

    Wang, Wei-Shin; Hardesty, Lara; Borgstede, James; Takahashi, Jayme; Sams, Sharon

    2016-11-01

    To compare the pathology and histologic grading of breast cancers detected with digital breast tomosynthesis to those found with conventional digital mammography. The institutional review board approved this study. A database search for all breast cancers diagnosed from June 2012 through December 2013 was performed. Imaging records for these cancers were reviewed and patients who had screening mammography with tomosynthesis as their initial examination were selected. Five dedicated breast imaging radiologists reviewed each of these screening mammograms to determine whether the cancer was visible on conventional digital mammography or whether tomosynthesis was needed to identify the cancer. A cancer was considered mammographically occult if all five radiologists agreed that the cancer could not be seen on conventional digital mammography. The size, pathology and histologic grading for all diagnosed breast cancers were then reviewed. The Mann-Whitney U and Fisher exact tests were utilized to determine any association between imaging findings and cancer size, pathologic type and histologic grade. Sixty-five cancers in 63 patients were identified. Ten of these cancers were considered occult on conventional digital mammography and detected with the addition of tomosynthesis. These mammographically occult cancers were significantly associated with Nottingham grade 1 histologic pathology (p = 0.02), were smaller (median size: 6 mm versus 10 mm, p = 0.07) and none demonstrated axillary nodal metastases. Breast cancers identified through the addition of tomosynthesis are associated with Nottingham grade 1 histologic pathology and prognostically more favorable than cancers identified with conventional digital mammography alone. © 2016 Wiley Periodicals, Inc.

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

    PubMed

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

    2011-03-01

    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. 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. 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. 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. 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, rating the comfort of the procedure as much higher than regular

  19. Dynamic Contrast-Enhanced Digital Breast Tomosynthesis

    DTIC Science & Technology

    2013-03-01

    algorithm described by Carton et al5, 6. For the tomosynthesis reconstructions, the MTF is computed by taking the MTF of an edge in a slice of the...Annual Meeting November 2011; Chicago, IL, p., 2011. 2. Carton AK, Bakic P, Ullberg C, Derand H, Maidment AD. Development of a physical 3D...Resolution in Digital Breast Tomosynthesis. Breast Imaging; 2012; Philadelphia, PA. 7361 2012. 5. Carton AK, Vandenbroucke D, Struye L, Maidment AD

  20. Detectors for digital mammography.

    PubMed

    Yaffe, Martin J; Mainprize, James G

    2004-08-01

    Interest in digital radiography was stimulated by the enthusiastic acceptance of computed tomography in the early 1970s. It quickly became apparent to the medical community that images with improved information content, whose display characteristics could be manipulated by the viewer, provided many advantages. Subsequently, digital systems for subtraction angiography and later for conventional projection radiography and fluoroscopy were developed. The timing of the introduction of these systems was highly dependent on the readiness of certain key component technologies to meet the requirements of each of these applications. These components are the x-ray detectors, analog to digital converters, computers, data storage systems and high-resolution electronic displays and printers used in image acquisition, storage and display. Mammography represents one of the most demanding radiographic applications, simultaneously requiring excellent contrast sensitivity, high spatial resolution, and wide dynamic range at as low as radiation dose to the breast as is reasonably achievable while meeting the other requirements. For this reason, it is one of the last radiographic procedures to "go digital". Here, some of the considerations related to the detector technology for digital mammography will be discussed and systems currently available will be described.

  1. Optimized lesion detection in digital breast tomosynthesis

    NASA Astrophysics Data System (ADS)

    Chawla, Amarpreet S.; Samei, Ehsan; Lo, Joseph Y.

    2009-02-01

    While diagnostic improvement via breast tomosynthesis has been notable, the full potential of tomosynthesis has not yet been realized. This is because of the complex task of optimizing multiple parameters that constitute image acquisition and thus affect tomosynthesis performance. Those parameters include dose, number of angular projections, and the total angular span of those projections. In this study, we investigated the effects of acquisition parameters, independent of each other, on the overall diagnostic image quality of tomosynthesis. 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 mammographic 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 non-overlapping ROIs. The projection images were then reconstructed using a filtered-back projection (FBP) algorithm at 224 different combinations of acquisition parameters to investigate which one of the many possible combinations maximized performance. Performance was evaluated in terms of a Laguerre-Gauss channelized Hotelling observer model-based measure of lesion detectability. Results showed that performance improved with an increase in the total acquisition dose level and the angular span. At a constant dose level and angular span, the performance rolled-off beyond a certain number of projections, indicating that simply increasing the number of projections in tomosynthesis may not necessarily improve its performance. The best performance was obtained with 15-17 projections spanning an angular arc of ~45° - the maximum tested in our study, and for an acquisition dose equal to single-view mammography. The optimization framework developed in this framework is applicable to other reconstruction techniques and other multi-projection systems.

  2. [Full-field digital mammography].

    PubMed

    Bick, U

    2000-12-01

    Due to the extremely high image quality requirements in mammography, there has for a long time been no adequate digital alternative to conventional film-screen mammography. The longest experience so far exists with digital mammography on the basis of storage phosphor (CR) systems. However, at normal dose this technique has a relatively poor signal-to-noise ratio and has not found general acceptance. Recently three novel systems for digital mammography by the companies Fischer (slot-scan detector), Trex (CCD-array), and GE (amorphous silicon detector) have been introduced and are currently under clinical investigation. The main advantage of digital mammography is the linear relationship between dose and detector signal with the possibility of a tailored optimization of image contrast. Other advantages include digital image storage, telemammography, and computer-assisted diagnosis.

  3. Validation of a new digital breast tomosynthesis medical display

    NASA Astrophysics Data System (ADS)

    Marchessoux, Cédric; Vivien, Nicolas; Kumcu, Asli; Kimpe, Tom

    2011-03-01

    The main objective of this study is to evaluate and validate the new Barco medical display MDMG-5221 which has been optimized for the Digital Breast Tomosynthesis (DBT) imaging modality system, and to prove the benefit of the new DBT display in terms of image quality and clinical performance. The clinical performance is evaluated by the detection of micro-calcifications inserted in reconstructed Digital Breast Tomosynthesis slices. The slices are shown in dynamic cine loops, at two frames rates. The statistical analysis chosen for this study is the Receiver Operating Characteristic Multiple-Reader, Multiple-Case methodology, in order to measure the clinical performance of the two displays. Four experienced radiologists are involved in this study. For this clinical study, 50 normal and 50 abnormal independent datasets were used. The result is that the new display outperforms the mammography display for a signal detection task using real DBT images viewed at 25 and 50 slices per second. In the case of 50 slices per second, the p-value = 0.0664. For a cut-off where alpha=0.05, the conclusion is that the null hypothesis cannot be rejected, however the trend is that the new display performs 6% better than the old display in terms of AUC. At 25 slices per second, the difference between the two displays is very apparent. The new display outperforms the mammography display by 10% in terms of AUC, with a good statistical significance of p=0.0415.

  4. [Digital breast tomosynthesis : technical principles, current clinical relevance and future perspectives].

    PubMed

    Hellerhoff, K

    2010-11-01

    In recent years digital full field mammography has increasingly replaced conventional film mammography. High quality imaging is guaranteed by high quantum efficiency and very good contrast resolution with optimized dosing even for women with dense glandular tissue. However, digital mammography remains a projection procedure by which overlapping tissue limits the detectability of subtle alterations. Tomosynthesis is a procedure developed from digital mammography for slice examination of breasts which eliminates the effects of overlapping tissue and allows 3D imaging of breasts. A curved movement of the X-ray tube during scanning allows the acquisition of many 2D images from different angles. Subseqently, reconstruction algorithms employing a shift and add method improve the recognition of details at a defined level and at the same time eliminate smear artefacts due to overlapping structures. The total dose corresponds to that of conventional mammography imaging. The technical procedure, including the number of levels, suitable anodes/filter combinations, angle regions of images and selection of reconstruction algorithms, is presently undergoing optimization. Previous studies on the clinical value of tomosynthesis have examined screening parameters, such as recall rate and detection rate as well as information on tumor extent for histologically proven breast tumors. More advanced techniques, such as contrast medium-enhanced tomosynthesis, are presently under development and dual-energy imaging is of particular importance.

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

    PubMed Central

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

    2008-01-01

    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 (DgN) 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 DgN 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. PMID:17278508

  6. Clinical Performance of Synthesized Two-dimensional Mammography Combined with Tomosynthesis in a Large Screening Population.

    PubMed

    Aujero, Mireille P; Gavenonis, Sara C; Benjamin, Ron; Zhang, Zugui; Holt, Jacqueline S

    2017-04-01

    Purpose To compare the clinical performance of synthesized two-dimensional (s2D) mammography combined with digital breast tomosynthesis (DBT) with that of full-field digital mammography (FFDM) alone and FFDM combined with DBT in a large community-based screening population by analyzing recall rate, positive predictive value, and cancer detection rate. Materials and Methods This was a retrospective study approved by the institutional review board and was HIPAA compliant with waiver of informed consent. A total of 78 810 screening mammograms from October 11, 2011, to June 30, 2016, were retrospectively collected. Of these, 32 076 were FFDM, 30 561 were DBT-FFDM, and 16 173 were DBT-s2D mammograms. Diagnostic performance of FFDM, DBT-FFDM, and DBT-s2D mammography was compared. Statistical significance was determined by using the Pearson χ(2) test and was expressed as odds ratios and related confidence intervals determined by means of logistic regression analysis with pairwise comparisons. Results Recall rates were significantly lower with DBT-s2D mammography (4.3%, 687 of 16 173) when compared with DBT-FFDM (5.8%, 1785 of 30 561; odds ratio, 0.72; 95% confidence interval: 0.65, 0.78; P < .0001) and when compared with FFDM alone (8.7%, 2799 of 32 076; odds ratio, 0.46; 95% confidence interval: 0.43, 0.51). The cancer detection rate was similar among FFDM alone (5.3 of 1000 screening examinations), DBT-FFDM (6.4 of 1000 screening examinations), and DBT-s2D mammography (6.1 of 1000 screening examinations) with no significant difference (FFDM vs DBT-FFDM, P = .08; FFDM vs DBT-s2D, P = .27). The percentage of invasive cancers detected was significantly higher with DBT-s2D mammography (76.5%) than with DBT-FFDM (61.3%, P = .01), and positive predictive values with DBT-s2D mammography (40.8%) were significantly higher than those with DBT-FFDM (28.5%, P < .0001). Conclusion Screening with DBT-s2D mammography in a large community-based practice improved recall rate and

  7. Quantification of resolution in multiplanar reconstructions for digital breast tomosynthesis

    NASA Astrophysics Data System (ADS)

    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.

  8. Clinical performance evaluation of the prototype digital breast tomosynthesis system

    NASA Astrophysics Data System (ADS)

    Kim, Y.; Kim, H.; Park, H.; Choi, J.; Choi, Y.

    2012-03-01

    The rapid development and clinical use of digital mammography in the past decade has made possible the development of digital breast tomosynthesis (DBT), which can overcome the limitation of conventional mammography and improve the specificity of mammography with improved marginal visibility of lesion and early breast cancer detection, especially for women with dense breast. The purpose of this study is to characterize the physical properties of DBT system and to optimize the exposure condition using effective modulation transfer function (eMTF), effective noise power spectrum (eNPS), and effective detective quantum efficiency (eDQE). The first generation KERI prototype digital tomosyntesis system for breast imaging using CMOS flat panel detector was used in this study. It was found that the spatial frequency dependent metrics depend on both the inherent properties of the detector and imaging geometry including breast thickness. For thicker breast, eDQE decreases as scatter fraction increases at fixed tube voltage. Moreover, eMTF shows no significant difference as changing tube voltage while eDQE at 27 kVp is relatively degraded. Consequently, the quantitative evaluation of the DBT system with different exposure condition and breast thickness should be fully considered before building the system and application in clinical hospital.

  9. Digital Breast Tomosynthesis: Lessons Learned from Early Clinical Implementation

    PubMed Central

    Maidment, Andrew D. A.; Weinstein, Susan P.; Roth, Susan Orel; Conant, Emily F.

    2014-01-01

    The limitations of mammography are well known and are partly related to the fact that with conventional imaging, the three-dimensional volume of the breast is imaged and presented in a two-dimensional format. Because normal breast tissue is similar in x-ray attenuation to some breast cancers, clinically relevant malignancies may be obscured by normal overlapping tissue. In addition, complex areas of normal tissue may be perceived as suspicious. The limitations of two-dimensional breast imaging lead to low sensitivity in detecting some cancers and high false-positive recall rates. Although mammographic screening has been shown to reduce breast cancer deaths by approximately 30%, controversy exists over when and how often screening mammography should occur. Digital breast tomosynthesis (DBT) is rapidly being implemented in breast imaging clinics around the world as early clinical data demonstrate that it may address some of the limitations of conventional mammography. With DBT, multiple low-dose x-ray images are acquired in an arc and reconstructed to create a three-dimensional image, thus minimizing the impact of overlapping breast tissue and improving lesion conspicuity. Early studies of screening DBT have shown decreased false-positive callback rates and increased rates of cancer detection (particularly for invasive cancers), resulting in increased sensitivity and specificity. In our clinical practice, we have completed more than 2 years of using two-view digital mammography combined with two-view DBT for all screening and select diagnostic imaging examinations (over 25,000 patients). Our experience, combined with previously published data, demonstrates that the combined use of DBT and digital mammography is associated with improved outcomes for screening and diagnostic imaging. Online supplemental material is available for this article. ©RSNA, 2014 PMID:25019451

  10. Investigation of the Z-axis resolution of breast tomosynthesis mammography systems

    NASA Astrophysics Data System (ADS)

    Zhang, Yiheng; Chan, Heang-Ping; Sahiner, Berkman; Wei, Jun; Ge, Jun; Hadjiiski, Lubomir M.; Zhou, Chuan

    2007-03-01

    Digital Tomosynthesis Mammography (DTM) is a promising modality that can improve breast cancer detection. DTM acquires low-dose mammograms at a number of projection angles over a limited angular range and reconstructs the 3D breast volume. DTM can provide depth information to separate overlapping breast tissues occurred in conventional mammograms, thereby facilitating detection of subtle lesions. In this work, we investigated the impact of the imaging parameters and reconstruction methods on the Z-axis resolution in DTM systems. The Z-axis resolution represents the ability of the DTM system to distinguish adjacent objects along the depth direction. A DTM system with variable image acquisition parameters was modeled. In this preliminary study, a computer phantom containing a high-density point object embedded in an air volume was used. We simulated a range of DTM conditions by generating an appropriate number of PV images in 3° increments covering a total tomosynthesis angle from +/-15° to +/-30°. The Simultaneous Algebraic Reconstruction Technique (SART) was used for reconstruction of the imaged volume from the noise-free projection data and the results were compared to those of back-projection method. Vertical line profiles along the Z-axis and through the object center were extracted from the reconstructed volume and the full-width-at-half-maximum (FWHM) of the normalized intensity profile was used to evaluate the Z-axis resolution. Preliminary results demonstrated that while the Z-axis resolution remains almost constant as a function of depth within a 5-cm-thick volume, it is strongly affected by the PV angular range such that the depth resolution improves with increasing total tomosynthesis angle. The depth resolution also depends on the reconstruction algorithm employed; the SART method is superior to the simple back-projection method in terms of depth resolution.

  11. Modeling digital breast tomosynthesis imaging systems for optimization studies

    NASA Astrophysics Data System (ADS)

    Lau, Beverly Amy

    last step of the model. The sPSFs and detector PRFs were verified to match published data, and noise power spectrum (NPS) from simulated flat field images were shown to match empirically measured data from a digital mammography unit. A novel anthropomorphic software breast phantom was developed for 3D imaging simulation. Projection view images of the phantom were shown to have similar structure as real breasts in the spatial frequency domain, using the power-law exponent beta to quantify tissue complexity. The physics simulation and computer breast phantom were used together, following methods from a published study with real tomosynthesis images of real breasts. The simulation model and 3D numerical breast phantoms were able to reproduce the trends in the experimental data. This result demonstrates the ability of the tomosynthesis physics model to generate images sensitive to changes in acquisition parameters.

  12. Value of one-view breast tomosynthesis versus two-view mammography in diagnostic workup of women with clinical signs and symptoms and in women recalled from screening.

    PubMed

    Waldherr, Christian; Cerny, Peter; Altermatt, Hans J; Berclaz, Gilles; Ciriolo, Michele; Buser, Katharina; Sonnenschein, Martin J

    2013-01-01

    The purpose of this study is to compare the diagnostic value of one-view digital breast tomosynthesis versus two-view full-field digital mammography (FFDM) alone, and versus a combined reading of both modalities. The datasets of one-view digital breast tomosynthesis and two-view FFDM of abnormal mammograms in 144 consecutive women admitted for diagnostic workup with clinical signs and symptoms (n = 78) or recalled from screening (n = 66) were read alone and in a combined setting. The malignant or benign nature of the lesions was established by histologic analysis of biopsied lesions or by 12-16-month follow-up. Eighty-six of the 144 patients were found to have breast cancer. The BI-RADS categories for one-view digital breast tomosynthesis were significantly better than those for two-view FFDM (p < 0.001) and were equal to those of the combined reading in both women admitted for diagnostic workup and women recalled from screening. The sensitivity and negative predictive values of digital breast tomosynthesis were superior to those of FFDM in fatty and dense breasts overall and in women admitted for diagnostic workup and in women recalled from screening. Only 11% of digital breast tomosynthesis examinations required additional imaging, compared with 23% of FFDMs. In patients with abnormal mammograms, one-view digital breast tomosynthesis had better sensitivity and negative predictive value than did FFDM in patients with fatty and dense breasts. They also suggest that digital breast tomosynthesis would likely increase the predictive values if incorporated in routine screening.

  13. Implementation of Upright Digital Breast Tomosynthesis-guided Stereotactic Biopsy.

    PubMed

    Omofoye, Toma S; Martaindale, Sarah; Teichgraeber, Davis C; Parikh, Jay R

    2017-06-27

    With growing adoption of digital breast tomosynthesis, an increasing number of imaging abnormalities are being identified only by tomosynthesis. Upright digital breast tomosynthesis-guided stereotactic biopsy is a proven method for sampling these abnormalities as well as abnormalities traditionally evaluated using conventional stereotactic biopsy. In this article, we describe the technique of upright digital breast tomosynthesis-guided stereotactic biopsy and outline a systematic operational approach to implementation of this technique in clinical radiology practices. Copyright © 2017 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

  14. Development and experience of quality control methods for digital breast tomosynthesis systems.

    PubMed

    Strudley, Cecilia J; Young, Kenneth C; Looney, Padraig; Gilbert, Fiona J

    2015-01-01

    To develop tomosynthesis quality control (QC) test methods and use them alongside established two-dimensional (2D) QC tests to measure the performance of digital breast tomosynthesis (DBT) systems used in a comparative trial with 2D mammography. DBT QC protocols and associated analysis were developed, incorporating adaptions of some 2D tests as well as some novel tests. The tomosynthesis tests were: mean glandular dose to the standard breast model; contrast-to-noise ratio in reconstructed focal planes; geometric distortion; artefact spread; threshold contrast detail detection in reconstructed focal planes, alignment of the X-ray beam to the reconstructed image and missed tissue; reproducibility of the tomosynthesis exposure; and homogeneity of the reconstructed focal planes. Summaries of results from the tomosynthesis QC tests are presented together with some 2D results for comparison. The tomosynthesis QC tests and analysis methods developed were successfully applied. The lessons learnt, which are detailed in the Discussion section, may be helpful to others embarking on DBT QC programmes. DBT performance test equipment and analysis methods have been developed. The experience gained has contributed to the subsequent drafting of DBT QC protocols in the UK and Europe.

  15. Measurement of breast density with digital breast tomosynthesis

    NASA Astrophysics Data System (ADS)

    Ren, Baorui; Smith, Andrew; Jing, Zhenxue

    2012-03-01

    Breast density is known as a strong risk factor for breast cancer. Clinical assessment of breast density during screening mammography is often done by radiologists through visual evaluation or by a computer program. Automated computer methods offer the potential for non-subjective density assessments. With the rapid development and increased utilization of tomosynthesis clinically, there is a practical need for systems to provide automated breast density measurements in tomosynthesis like those available in mammography. QuantraTM is a software package using physical modeling of mammography systems, and performs volumetric assessment of breast tissue composition for conventional mammography. In this paper, we describe recent developments to extend Quantra to calculate breast density using tomosynthesis projection images. Our development took advantage of the combo imaging mode of Hologic Selenia DimensionsTM system, which allowed co-registered conventional 2D mammogram and 3D tomosynthesis images to be acquired in a single compression. We used the Quantra results of 2D mammograms as a reference to refine the new processing algorithm for tomosynthesis images. This paper describes details of the new algorithm and provides some preliminary results.

  16. Automated lung segmentation in digital chest tomosynthesis

    PubMed Central

    Wang, Jiahui; Dobbins, James T.; Li, Qiang

    2012-01-01

    Purpose: The purpose of this study was to develop an automated lung segmentation method for computerized detection of lung nodules in digital chest tomosynthesis. Methods: The authors collected 45 digital tomosynthesis scans and manually segmented reference lung regions in each scan to assess the performance of the method. The authors automated the technique by calculating the edge gradient in an original image for enhancing lung outline and transforming the edge gradient image to polar coordinate space. The authors then employed a dynamic programming technique to delineate outlines of the unobscured lungs in the transformed edge gradient image. The lung outlines were converted back to the original image to provide the final segmentation result. The above lung segmentation algorithm was first applied to the central reconstructed tomosynthesis slice because of the absence of ribs overlapping lung structures. The segmented lung in the central slice was then used to guide lung segmentation in noncentral slices. The authors evaluated the segmentation method by using (1) an overlap rate of lung regions, (2) a mean absolute distance (MAD) of lung borders, (3) a Hausdorff distance of lung borders between the automatically segmented lungs and manually segmented reference lungs, and (4) the fraction of nodules included in the automatically segmented lungs. Results: The segmentation method achieved mean overlap rates of 85.7%, 88.3%, and 87.0% for left lungs, right lungs, and entire lungs, respectively; mean MAD of 4.8, 3.9, and 4.4 mm for left lungs, right lungs, and entire lungs, respectively; and mean Hausdorrf distance of 25.0 mm, 25.5 mm, and 30.1 mm for left lungs, right lungs, and entire lungs, respectively. All of the nodules inside the reference lungs were correctly included in the segmented lungs obtained with the lung segmentation method. Conclusions: The method achieved relatively high accuracy for lung segmentation and will be useful for computer-aided detection

  17. Image reconstruction for a stationary digital breast tomosynthesis system

    NASA Astrophysics Data System (ADS)

    Rajaram, Ramya; Yang, Guang; Quan, Enzhuo; Frederick, Brandon; Lalush, David S.; Zhou, Otto Z.

    2009-02-01

    We have designed and built a stationary digital breast tomosynthesis (DBT) system containing a carbon nanotube based field emission x-ray source array to examine the possibility of obtaining a reduced scan time and improved image quality compared to conventional DBT systems. There are 25 individually addressable x-ray sources in our linear source array that are evenly angularly spaced to cover an angle of 48°. The sources are turned on sequentially during imaging and there is no motion of either the source or the detector. We present here an iterative reconstruction method based on a modified Ordered-Subset Convex (MOSC) algorithm that was employed for the reconstruction of images from the new DBT system. Using this algorithm based on a maximum-likelihood model, we reconstruct on non-cubic voxels for increased computational efficiency resulting in high in-plane resolution in the images. We have applied the reconstruction technique on simulated and phantom data from the system. Even without the use of the subsets, the reconstruction of an experimental 9-beam system with 960×768 pixels took less than 6 minutes (10 iterations). The projection images of a simulated mammography accreditation phantom were reconstructed using MOSC and a Simultaneous Algebraic Reconstruction technique (SART) and the results from the comparison between the two algorithms allow us to conclude that the MOSC is capable of delivering excellent image quality when used in tomosynthesis image reconstruction.

  18. Uses of megavoltage digital tomosynthesis in radiotherapy

    NASA Astrophysics Data System (ADS)

    Sarkar, Vikren

    With the advent of intensity modulated radiotherapy, radiation treatment plans are becoming more conformal to the tumor with the decreasing margins. It is therefore of prime importance that the patient be positioned correctly prior to treatment. Therefore, image guided treatment is necessary for intensity modulated radiotherapy plans to be implemented successfully. Current advanced imaging devices require costly hardware and software upgrade, and radiation imaging solutions, such as cone beam computed tomography, may introduce extra radiation dose to the patient in order to acquire better quality images. Thus, there is a need to extend current existing imaging device ability and functions while reducing cost and radiation dose. Existing electronic portal imaging devices can be used to generate computed tomography-like tomograms through projection images acquired over a small angle using the technique of cone-beam digital tomosynthesis. Since it uses a fraction of the images required for computed tomography reconstruction, use of this technique correspondingly delivers only a fraction of the imaging dose to the patient. Furthermore, cone-beam digital tomosynthesis can be offered as a software-only solution as long as a portal imaging device is available. In this study, the feasibility of performing digital tomosynthesis using individually-acquired megavoltage images from a charge coupled device-based electronic portal imaging device was investigated. Three digital tomosynthesis reconstruction algorithms, the shift-and-add, filtered back-projection, and simultaneous algebraic reconstruction technique, were compared considering the final image quality and radiation dose during imaging. A software platform, DART, was created using a combination of the Matlab and C++ languages. The platform allows for the registration of a reference Cone Beam Digital Tomosynthesis (CBDT) image against a daily acquired set to determine how to shift the patient prior to treatment. Finally

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

    PubMed

    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

  20. Stereotactic vacuum-assisted biopsies on a digital breast 3D-tomosynthesis system.

    PubMed

    Viala, Juliette; Gignier, Pierre; Perret, Baudouin; Hovasse, Claudie; Hovasse, Denis; Chancelier-Galan, Marie-Dominique; Bornet, Gregoire; Hamrouni, Adel; Lasry, Jean-Louis; Convard, Jean-Paul

    2013-01-01

    The purpose of this study was to describe our operating process and to report results of 118 stereotactic vacuum-assisted biopsies performed on a digital breast 3D-tomosynthesis system. From October 2009 to December 2010, 118 stereotactic vacuum assisted biopsies have been performed on a digital breast 3D-tomosynthesis system. Informed consent was obtained for all patients. A total of 106 patients had a lesion, six had two lesions. Sixty-one lesions were clusters of micro-calcifications, 54 were masses and three were architectural distortions. Patients were in lateral decubitus position to allow shortest skin-target approach (or sitting). Specific compression paddle, adapted on the system, performed, and graduated, allowing localization in X-Y. Tomosynthesis views define the depth of lesion. Graduated Coaxial localization kit determines the beginning of the biopsy window. Biopsies were performed with an ATEC-Suros, 9 Gauge handpiece. All biopsies, except one, have reached the lesions. Five hemorrhages were incurred in the process, but no interruption was needed. Eight breast hematomas, were all spontaneously resolved. One was an infection. About 40% of patients had a skin ecchymosis. Processing is fast, easy, and requires lower irradiation dose than with classical stereotactic biopsies. Histology analysis reported 45 benign clusters of micro-calcifications, 16 malignant clusters of micro-calcifications, 24 benign masses, and 33 malignant masses. Of 13 malignant lesions, digital 2D-mammography failed to detect eight lesions and underestimated the classification of five lesions. Digital breast 3D-tomosynthesis depicts malignant lesions not visualized on digital 2D-mammography. Development of tomosynthesis biopsy unit integrated to stereotactic system will permit histology analysis for suspicious lesions.

  1. The Adjunctive Digital Breast Tomosynthesis in Diagnosis of Breast Cancer

    PubMed Central

    Yang, Tsung-Lung; Liang, Huei-Lung; Huang, Jer-Shyung; Pan, Huay-Ben

    2013-01-01

    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. PMID:23844366

  2. The adjunctive digital breast tomosynthesis in diagnosis of breast cancer.

    PubMed

    Yang, Tsung-Lung; Liang, Huei-Lung; Chou, Chen-Pin; Huang, Jer-Shyung; Pan, Huay-Ben

    2013-01-01

    To compare the diagnostic performance of digital breast tomosynthesis (DBT) and digital mammography (DM) for breast cancers. 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. 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. Adjunctive DBT gives exquisite information for mass lesion, focal asymmetry, and/or architecture distortion to improve the diagnostic performance in mammography.

  3. Clinical benefits of combined diagnostic three-dimensional digital breast tomosynthesis and ultrasound imaging

    NASA Astrophysics Data System (ADS)

    Varjonen, Mari; Pamilo, Martti; Raulisto, Leena

    2005-04-01

    Our goal is to evaluate diagnostic digital breast tomosynthesis and ultrasound imaging clinical value in detecting and diagnosing early stage breast cancers. Determine if fusion imaging would decrease the number of biopsies and reduce further patient workup otherwise required to establish a definitive diagnosis. This paper presents the clinical results based on the study conducted at Helsinki University Central Hospital. Presentation demonstrates clinical dual modality images and results. Tomosynthesis of amorphous selenium based full field digital mammography system will be also presented. Forty asymptomatic women enrolled in the study based on prior identification of suspicious findings on screening mammograms where the possibility of breast cancer could not be excluded. Abnormal screening mammogram findings included tumor-like densities, parenchymal asymmetries and architectural distortions. Eight women were operated and 32 were not referred for surgery. Those cases, which were operated, three lesions represented ductal carcinoma in situ, two ductal carcinomas, one atypical ductal hyperplasia, one fibroadenoma and one radial scar. The 32 not operated cases revealed to be benign or superimposition of normal parenchymal breast tissue. The cases were returned to biennial screening. Ultrasound did not show clearly any lesions, but using tomosynthesis and ultrasound together we were able to analyze and locate the lesions exactly. Special tomosynthesis improves overall lesion detection and analysis. The value of tomosynthesis and ultrasound fusion imaging will be to provide additional clinical information in order to improve decision making accuracy to either confirm or exclude a suspected abnormality and in particular detect small breast cancers.

  4. Efficacy of digital breast tomosynthesis for breast cancer diagnosis

    NASA Astrophysics Data System (ADS)

    Alakhras, M.; Mello-Thoms, C.; Rickard, M.; Bourne, R.; Brennan, P. C.

    2014-03-01

    Purpose: To compare the diagnostic performance of digital breast tomosynthesis (DBT) in combination with digital mammography (DM) with that of digital mammography alone. Materials and Methods: Twenty six experienced radiologists who specialized in breast imaging read 50 cases (27 cancers and 23 non-cancer cases) of patients who underwent DM and DBT. Both exams included the craniocaudal (CC) and mediolateral oblique (MLO) views. Histopathologic examination established truth in all lesions. Each case was interpreted in two modes, once with DM alone followed by DM+DBT, and the observers were asked to mark the location of any lesions, if present, and give it a score based on a five-category assessment by the Royal Australian and New Zealand College of Radiologists (RANZCR). The diagnostic performance of DM compared with that of DM+DBT was evaluated in terms of the difference between areas under receiver-operating characteristic curves (AUCs), Jackknife free-response receiver operator characteristics (JAFROC) figure-of-merit, sensitivity, location sensitivity and specificity. Results: Average AUC and JAFROC for DM versus DM+DBT was significantly different (AUCs 0.690 vs 0.781, p=< 0.0001), (JAFROC 0.618 vs. 0.732, p=< 0.0001) respectively. In addition, the use of DM+DBT resulted in an improvement in sensitivity (0.629 vs. 0.701, p=0.0011), location sensitivity (0.548 vs. 0.690, p=< 0.0001) and specificity (0.656 vs. 0.758, p=0.0015) when compared to DM alone. Conclusion: Adding DBT to the standard DM significantly improved radiologists' performance in terms of AUCs, JAFROC figure of merit, sensitivity, location sensitivity and specificity values.

  5. Breast cancer screening with tomosynthesis (3D mammography) with acquired or synthetic 2D mammography compared with 2D mammography alone (STORM-2): a population-based prospective study.

    PubMed

    Bernardi, Daniela; Macaskill, Petra; Pellegrini, Marco; Valentini, Marvi; Fantò, Carmine; Ostillio, Livio; Tuttobene, Paolina; Luparia, Andrea; Houssami, Nehmat

    2016-08-01

    Breast tomosynthesis (pseudo-3D mammography) improves breast cancer detection when added to 2D mammography. In this study, we examined whether integrating 3D mammography with either standard 2D mammography acquisitions or with synthetic 2D images (reconstructed from 3D mammography) would detect more cases of breast cancer than 2D mammography alone, to potentially reduce the radiation burden from the combination of 2D plus 3D acquisitions. The Screening with Tomosynthesis Or standard Mammography-2 (STORM-2) study was a prospective population-based screening study comparing integrated 3D mammography (dual-acquisition 2D-3D mammography or 2D synthetic-3D mammography) with 2D mammography alone. Asymptomatic women aged 49 years or older who attended population-based screening in Trento, Italy were recruited for the study. All participants underwent digital mammography with 2D and 3D mammography acquisitions, with the use of software that allowed synthetic 2D mammographic images to be reconstructed from 3D acquisitions. Mammography screen-reading was done in two parallel double-readings conducted sequentially for 2D acquisitions followed by integrated acquisitions. Recall based on a positive mammography result was defined as recall at any screen read. Primary outcome measures were a comparison between integrated (2D-3D or 2D synthetic-3D) mammography and 2D mammography alone of the number of cases of screen-detected breast cancer, the cancer detection rate per 1000 screens, the incremental cancer detection rate, and the number and percentage of false-positive recalls. Between May 31, 2013, and May 29, 2015, 10 255 women were invited to participate, of whom 9672 agreed to participate and were screened. In these 9672 participants (median age 58 years [IQR 53-63]), screening detected 90 cases of breast cancer, including 74 invasive breast cancers, in 85 women (five women had bilateral breast cancer). To account for these bilateral cancers in cancer detection rate

  6. Rapid review: Estimates of incremental breast cancer detection from tomosynthesis (3D-mammography) screening in women with dense breasts.

    PubMed

    Houssami, Nehmat; Turner, Robin M

    2016-12-01

    High breast tissue density increases breast cancer (BC) risk, and the risk of an interval BC in mammography screening. Density-tailored screening has mostly used adjunct imaging to screen women with dense breasts, however, the emergence of tomosynthesis (3D-mammography) provides an opportunity to steer density-tailored screening in new directions potentially obviating the need for adjunct imaging. A rapid review (a streamlined evidence synthesis) was performed to summarise data on tomosynthesis screening in women with heterogeneously dense or extremely dense breasts, with the aim of estimating incremental (additional) BC detection attributed to tomosynthesis in comparison with standard 2D-mammography. Meta-analysed data from prospective trials comparing these mammography modalities in the same women (N = 10,188) in predominantly biennial screening showed significant incremental BC detection of 3.9/1000 screens attributable to tomosynthesis (P < 0.001). Studies comparing different groups of women screened with tomosynthesis (N = 103,230) or with 2D-mammography (N = 177,814) yielded a pooled difference in BC detection of 1.4/1000 screens representing significantly higher BC detection in tomosynthesis-screened women (P < 0.001), and a pooled difference for recall of -23.3/1000 screens representing significantly lower recall in tomosynthesis-screened groups (P < 0.001), than for 2D-mammography. These estimates can inform planning of future trials of density-tailored screening and may guide discussion of screening women with dense breasts.

  7. Task-based assessment and optimization of digital breast tomosynthesis

    NASA Astrophysics Data System (ADS)

    Young, Stefano

    Digital breast tomosynthesis (DBT) is a new technology for breast cancer screening that promises to complement mammography or supersede it to become the standard for breast imaging. DBT involves taking multiple images in order to synthesize a new image that represents a slice through the breast volume---hence the term tomosynthesis. The primary advantage of this paradigm is that it can reduce the amount of overlapping anatomy in the data, leading to improved visualization of potentially-cancerous findings. The difficulty in DBT is quantifying the advantages of the technology and determining the optimal conditions for its clinical use. This dissertation describes a virtual trial framework for assessing and optimizing DBT technology for the specific task of detecting small, low-contrast masses in the breast. It addresses each component of the imaging chain to some degree, from the patients/phantoms to the imaging hardware to the model observers used to measure signal detectability. The main focus, however, is on quantifying tradeoffs between three key parameters that affect image quality: (1) scan angle, (2) number of projections, and (3) exposure. We show that in low-density breast phantoms, detectability generally increases with both scan angle and number of projections in the anatomical-variability-limited (high-exposure) regime. We also investigate how breast density affects the optimal DBT scan parameters. We show task-specific results that support using an adaptive paradigm in DBT, where the imaging system reconfigures itself in response to information about the patient's breast density. The virtual framework described in this dissertation provides a platform for further investigations of image quality in 3D breast imaging.

  8. 3D lesion insertion in digital breast tomosynthesis images

    NASA Astrophysics Data System (ADS)

    Vaz, Michael S.; Besnehard, Quentin; Marchessoux, Cédric

    2011-03-01

    Digital breast tomosynthesis (DBT) is a new volumetric breast cancer screening modality. It is based on the principles of computed tomography (CT) and shows promise for improving sensitivity and specificity compared to digital mammography, which is the current standard protocol. A barrier to critically evaluating any new modality, including DBT, is the lack of patient data from which statistically significant conclusions can be drawn; such studies require large numbers of images from both diseased and healthy patients. Since the number of detected lesions is low in relation to the entire breast cancer screening population, there is a particular need to acquire or otherwise create diseased patient data. To meet this challenge, we propose a method to insert 3D lesions in the DBT images of healthy patients, such that the resulting images appear qualitatively faithful to the modality and could be used in future clinical trials or virtual clinical trials (VCTs). The method facilitates direct control of lesion placement and lesion-to-background contrast and is agnostic to the DBT reconstruction algorithm employed.

  9. TU-AB-207-00: Digital Tomosynthesis

    SciTech Connect

    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.

  10. Image performance of a new amorphous selenium flat panel x-ray detector designed for digital breast tomosynthesis

    NASA Astrophysics Data System (ADS)

    Cheung, L. K.; Jing, Z.; Bogdanovich, S.; Golden, K.; Robinson, S.; Beliaevskaia, E.; Parikh, S.

    2005-04-01

    The purpose of this work is to report the performance of an amorphous selenium (a-Se) based flat-panel x-ray imager under development for application in digital breast tomosynthesis. This detector is designed to perform both in the conventional Full Field Digital Mammography (FFDM) mode and the tomosynthesis mode. The large area 24 x 29 cm detector achieves rapid image acquisition rates of up to 4 frames per second with minimal trapped charge induced effects such as ghost or lag images of previously acquired objects. In this work, a new a-Se/TFT detector layer structure is evaluated. The design uses a top conductive layer in direct contact with the a-Se x-ray detection layer. The simple structure has few layers and minimal hole and electron trapping effects. Prototype detectors were built to investigate the basic image performance of this new a-Se/TFT detector. Image signal generation, image ghosting, image lag, and detector DQE were studied. For digital mammography applications, the residual image ghosting was less than 1% at 30 seconds elapsed time. DQE, measured at a field of 5.15 V/um, showed significantly higher values over previously reported data, especially at low exposure levels. For digital breast tomosynthesis, the image lag at dynamic readout rate was < 0.6 % at 0.5-second elapsed time. A prototype tomosynthesis system is being developed utilizing this new a-Se/TFT detector.

  11. Digital Breast Tomosynthesis and the Challenges of Implementing an Emerging Breast Cancer Screening Technology Into Clinical Practice.

    PubMed

    Lee, Christoph I; Lehman, Constance D

    2016-11-01

    Emerging imaging technologies, including digital breast tomosynthesis, have the potential to transform breast cancer screening. However, the rapid adoption of these new technologies outpaces the evidence of their clinical and cost-effectiveness. The authors describe the forces driving the rapid diffusion of tomosynthesis into clinical practice, comparing it with the rapid diffusion of digital mammography shortly after its introduction. They outline the potential positive and negative effects that adoption can have on imaging workflow and describe the practice management challenges when incorporating tomosynthesis. The authors also provide recommendations for collecting evidence supporting the development of policies and best practices. Copyright © 2013 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  12. Digital breast tomosynthesis and the challenges of implementing an emerging breast cancer screening technology into clinical practice.

    PubMed

    Lee, Christoph I; Lehman, Constance D

    2013-12-01

    Emerging imaging technologies, including digital breast tomosynthesis, have the potential to transform breast cancer screening. However, the rapid adoption of these new technologies outpaces the evidence of their clinical and cost-effectiveness. The authors describe the forces driving the rapid diffusion of tomosynthesis into clinical practice, comparing it with the rapid diffusion of digital mammography shortly after its introduction. They outline the potential positive and negative effects that adoption can have on imaging workflow and describe the practice management challenges when incorporating tomosynthesis. The authors also provide recommendations for collecting evidence supporting the development of policies and best practices. Copyright © 2013 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  13. Stationary Digital Tomosynthesis System for Early Detection of Breast Tumors

    DTIC Science & Technology

    2011-05-01

    area needed to get high current as well as sustainability of thermal loading by the gate mesh. The process of design optimization involved varying...feasibility of improving spatial resolution and scanning speed of the current DBT device by replacing mammography tube with a stationary carbon nanotube (CNT...tomosynthesis (s-DBT) utilizing a carbon nanotube (CNT) based distributed x-ray source array. The device generates the projection views by electronically

  14. Whole-Body Clinical Applications of Digital Tomosynthesis.

    PubMed

    Machida, Haruhiko; Yuhara, Toshiyuki; Tamura, Mieko; Ishikawa, Takuya; Tate, Etsuko; Ueno, Eiko; Nye, Katelyn; Sabol, John M

    2016-01-01

    With flat-panel detector mammography, radiography, and fluoroscopy systems, digital tomosynthesis (DT) has been recently introduced as an advanced clinical application that removes overlying structures, enhances local tissue separation, and provides depth information about structures of interest by providing high-quality tomographic images. DT images are generated from projection image data, typically using filtered back-projection or iterative reconstruction. These low-dose x-ray projection images are easily and swiftly acquired over a range of angles during a single linear or arc sweep of the x-ray tube assembly. DT is advantageous in a variety of clinical contexts, including breast, chest, head and neck, orthopedic, emergency, and abdominal imaging. Specifically, compared with conventional mammography, radiography, and fluoroscopy, as a result of reduced tissue overlap DT can improve detection of breast cancer, pulmonary nodules, sinonasal mucosal thickening, and bone fractures and delineation of complex anatomic structures such as the ostiomeatal unit, atlantoaxial joint, carpal and tarsal bones, and pancreatobiliary and gastrointestinal tracts. Compared with computed tomography, DT offers reduced radiation exposure, better in-plane resolution to improve assessment of fine bony changes, and less metallic artifact, improving postoperative evaluation of patients with metallic prostheses and osteosynthesis materials. With more flexible patient positioning, DT is also useful for functional, weight-bearing, and stress tests. To optimize patient management, a comprehensive understanding of the clinical applications and limitations of whole-body DT applications is important for improvement of diagnostic quality, workflow, and cost-effectiveness. Online supplemental material is available for this article. (©)RSNA, 2016.

  15. Estimation of scattered radiation in digital breast tomosynthesis

    NASA Astrophysics Data System (ADS)

    Diaz, O.; Dance, D. R.; Young, K. C.; Elangovan, P.; Bakic, P. R.; Wells, K.

    2014-08-01

    Digital breast tomosynthesis (DBT) is a promising technique to overcome the tissue superposition limitations found in planar 2D x-ray mammography. However, as most DBT systems do not employ an anti-scatter grid, the levels of scattered radiation recorded within the image receptor are significantly higher than that observed in planar 2D x-ray mammography. Knowledge of this field is necessary as part of any correction scheme and for computer modelling and optimisation of this examination. Monte Carlo (MC) simulations are often used for this purpose, however they are computationally expensive and a more rapid method of calculation is desirable. This issue is addressed in this work by the development of a fast kernel-based methodology for scatter field estimation using a detailed realistic DBT geometry. Thickness-dependent scatter kernels, which were validated against the literature with a maximum discrepancy of 4% for an idealised geometry, have been calculated and a new physical parameter (air gap distance) was used to estimate more accurately the distribution of scattered radiation for a series of anthropomorphic breast phantom models. The proposed methodology considers, for the first time, the effects of scattered radiation from the compression paddle and breast support plate, which can represent more than 30% of the total scattered radiation recorded within the image receptor. The results show that the scatter field estimator can calculate scattered radiation images in an average of 80 min for projection angles up to 25° with equal to or less than a 10% error across most of the breast area when compared with direct MC simulations.

  16. "Off Label" Use of FDA-Approved Devices and Digital Breast Tomosynthesis.

    PubMed

    Kopans, Daniel B

    2015-11-01

    The purpose of this article is to clarify for radiologists the meaning of U.S. Food and Drug Administration (FDA) approval with respect to Digital Breast Tomosynthesis (DBT). DBT is a major improvement over 2D mammography in the detection of cancers (sensitivity) and the reduction in recalls resulting from screening (specificity). Most imaging systems that have been approved by the FDA are used "off label" for breast imaging. Although the FDA determines which claims a manufacturer can make for a device, physicians may use approved devices, such as DBT, off label to provide better patient care.

  17. Contrast enhanced imaging with a stationary digital breast tomosynthesis system

    NASA Astrophysics Data System (ADS)

    Puett, Connor; Calliste, Jabari; Wu, Gongting; Inscoe, Christina R.; Lee, Yueh Z.; Zhou, Otto; Lu, Jianping

    2017-03-01

    Digital breast tomosynthesis (DBT) captures some depth information and thereby improves the conspicuity of breast lesions, compared to standard mammography. Using contrast during DBT may also help distinguish malignant from benign sites. However, adequate visualization of the low iodine signal requires a subtraction step to remove background signal and increase lesion contrast. Additionally, attention to factors that limit contrast, including scatter, noise, and artifact, are important during the image acquisition and post-acquisition processing steps. Stationary DBT (sDBT) is an emerging technology that offers a higher spatial and temporal resolution than conventional DBT. This phantom-based study explored contrast-enhanced sDBT (CE sDBT) across a range of clinically-appropriate iodine concentrations, lesion sizes, and breast thicknesses. The protocol included an effective scatter correction method and an iterative reconstruction technique that is unique to the sDBT system. The study demonstrated the ability of this CE sDBT system to collect projection images adequate for both temporal subtraction (TS) and dual-energy subtraction (DES). Additionally, the reconstruction approach preserved the improved contrast-to-noise ratio (CNR) achieved in the subtraction step. Finally, scatter correction increased the iodine signal and CNR of iodine-containing regions in projection views and reconstructed image slices during both TS and DES. These findings support the ongoing study of sDBT as a potentially useful tool for contrast-enhanced breast imaging and also highlight the significant effect that scatter has on image quality during DBT.

  18. A stationary digital breast tomosynthesis scanner

    NASA Astrophysics Data System (ADS)

    Qian, Xin; Tucker, Andrew; Gidcumb, Emily; Lu, Jianping; Zhou, Otto; Spronk, Derrek; Sprenger, Frank; Zhang, Yiheng; Kennedy, Don; Farbizio, Tom; Jing, Zhenxue

    2012-03-01

    A prototype stationary digital breast tomosynthesis (s-DBT) system has been developed by retrofitting a Hologic Selenia Dimension rotating gantry tomosynthesis scanner with a spatially distributed carbon nanotube (CNT) x-ray source array. The goal is to improve the system spatial resolution by removing the x-ray tube motion induced focal spot blurring. The CNT x-ray source array comprises 31 individually addressable x-ray beams covering 30° angular span. Each x-ray beam has a minimum focal spot size of 0.64×0.61mm (full-width-at-half-maximum), a stationary W anode operating up to 50kVp, and 1mm thick Al filter. The flux from each beam is regulated and varied using dedicated control electronics. The maximum tube current is determined by the heat load of the stationary anode and depends on the energy, pulse width and the focal spot size used. Stable operation at 28kVp, 27mA tube current, 250msec pulse width and 38mA tube current, 183msec pulse width per exposure was achieved with extended lifetime. The standard ACR phantom was imaged and analyzed to evaluate the image quality. The actual scanning speed depends on the number of views and the readout time of the x-ray detector. With the present detector, 6 second scanning time at either 15 views or 31 views can be achieved at 100mAs total imaging dose with a detector readout time of 240msec.

  19. Targeted Gold Nanoparticle Contrast Agent for Digital Breast Tomosynthesis and Computed Tomography

    DTIC Science & Technology

    2012-03-01

    Agent for Digital Breast Tomosynthesis and Computed Tomography PRINCIPAL INVESTIGATOR: Roshan Karunamuni...February 2009 – 14 February 2012 4. TITLE AND SUBTITLE 5a. CONTRACT NUMBER Targeted Gold Nanoparticle Contrast Agent for Digital Breast Tomosynthesis ...agent injected into a living animal. Technical characterization of a contrast-enhanced digital breast tomosynthesis system A second generation

  20. Gold Nanoparticle Contrast Agents in Mammography: A Feasibility Study

    DTIC Science & Technology

    2007-08-01

    breast tomosynthesis would allow clinical molecular imaging of the breast. This is a potentially more sensitive approach to early breast cancer...breast tomosynthesis , should provide improved lesion conspicuity. We are studying the feasibility of mammographic molecular imaging through in vitro...mammography and digital breast tomosynthesis to test for adequate contrast enhancement, both conventionally and using dual-energy subtraction methods

  1. Comparison of two-dimensional synthesized mammograms versus original digital mammograms alone and in combination with tomosynthesis images.

    PubMed

    Zuley, Margarita L; 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

    2014-06-01

    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. 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. 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. 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.

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

    PubMed Central

    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

  3. Temporal Subtraction of Digital Breast Tomosynthesis Images for Improved Mass Detection

    DTIC Science & Technology

    2007-10-01

    Tomosynthesis Images for Improved Mass Detection PRINCIPAL INVESTIGATOR: Christina M. Li...DATES COVERED 15 Sep 2006 – 14 Sep 2007 4. TITLE AND SUBTITLE 5a. CONTRACT NUMBER Temporal Subtraction of Digital Breast Tomosynthesis Images for...13. SUPPLEMENTARY NOTES 14. ABSTRACT Digital breast tomosynthesis (DBT) strives to overcome the obstacles presented in conventional 2D

  4. A phantom-based calibration method for digital x-ray tomosynthesis

    PubMed Central

    Miao, Hui; Wu, Xizeng; Zhao, Huijuan; Liu, Hong

    2012-01-01

    Objective The purpose of this study was to develop a phantom-based experimental calibration method to minimize the reconstruction artifacts for the geometric misalignments of the digital tomosynthesis prototype. Methods A calibration phantom with ten fiducial markers was designed. Using this calibration phantom, the projection matrices of an experimental digital tomosynthesis prototype were acquired from each projection view under a series of misalignment conditions. The American College of Radiology mammography phantom was imaged and reconstructed with and without using the correction of the corresponding calibration projection matrices. The effectiveness of the calibration technique was then quantitatively analyzed through comparison of the calibrated and uncalibrated images. Results As the isocenter horizontal-shift increases, the reconstruction artifacts become clearly distinguishable. Using the calibration technique, the reconstruction artifacts resulting from the isocenter horizontal-shift were effectively minimized for the prototype. Conclusions For the specific experimental conditions utilized in this study, the phantom-based calibration method effectively reduced reconstruction artifacts for the prototype investigated in this study. The calibration method holds potential to benefit other tomosynthesis applications. PMID:22398585

  5. Low dose scatter correction for digital chest tomosynthesis

    NASA Astrophysics Data System (ADS)

    Inscoe, Christina R.; Wu, Gongting; Shan, Jing; Lee, Yueh Z.; Zhou, Otto; Lu, Jianping

    2015-03-01

    Digital chest tomosynthesis (DCT) provides superior image quality and depth information for thoracic imaging at relatively low dose, though the presence of strong photon scatter degrades the image quality. In most chest radiography, anti-scatter grids are used. However, the grid also blocks a large fraction of the primary beam photons requiring a significantly higher imaging dose for patients. Previously, we have proposed an efficient low dose scatter correction technique using a primary beam sampling apparatus. We implemented the technique in stationary digital breast tomosynthesis, and found the method to be efficient in correcting patient-specific scatter with only 3% increase in dose. In this paper we reported the feasibility study of applying the same technique to chest tomosynthesis. This investigation was performed utilizing phantom and cadaver subjects. The method involves an initial tomosynthesis scan of the object. A lead plate with an array of holes, or primary sampling apparatus (PSA), was placed above the object. A second tomosynthesis scan was performed to measure the primary (scatter-free) transmission. This PSA data was used with the full-field projections to compute the scatter, which was then interpolated to full-field scatter maps unique to each projection angle. Full-field projection images were scatter corrected prior to reconstruction. Projections and reconstruction slices were evaluated and the correction method was found to be effective at improving image quality and practical for clinical implementation.

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

    PubMed

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

    2017-08-15

    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.

  7. Development of a stationary digital breast tomosynthesis system for clinical applications

    NASA Astrophysics Data System (ADS)

    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

  8. Optical geometry calibration method for free-form digital tomosynthesis

    NASA Astrophysics Data System (ADS)

    Chtcheprov, Pavel; Hartman, Allison; Shan, Jing; Lee, Yueh Z.; Zhou, Otto; Lu, Jianping

    2016-03-01

    Digital tomosynthesis is a type of limited angle tomography that allows 3D information to be reconstructed from a set of x-ray projection images taken at various angles using an x-ray tube, a mechanical arm to rotate the tube about the object, and a digital detector. Tomosynthesis reconstruction requires the precise location of the detector with respect to each x-ray source, forcing all current clinical tomosynthesis systems to use a physically coupled source and detector so the geometry is always known and is always the same. This limits the imaging geometries and its large size is impractical for mobile or field operations. To counter this, we have developed a free form tomosynthesis with a decoupled, free-moving source and detector that uses a novel optical method for accurate and real-time geometry calibration to allow for manual, hand-held tomosynthesis and even CT imaging. We accomplish this by using a camera, attached to the source, to track the motion of the source relative to the detector. Attached to the detector is an optical pattern and the image captured by the camera is then used to determine the relative camera/pattern position and orientation by analyzing the pattern distortion and calculating the source positions for each projection, necessary for 3D reconstruction. This allows for portable imaging in the field and also as an inexpensive upgrade to existing 2D systems, such as in developing countries, to provide 3D image data. Here we report the first feasibility demonstrations of free form digital tomosynthesis systems using the method.

  9. Optimization and Comparison of Different Digital Mammographic Tomosynthesis Reconstruction Methods

    DTIC Science & Technology

    2008-04-01

    vuNPSvuNNPS tomo= due to the logarithmic transform in digital tomosynthesis. Hence, the NEQ (f) can be calculated by: )( )()( 22 fNPS fMTFgainfNEQ tomo...f) can be calculated by: )( )()( 22 fNPS fMTFgainfNEQ tomo ⋅ = . After measuring the MTF, NPS and gain factor, one can combine them together to get

  10. Digital breast tomosynthesis (DBT): recommendations from the Italian College of Breast Radiologists (ICBR) by the Italian Society of Medical Radiology (SIRM) and the Italian Group for Mammography Screening (GISMa).

    PubMed

    Bernardi, Daniela; Belli, Paolo; Benelli, Eva; Brancato, Beniamino; Bucchi, Lauro; Calabrese, Massimo; Carbonaro, Luca A; Caumo, Francesca; Cavallo-Marincola, Beatrice; Clauser, Paola; Fedato, Chiara; Frigerio, Alfonso; Galli, Vania; Giordano, Livia; Giorgi Rossi, Paolo; Golinelli, Paola; Morrone, Doralba; Mariscotti, Giovanna; Martincich, Laura; Montemezzi, Stefania; Naldoni, Carlo; Paduos, Adriana; Panizza, Pietro; Pediconi, Federica; Querci, Fiammetta; Rizzo, Antonio; Saguatti, Gianni; Tagliafico, Alberto; Trimboli, Rubina M; Zappa, Marco; Zuiani, Chiara; Sardanelli, Francesco

    2017-05-25

    This position paper, issued by ICBR/SIRM and GISMa, summarizes the evidence on DBT and provides recommendations for its use. In the screening setting, DBT in adjunct to digital mammography (DM) increased detection rate by 0.5-2.7‰ and decreased false positives by 0.8-3.6% compared to DM alone in observational and double-testing experimental studies. The reduction in recall rate could be less prominent in those screening programs which already have low recall rates with DM. The increase in radiation exposure associated with DM/DBT protocols has been solved by the introduction of synthetic mammograms (sDM) reconstructed from DBT datasets. Thus, whenever possible, sDM/DBT should be preferred to DM/DBT. However, before introducing DBT as a routine screening tool for average-risk women, we should wait for the results of randomized controlled trials and for a statistically significant and clinically relevant reduction in the interval cancer rate, hopefully associated with a reduction in the advanced cancer rate. Otherwise, a potential for overdiagnosis and overtreatment cannot be excluded. Studies exploring this issue are ongoing. Screening of women at intermediate risk should follow the same recommendations, with particular protocols for women with previous BC history. In high-risk women, if mammography is performed as an adjunct to MRI or in the case of MRI contraindications, sDM/DBT protocols are suggested. Evidence exists in favor of DBT usage in women with clinical symptoms/signs and asymptomatic women with screen-detected findings recalled for work-up. The possibility to perform needle biopsy or localization under DBT guidance should be offered when DBT-only findings need characterization or surgery.

  11. Tomosynthesis Breast Imaging: Early Detection and Characterization of Breast Cancer

    DTIC Science & Technology

    1999-07-01

    developed phantoms and to quantitate tomosynthesis image quality parameters by using image post processing. Moreover we have further improved the...contrast lesion detection characteristics of our digital mammography system capable of tomosynthesis and did a comparison with a - conventional film/screen technique.

  12. Effect of radiologists' experience on breast cancer detection and localization using digital breast tomosynthesis.

    PubMed

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

    2015-02-01

    The objectives are To to compare the diagnostic performance of combined digital breast tomosynthesis (DBT) and digital mammography (DM) with that of DM alone, as a function of radiologists' experience with DBT. Ethical committee approval was obtained. Fifty cases (27 cancer, 23 normal), each containing both digital mammography (DM) and digital breast tomosynthesis (DBT) images, were reviewed by 26 radiologists, divided into three groups according to level of experience with DBT (none, workshop experience, and clinical experience). The radiologists' diagnostic performance using DM was compared with that using DM + DBT, and evaluated by area under receiver-operating characteristic curve (AUC), jackknife free-response receiver-operator characteristics figure of metric (JAFROC FOM), sensitivity, location sensitivity, and specificity. For all readers combined, performance using DM + DBT was significantly higher than for DM alone by both AUC (0.788 vs 0.681, p < 0.001) and JAFROC FOM (0.745 vs 0.621, p < 0.001). Similar results were obtained for readers with no DBT experience (AUC 0.775 vs 0.682, p = 0.004; JAFROC FOM 0.695 vs 0.603, p = 0.016) and with clinical DBT experience (AUC 0.789 vs 0.681, p = 0.042; and JAFROC FOM 0.764 vs 0.632, p = 0.031). Addition of DBT to DM significantly improves radiologists' diagnostic performance whether or not they have prior DBT experience. • Adding DBT to DM increased the number of detected cancers • DBT + DM led to more accurate localization of breast cancers than DM • Addition of DBT improved radiologists' performance regardless of prior DBT experience • High-volume radiologists with different DBT experience levels performed similarly on DM + DBT.

  13. Clinical Study of Orthogonal-View Phase-Matched Digital Tomosynthesis for Lung Tumor Localization.

    PubMed

    Zhang, You; Ren, Lei; Vergalasova, Irina; Yin, Fang-Fang

    2017-01-01

    Compared to cone-beam computed tomography, digital tomosynthesis imaging has the benefits of shorter scanning time, less imaging dose, and better mechanical clearance for tumor localization in radiation therapy. However, for lung tumors, the localization accuracy of the conventional digital tomosynthesis technique is affected by the lack of depth information and the existence of lung tumor motion. This study investigates the clinical feasibility of using an orthogonal-view phase-matched digital tomosynthesis technique to improve the accuracy of lung tumor localization. The proposed orthogonal-view phase-matched digital tomosynthesis technique benefits from 2 major features: (1) it acquires orthogonal-view projections to improve the depth information in reconstructed digital tomosynthesis images and (2) it applies respiratory phase-matching to incorporate patient motion information into the synthesized reference digital tomosynthesis sets, which helps to improve the localization accuracy of moving lung tumors. A retrospective study enrolling 14 patients was performed to evaluate the accuracy of the orthogonal-view phase-matched digital tomosynthesis technique. Phantom studies were also performed using an anthropomorphic phantom to investigate the feasibility of using intratreatment aggregated kV and beams' eye view cine MV projections for orthogonal-view phase-matched digital tomosynthesis imaging. The localization accuracy of the orthogonal-view phase-matched digital tomosynthesis technique was compared to that of the single-view digital tomosynthesis techniques and the digital tomosynthesis techniques without phase-matching. The orthogonal-view phase-matched digital tomosynthesis technique outperforms the other digital tomosynthesis techniques in tumor localization accuracy for both the patient study and the phantom study. For the patient study, the orthogonal-view phase-matched digital tomosynthesis technique localizes the tumor to an average (± standard

  14. Stationary digital chest tomosynthesis for coronary artery calcium scoring

    NASA Astrophysics Data System (ADS)

    Wu, Gongting; Wang, Jiong; Potuzko, Marci; Harman, Allison; Pearce, Caleb; Shan, Jing; Lee, Yueh Z.; Zhou, Otto; Lu, Jianping

    2016-03-01

    The coronary artery calcium score (CACS) measures the buildup of calcium on the coronary artery wall and has been shown to be an important predictor of the risk of coronary artery diseases (CAD). Currently CACS is measured using CT, though the relatively high cost and high radiation dose has limited its adoption as a routine screening procedure. Digital Chest Tomosynthesis (DCT), a low dose and low cost alternative to CT, and has been shown to achieve 90% of sensitivity of CT in lung disease screening. However commercial DCT requires long scanning time and cannot be adapted for high resolution gated cardiac imaging, necessary for CACS. The stationary DCT system (s- DCT), developed in our lab, has the potential to significantly shorten the scanning time and enables high resolution cardiac gated imaging. Here we report the preliminary results of using s-DCT to estimate the CACS. A phantom heart model was developed and scanned by the s-DCT system and a clinical CT in a phantom model with realistic coronary calcifications. The adapted fan-beam volume reconstruction (AFVR) method, developed specifically for stationary tomosynthesis systems, is used to obtain high resolution tomosynthesis images. A trained cardiologist segmented out the calcifications and the CACS was obtained. We observed a strong correlation between the tomosynthesis derived CACS and CT CACS (r2 = 0.88). Our results shows s-DCT imaging has the potential to estimate CACS, thus providing a possible low cost and low dose imaging protocol for screening and monitoring CAD.

  15. Stationary Digital Tomosynthesis System for Early Detection of Breast Tumors

    DTIC Science & Technology

    2012-05-01

    PLEASE DO NOT RETURN YOUR FORM TO THE ABOVE ADDRESS. 1. REPORT DATE (DD-MM-YYYY) 2. REPORT TYPE 3. DATES COVERED (From - To) 4 . TITLE AND SUBTITLE...Early detection is considered as the best hope for decreasing the mortality rate from breast cancer [1- 4 ]. Digital breast tomosynthesis (DBT) has the...and collimators can be installed on the tube housing. Figure 1. Front and back views of the CNT x-ray source array. 4 1.3 System

  16. Semi-automated segmentation and classification of digital breast tomosynthesis reconstructed images.

    PubMed

    Vedantham, Srinivasan; Shi, Linxi; Karellas, Andrew; Michaelsen, Kelly E; Krishnaswamy, Venkataramanan; Pogue, Brian W; Paulsen, Keith D

    2011-01-01

    Digital breast tomosynthesis (DBT) is a limited-angle tomographic x-ray imaging technique that reduces the effect of tissue superposition observed in planar mammography. An integrated imaging platform that combines DBT with near infrared spectroscopy (NIRS) to provide co-registered anatomical and functional imaging is under development. Incorporation of anatomic priors can benefit NIRS reconstruction. In this work, we provide a segmentation and classification method to extract potential lesions, as well as adipose, fibroglandular, muscle and skin tissue in reconstructed DBT images that serve as anatomic priors during NIRS reconstruction. The method may also be adaptable for estimating tumor volume, breast glandular content, and for extracting lesion features for potential application to computer aided detection and diagnosis.

  17. Workload and transmission data for the installation of a digital breast tomosynthesis system

    SciTech Connect

    Li Xinhua; Zhang Da; Liu, Bob

    2013-06-15

    Purpose: Digital breast tomosynthesis (DBT) differs from conventional mammography in target/filter, kVp range, and imaging geometry. The aim of this study was to assess the breast input exposure of a DBT system by completing a workload survey of DBT installations, and to determine the parameters {alpha}, {beta}, and {gamma} in the Archer equation for the primary radiation generated by the clinical workload distributions. Methods: The authors conducted a retrospective survey of the x-ray breast imaging performed between September 2011 and September 2012 in three clinical DBT rooms equipped with Selenia Dimensions systems (Hologic Inc., Bedford, MA). A total of 343 examinations were analyzed to calculate the workload (mA-minute) and the primary air kerma at 1 m from the source (K{sup 1}). Transmission curves were calculated for the primary radiation generated by the workload distributions of the DBT rooms, and were fitted to the Archer equation. Results: There were large variations in patient volume and workload in the three examination rooms. In all these rooms, the average tube voltage (kVp) was about 31, the average K{sup 1} per patient was 16-21 mGy, and the average mA-minute per patient was 1.4-2.2 times higher than that of the mammography room described in NCRP Report No. 147. Most DBT screening examinations consisted of four two-dimensional mammographic views plus four tomosynthesis scans; the numbers of views acquired in diagnostic examinations varied widely. Tomosynthesis scans contributed about 30% of total mA-minute and about 50% of K{sup 1}. For the primary radiation generated by the clinical workload distributions, {alpha} was similar to that of 40-45 kVp W/Al (target/filter), and {alpha}+{beta} was similar to that of 30 kVp W/Al. Conclusions: The workload (mA-minute and K{sup 1}) distributions of mammographic examinations with DBT differ from conventional mammography. A field survey of patient volume and x-ray tube usage is important for the shielding

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

    NASA Astrophysics Data System (ADS)

    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.

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

    PubMed

    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

  20. Digital Mammography with Storage Phosphors

    DTIC Science & Technology

    1993-12-31

    of the data). Phanto imag Image quality of a mammographic unit is often checked with phantoms simulating a breast with the three major disease ...1981; 138:219-22. 28. Andersson I, Andren L, HildelU J, Linell F, Ljungqvist U, Pettersson H: Breast cancer screening with mammography. Radiology...breast scanner (CT/M) in diagnosis of breast diseases . Radiology 1979; 132:647-52. 47. Gisvold JJ,Karsell PR, Reese DF: Computerized tomographic

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

    NASA Astrophysics Data System (ADS)

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

    2014-11-01

    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.

  2. Digital Mammography: Improvements in Breast Cancer Diagnostic

    SciTech Connect

    Montano Zetina, Luis Manuel

    2006-01-06

    X-ray mammography is the most sensitive imaging technique for early detection of breast cancer (diagnostics). It is performed by a radiological system equipped with a rotating molybdenum (Mo) anode tube with an additional Mo filter. In the production of X-ray, bremsstrahlung photons produce an intense diffuse radiation, affecting the contrast between normal and cancerous tissue. So it is known that a good mammographic imaging can help to detect cancer in the first stages avoiding surgery, amputation or even death. In the last years there has been some developments in new imaging techniques to improve the contrast spatial resolution between different tissues: digital imaging, or the so call digital mammography. Digital mammographic imaging is considered an improvement in the prevention of breast cancer due to the advantages it offers.

  3. Digital Mammography: Improvements in Breast Cancer Diagnostic

    NASA Astrophysics Data System (ADS)

    Montaño Zetina, Luis Manuel

    2006-01-01

    X-ray mammography is the most sensitive imaging technique for early detection of breast cancer (diagnostics). It is performed by a radiological system equipped with a rotating molybdenum (Mo) anode tube with an additional Mo filter. In the production of X-ray, bremsstrahlung photons produce an intense diffuse radiation, affecting the contrast between normal and cancerous tissue. So it is known that a good mammographic imaging can help to detect cancer in the first stages avoiding surgery, amputation or even death. In the last years there has been some developments in new imaging techniques to improve the contrast spatial resolution between different tissues: digital imaging, or the so call digital mammography. Digital mammographic imaging is considered an improvement in the prevention of breast cancer due to the advantages it offers.

  4. A comparison of reconstruction algorithms for C-arm mammography tomosynthesis

    SciTech Connect

    Rakowski, Joseph T.; Dennis, Michael J.

    2006-08-15

    Digital tomosynthesis is an imaging technique to produce a tomographic image from a series of angular digital images in a manner similar to conventional focal plane tomography. Unlike film focal plane tomography, the acquisition of the data in a C-arm geometry causes the image receptor to be positioned at various angles to the reconstruction tomogram. The digital nature of the data allows for input images to be combined into the desired plane with the flexibility of generating tomograms of many separate planes from a single set of input data. Angular datasets were obtained of a low contrast detectability (LCD) phantom and cadaver breast utilizing a Lorad stereotactic biopsy unit with a coupled source and digital detector in a C-arm configuration. Datasets of 9 and 41 low-dose projections were collected over a 30 deg. angular range. Tomographic images were reconstructed using a Backprojection (BP) algorithm, an Iterative Subtraction (IS) algorithm that allows the partial subtraction of out-of-focus planes, and an Algebraic Reconstruction (AR) algorithm. These were compared with single view digital radiographs. The methods' effectiveness at enhancing visibility of an obscured LCD phantom was quantified in terms of the Signal to Noise Ratio (SNR), and Signal to Background Ratio (SBR), all normalized to the metric value for the single projection image. The methods' effectiveness at removing ghosting artifacts in a cadaver breast was quantified in terms of the Artifact Spread Function (ASF). The technology proved effective at partially removing out of focus structures and enhancing SNR and SBR. The normalized SNR was highest at 4.85 for the obscured LCD phantom, using nine projections and IS algorithm. The normalized SBR was highest at 23.2 for the obscured LCD phantom, using 41 projections and an AR algorithm. The highest normalized metric values occurred with the obscured phantom. This supports the assertion that the greatest value of tomosynthesis is in imaging

  5. Discrepancies between film and digital mammography interpretations

    NASA Astrophysics Data System (ADS)

    Malhotra, Poonam; Kallergi, Maria; Alexander, Dominik; Berman, Claudia G.; Gardner, Mary; Hersh, Marla R.; Hooper, Lisa; Kim, Jihai J.; Venugopal, Priya

    2002-04-01

    The purpose of this study was to evaluate the frequency and reasons of disagreement between film and full-field digital mammography (FFDM) interpretations observed in a prospective clinical trial performed with the GE Senographe 2000D system. The data from 643 mammography examinations comprising both digital and film mammograms were analyzed for this purpose. Reports indicated that 455 findings were identified on the digital softcopy reading and 457 findings on the standard film mammography with 408 discrepancies. Findings with discrepancies were matched and analyzed. A reason was identified and a relative conspicuity score of 0 to 10 was assigned to each finding at the time of resolution; 0 corresponded to a finding highly conspicuous on digital, 10 to a finding highly conspicuous on film, and 5 denoted equal visibility on both. After review, agreement was established between the two modalities in 73.3% of the findings; 13.5% of findings were seen better on digital and 13.2% of the findings were seen better on film. Approximately 63% of the discrepancies occurred due to variability in the reporting style of the radiologists and/or unavailability of prior films for comparison. Three cancer cases were identified in this study; two were seen on both modalities and one only on film. In conclusion, no statistically significant differences were observed between digital and film mammography, a result that despite the small size of our dataset is in agreement with previous reports. Inter-observer variability, display differences, and presentation disagreements are the main reasons for interpretation differences that are primarily identified in the classification and BIRADS assignment.

  6. Digital mammography: physical principles and future applications.

    PubMed

    Gambaccini, Mauro; Baldelli, Paola

    2003-01-01

    Mammography is currently considered the best tool for the detection of breast cancer, pathology with a rate of incidence in constant increase. To produce the radiological picture a screen film combination is conventionally used. One of the inherent limitations of screen- film combination is the fact that the detection, display and storage processes are one and the same, making it impossible to separately optimize each stage. These limitations can be overcome with digital systems. In this work we evaluate the main characteristics of digital detectors available on the market and we compare the performance of digital and conventional systems. Digital mammography, due to the possibility to process images, offers many potential advantages, among these the possibility to introduce the dual-energy technique which employs the composition of two digital images obtained with two different energies to enhance the inherent contrast of pathologies by removing the uniform background. This technique was previously tested by using synchrotron monochromatic beam and a digital detector, and then the Senographe 2000D full-field digital system manufactured by GE Medical Systems. In this work we present preliminary results and the future applications of this technique.

  7. Breast cancers detected in only one of two arms of a tomosynthesis (3D-mammography) population screening trial (STORM-2).

    PubMed

    Bernardi, Daniela; Houssami, Nehmat

    2017-04-01

    The prospective 'screening with tomosynthesis or standard mammography-2 (STORM-2)' trial compared mammography screen-reading strategies and showed that each of integrated 2D/3D-mammography or 2Dsynthetic/3D-mammography detected significantly more breast cancers than 2D-mammography alone. This short report describes 13 (from 90) cancers detected in only one of two parallel double-reading arms implemented in STORM-2. Amongst this subset of cases, the majority was invasive cancer ≤16 mm, mostly depicted as irregular masses or distortions. Furthermore, most were detected at 3D-mammography only and predominantly by one reader from double-reading pairs, highlighting that 3D-mammography may enable detection of cancers that are challenging to perceive at routine screening.

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

    PubMed

    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 (P<0.05). The area under FFDM ROC curve is 0.805, while that is 0.941 in COMBO pattern. COMBO shows relation of mass with the surrounding tissues, the calcification in the mass, and multiple foci clearly in breast cancer tissues. The optimal sensitivity of cut-off value in COMBO pattern is 82.9%, which is higher than that in FFDM (60%). They share the same specificity which is both 93.2%. Digital Breast Tomosynthesis (DBT) could be used for the BI-RADS classification in breast cancer in clinical.

  9. Detection of soft tissue densities from digital breast tomosynthesis: comparison of conventional and deep learning approaches

    NASA Astrophysics Data System (ADS)

    Fotin, Sergei V.; Yin, Yin; Haldankar, Hrishikesh; Hoffmeister, Jeffrey W.; Periaswamy, Senthil

    2016-03-01

    Computer-aided detection (CAD) has been used in screening mammography for many years and is likely to be utilized for digital breast tomosynthesis (DBT). Higher detection performance is desirable as it may have an impact on radiologist's decisions and clinical outcomes. Recently the algorithms based on deep convolutional architectures have been shown to achieve state of the art performance in object classification and detection. Similarly, we trained a deep convolutional neural network directly on patches sampled from two-dimensional mammography and reconstructed DBT volumes and compared its performance to a conventional CAD algorithm that is based on computation and classification of hand-engineered features. The detection performance was evaluated on the independent test set of 344 DBT reconstructions (GE SenoClaire 3D, iterative reconstruction algorithm) containing 328 suspicious and 115 malignant soft tissue densities including masses and architectural distortions. Detection sensitivity was measured on a region of interest (ROI) basis at the rate of five detection marks per volume. Moving from conventional to deep learning approach resulted in increase of ROI sensitivity from 0:832 +/- 0:040 to 0:893 +/- 0:033 for suspicious ROIs; and from 0:852 +/- 0:065 to 0:930 +/- 0:046 for malignant ROIs. These results indicate the high utility of deep feature learning in the analysis of DBT data and high potential of the method for broader medical image analysis tasks.

  10. Initial clinical evaluation of stationary digital chest tomosynthesis

    NASA Astrophysics Data System (ADS)

    Hartman, Allison E.; Shan, Jing; Wu, Gongting; Lee, Yueh Z.; Zhou, Otto; Lu, Jianping; Heath, Michael; Wang, Xiaohui; Foos, David

    2016-03-01

    Computed Tomography (CT) is the gold standard for image evaluation of lung disease, including lung cancer and cystic fibrosis. It provides detailed information of the lung anatomy and lesions, but at a relatively high cost and high dose of radiation. Chest radiography is a low dose imaging modality but it has low sensitivity. Digital chest tomosynthesis (DCT) is an imaging modality that produces 3D images by collecting x-ray projection images over a limited angle. DCT is less expensive than CT and requires about 1/10th the dose of radiation. Commercial DCT systems acquire the projection images by mechanically scanning an x-ray tube. The movement of the tube head limits acquisition speed. We recently demonstrated the feasibility of stationary digital chest tomosynthesis (s-DCT) using a carbon nanotube (CNT) x-ray source array in benchtop phantom studies. The stationary x-ray source allows for fast image acquisition. The objective of this study is to demonstrate the feasibility of s-DCT for patient imaging. We have successfully imaged 31 patients. Preliminary evaluation by board certified radiologists suggests good depiction of thoracic anatomy and pathology.

  11. Wavelet Representations for Digital Mammography.

    DTIC Science & Technology

    1994-12-15

    Gaussian low-pass filtering. In addition, a digital image editor is described that allows radiologists to interactively indicate on computer screens...masses. spicules and microcalcifications. Finally, we report on the development of objective ways to assess the performance of wavelet image

  12. Position paper: recommendations for a digital mammography quality assurance program V4.0.

    PubMed

    Heggie, J C P; Barnes, P; Cartwright, L; Diffey, J; Tse, J; Herley, J; McLean, I D; Thomson, F J; Grewal, R K; Collins, L T

    2017-09-15

    In 2001 the ACPSEM published a position paper on quality assurance in screen film mammography which was subsequently adopted as a basis for the quality assurance programs of both the Royal Australian and New Zealand College of Radiologists (RANZCR) and of BreastScreen Australia. Since then the clinical implementation of digital mammography has been realised and it has become evident that existing screen-film protocols were not appropriate to assure the required image quality needed for reliable diagnosis or to address the new dose implications resulting from digital technology. In addition, the advantages and responsibilities inherent in teleradiology are most critical in mammography and also need to be addressed. The current document is the result of a review of current overseas practice and local experience in these areas. At this time the technology of digital imaging is undergoing significant development and there is still a lack of full international consensus about some of the detailed quality control (QC) tests that should be included in quality assurance (QA) programs. This document describes the current status in digital mammography QA and recommends test procedures that may be suitable in the Australasian environment. For completeness, this document also includes a review of the QA programs required for the various types of digital biopsy units used in mammography. In the future, international harmonisation of digital quality assurance in mammography and changes in the technology may require a review of this document. Version 2.0 represented the first of these updates and key changes related to image quality evaluation, ghost image evaluation and interpretation of signal to noise ratio measurements. In Version 3.0 some significant changes, made in light of further experience gained in testing digital mammography equipment were introduced. In Version 4.0, further changes have been made, most notably digital breast tomosynthesis (DBT) testing and QC have

  13. Imaging performance of a clinical selenium flat-panel detector for advanced applications in full-field digital mammography

    NASA Astrophysics Data System (ADS)

    Loustauneau, Vincent; Bissonnette, Michel; Cadieux, Sebastien; Hansroul, Marc; Masson, E.; Savard, Serge; Polischuk, Brad T.; Lehtimauki, Mari J.

    2003-06-01

    The advent of digital detectors will enable several advanced imaging applications to be used in the fight against breast cancer. For example, dynamic imaging applications such as tomosynthesis, contrast enhanced and dual energy mammography have demonstrated promising results. In this paper, we will assess the suitability of this detector for these advanced applications. MTF and DQE measurements were performed on a selenium FFDM detector to assess image quality. Ghosting properties of a digital detector are also an important factor, since it can strongly degrade image quality. In this paper, we will also report on the ghosting characteristics of the selenium detector, using typical exposures envisioned to be used in tomosynthesis exams. The physical mechanisms that create ghost images will be discussed and will be quantified.

  14. Breast Cancer: Computer-aided Detection with Digital Breast Tomosynthesis.

    PubMed

    Morra, Lia; Sacchetto, Daniela; Durando, Manuela; Agliozzo, Silvano; Carbonaro, Luca Alessandro; Delsanto, Silvia; Pesce, Barbara; Persano, Diego; Mariscotti, Giovanna; Marra, Vincenzo; Fonio, Paolo; Bert, Alberto

    2015-10-01

    To evaluate a commercial tomosynthesis computer-aided detection (CAD) system in an independent, multicenter dataset. Diagnostic and screening tomosynthesis mammographic examinations (n = 175; cranial caudal and mediolateral oblique) were randomly selected from a previous institutional review board-approved trial. All subjects gave informed consent. Examinations were performed in three centers and included 123 patients, with 132 biopsy-proven screening-detected cancers, and 52 examinations with negative results at 1-year follow-up. One hundred eleven lesions were masses and/or microcalcifications (72 masses, 22 microcalcifications, 17 masses with microcalcifications) and 21 were architectural distortions. Lesions were annotated by radiologists who were aware of all available reports. CAD performance was assessed as per-lesion sensitivity and false-positive results per volume in patients with negative results. Use of the CAD system showed per-lesion sensitivity of 89% (99 of 111; 95% confidence interval: 81%, 94%), with 2.7 ± 1.8 false-positive rate per view, 62 of 72 lesions detected were masses, 20 of 22 were microcalcification clusters, and 17 of 17 were masses with microcalcifications. Overall, 37 of 39 microcalcification clusters (95% sensitivity, 95% confidence interval: 81%, 99%) and 79 of 89 masses (89% sensitivity, 95% confidence interval: 80%, 94%) were detected with the CAD system. On average, 0.5 false-positive rate per view were microcalcification clusters, 2.1 were masses, and 0.1 were masses and microcalcifications. A digital breast tomosynthesis CAD system can allow detection of a large percentage (89%, 99 of 111) of breast cancers manifesting as masses and microcalcification clusters, with an acceptable false-positive rate (2.7 per breast view). Further studies with larger datasets acquired with equipment from multiple vendors are needed to replicate the findings and to study the interaction of radiologists and CAD systems. (©) RSNA, 2015.

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

    PubMed

    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.

  16. Scatter rejection in multislit digital mammography

    SciTech Connect

    Aaslund, Magnus; Cederstroem, Bjoern; Lundqvist, Mats; Danielsson, Mats

    2006-04-15

    The scatter to primary ratio (SPR) was measured on a scanning multislit full-field digital mammography system for different thickness of breast equivalent material and different tube voltages. Scatter within the detector was measured separately and was found to be the major source of scatter in the assembly. Measured total SPRs below 6% are reported for breast range 3-7 cm. The performance of the multislit assembly is compared to other imaging geometries with different scatter rejection schemes by using the scatter detective quantum efficiency.

  17. Adapted fan-beam volume reconstruction for stationary digital breast tomosynthesis

    NASA Astrophysics Data System (ADS)

    Wu, Gongting; Inscoe, Christine; Calliste, Jabari; Lee, Yueh Z.; Zhou, Otto; Lu, Jianping

    2015-03-01

    Digital breast tomosynthesis (DBT) provides 3D images which remove tissue overlapping and enables better cancer detection. Stationary DBT (s-DBT) uses a fixed X-ray source array to eliminate image blur associated with the x-ray tube motion and provides better image quality as well as faster scanning speed. For limited angle tomography, it is known that iterative reconstructions generally produces better images with fewer artifacts. However classical iterative tomosynthesis reconstruction methods are considerably slower than the filtered back-projection (FBP) reconstruction. The linear x-ray source array used in s-DBT enables a computationally more efficient volume reconstruction using adapted fan beam slice sampling, which transforms the 3-D cone beam reconstruction to a series of 2-D fan beam slice reconstructions. In this paper, we report the first results of the adapted fan-beam volume reconstruction (AFVR) for the s-DBT system currently undergoing clinical trial at UNC, using a simultaneous algebraic reconstruction technique (SART). An analytic breast phantom is used to quantitatively analyze the performance of the AFVR. Image quality of a CIRS biopsy phantom reconstructed using the AFVR method are compared to that using FBP algorithm with a commercial package. Our results show a significant reduction in memory usage and an order of magnitude speed increase in reconstructing speed using AFVR compared to that of classical 3-D cone beam reconstruction. We also observed that images reconstructed by AFVR with SART had a better sharpness and contrast compared to that using FBP. Preliminary results on patient images demonstrates the improved detectability of the s-DBT system over the mammography. By utilizing parallel computing with graphics processing unit (GPU), it is expected that the AFVR method will enable iterative reconstruction technique to be practical for clinical applications.

  18. A task-based comparison of two reconstruction algorithms for digital breast tomosynthesis

    NASA Astrophysics Data System (ADS)

    Mahadevan, Ravi; Ikejimba, Lynda C.; Lin, Yuan; Samei, Ehsan; Lo, Joseph Y.

    2014-03-01

    Digital breast tomosynthesis (DBT) generates 3-D reconstructions of the breast by taking X-Ray projections at various angles around the breast. DBT improves cancer detection as it minimizes tissue overlap that is present in traditional 2-D mammography. In this work, two methods of reconstruction, filtered backprojection (FBP) and the Newton-Raphson iterative reconstruction were used to create 3-D reconstructions from phantom images acquired on a breast tomosynthesis system. The task based image analysis method was used to compare the performance of each reconstruction technique. The task simulated a 10mm lesion within the breast containing iodine concentrations between 0.0mg/ml and 8.6mg/ml. The TTF was calculated using the reconstruction of an edge phantom, and the NPS was measured with a structured breast phantom (CIRS 020) over different exposure levels. The detectability index d' was calculated to assess image quality of the reconstructed phantom images. Image quality was assessed for both conventional, single energy and dual energy subtracted reconstructions. Dose allocation between the high and low energy scans was also examined. Over the full range of dose allocations, the iterative reconstruction yielded a higher detectability index than the FBP for single energy reconstructions. For dual energy subtraction, detectability index was maximized when most of the dose was allocated to the high energy image. With that dose allocation, the performance trend for reconstruction algorithms reversed; FBP performed better than the corresponding iterative reconstruction. However, FBP performance varied very erratically with changing dose allocation. Therefore, iterative reconstruction is preferred for both imaging modalities despite underperforming dual energy FBP, as it provides stable results.

  19. Fusion of digital breast tomosynthesis images via wavelet synthesis for improved lesion conspicuity

    NASA Astrophysics Data System (ADS)

    Hariharan, Harishwaran; Pomponiu, Victor; Zheng, Bin; Whiting, Bruce; Gur, David

    2014-03-01

    Full-field digital mammography (FFDM) is the most common screening procedure for detecting early breast cancer. However, due to complications such as overlapping breast tissue in projection images, the efficacy of FFDM reading is reduced. Recent studies have shown that digital breast tomosynthesis (DBT), in combination with FFDM, increases detection sensitivity considerably while decreasing false-positive, recall rates. There is a huge interest in creating diagnostically accurate 2-D interpretations from the DBT slices. Most of the 2-D syntheses rely on visualizing the maximum intensities (brightness) from each slice through different methods. We propose a wavelet based fusion method, where we focus on preserving holistic information from larger structures such as masses while adding high frequency information that is relevant and helpful for diagnosis. This method enables the spatial generation of a 2D image from a series of DBT images, each of which contains both smooth and coarse structures distributed in the wavelet domain. We believe that the wavelet-synthesized images, generated from their DBT image datasets, provide radiologists with improved lesion and micro-calcification conspicuity as compared with FFDM images. The potential impact of this fusion method is (1) Conception of a device-independent, data-driven modality that increases the conspicuity of lesions, thereby facilitating early detection and potentially reducing recall rates; (2) Reduction of the accompanying radiation dose to the patient.

  20. Dual-energy contrast enhanced digital breast tomosynthesis: concept, method, and evaluation on phantoms

    NASA Astrophysics Data System (ADS)

    Puong, Sylvie; Patoureaux, Fanny; Iordache, Razvan; Bouchevreau, Xavier; Muller, Serge

    2007-03-01

    In this paper, we present the development of dual-energy Contrast-Enhanced Digital Breast Tomosynthesis (CEDBT). A method to produce background clutter-free slices from a set of low and high-energy projections is introduced, along with a scheme for the determination of the optimal low and high-energy techniques. Our approach consists of a dual-energy recombination of the projections, with an algorithm that has proven its performance in Contrast-Enhanced Digital Mammography1 (CEDM), followed by an iterative volume reconstruction. The aim is to eliminate the anatomical background clutter and to reconstruct slices where the gray level is proportional to the local iodine volumetric concentration. Optimization of the low and high-energy techniques is performed by minimizing the total glandular dose to reach a target iodine Signal Difference to Noise Ratio (SDNR) in the slices. In this study, we proved that this optimization could be done on the projections, by consideration of the SDNR in the projections instead of the SDNR in the slices, and verified this with phantom measurements. We also discuss some limitations of dual-energy CEDBT, due to the restricted angular range for the projection views, and to the presence of scattered radiation. Experiments on textured phantoms with iodine inserts were conducted to assess the performance of dual-energy CEDBT. Texture contrast was nearly completely removed and the iodine signal was enhanced in the slices.

  1. Detection of mammographically occult architectural distortion on digital breast tomosynthesis screening: initial clinical experience.

    PubMed

    Partyka, Luke; Lourenco, Ana P; Mainiero, Martha B

    2014-07-01

    Digital breast tomosynthesis (DBT) has been shown to improve the sensitivity of screening mammography. DBT may have the most potential impact in cases of subtle mammographic findings such as architectural distortion (AD). The objective of our study was to determine whether DBT provides better visualization of AD than digital mammography (DM) and whether sensitivity for cancer detection is increased by the addition of DBT as it relates to cases of mammographically occult AD. Retrospective review of BI-RADS category 0 reports from 9982 screening DM examinations with adjunct DBT were searched for the term "architectural distortion" and were reviewed in consensus by three radiologists. ADs were classified by whether they were seen better on DM or DBT, were seen equally well on both, or were occult on either modality. The electronic medical record was reviewed to identify additional imaging studies, biopsy results, and surgical excision pathology results. Review identified 26 cases of AD, 19 (73%) of which were seen only on the DBT images. Of the remaining seven ADs, six were seen better on DBT than DM. On diagnostic workup, nine lesions were assigned to BI-RADS category 4 or 5. Surgical pathology revealed two invasive carcinomas, two ductal carcinoma in situ lesions, three radial scars, and two lesions showing atypia. The cancer detection rate of DBT in mammographically occult AD was 21% (4/19). The positive predictive value of biopsy was 44%. DBT provides better visualization of AD than DM and identifies a subset of ADs that are occult on DM. Identification of additional ADs on DBT increases the cancer detection rate.

  2. Breast percent density estimation from 3D reconstructed digital breast tomosynthesis images

    NASA Astrophysics Data System (ADS)

    Bakic, Predrag R.; Kontos, Despina; Carton, Ann-Katherine; Maidment, Andrew D. A.

    2008-03-01

    Breast density is an independent factor of breast cancer risk. In mammograms breast density is quantitatively measured as percent density (PD), the percentage of dense (non-fatty) tissue. To date, clinical estimates of PD have varied significantly, in part due to the projective nature of mammography. Digital breast tomosynthesis (DBT) is a 3D imaging modality in which cross-sectional images are reconstructed from a small number of projections acquired at different x-ray tube angles. Preliminary studies suggest that DBT is superior to mammography in tissue visualization, since superimposed anatomical structures present in mammograms are filtered out. We hypothesize that DBT could also provide a more accurate breast density estimation. In this paper, we propose to estimate PD from reconstructed DBT images using a semi-automated thresholding technique. Preprocessing is performed to exclude the image background and the area of the pectoral muscle. Threshold values are selected manually from a small number of reconstructed slices; a combination of these thresholds is applied to each slice throughout the entire reconstructed DBT volume. The proposed method was validated using images of women with recently detected abnormalities or with biopsy-proven cancers; only contralateral breasts were analyzed. The Pearson correlation and kappa coefficients between the breast density estimates from DBT and the corresponding digital mammogram indicate moderate agreement between the two modalities, comparable with our previous results from 2D DBT projections. Percent density appears to be a robust measure for breast density assessment in both 2D and 3D x-ray breast imaging modalities using thresholding.

  3. Digital mammography, cancer screening: Factors important for image compression

    NASA Technical Reports Server (NTRS)

    Clarke, Laurence P.; Blaine, G. James; Doi, Kunio; Yaffe, Martin J.; Shtern, Faina; Brown, G. Stephen; Winfield, Daniel L.; Kallergi, Maria

    1993-01-01

    The use of digital mammography for breast cancer screening poses several novel problems such as development of digital sensors, computer assisted diagnosis (CAD) methods for image noise suppression, enhancement, and pattern recognition, compression algorithms for image storage, transmission, and remote diagnosis. X-ray digital mammography using novel direct digital detection schemes or film digitizers results in large data sets and, therefore, image compression methods will play a significant role in the image processing and analysis by CAD techniques. In view of the extensive compression required, the relative merit of 'virtually lossless' versus lossy methods should be determined. A brief overview is presented here of the developments of digital sensors, CAD, and compression methods currently proposed and tested for mammography. The objective of the NCI/NASA Working Group on Digital Mammography is to stimulate the interest of the image processing and compression scientific community for this medical application and identify possible dual use technologies within the NASA centers.

  4. Application of digital tomosynthesis in diagnosing the fractures or dislocations in irregular bones and regions with complex structures.

    PubMed

    Tuerdi, Batuer; Wang, Hui; Zhang, Ying; Zhou, Hao; Zhang, Hao

    2015-01-01

    The application potential of digital tomosynthesis in diagnosing fractures or dislocations in irregular bones and regions with complex structures was evaluated. Digital radiography and tomosynthesis were performed in 121 patients, and the image quality, accuracy, sensitivity, and specificity were compared. The number of participants with a definite diagnosis of fracture and/or dislocation was 98. The ratio of excellent images, accuracy, sensitivity, and specificity of digital tomosynthesis were higher than that of direct radiography. Digital tomosynthesis could be applied in the diagnosis of fractures or dislocations in irregular bones and regions with complex structures. Copyright © 2015 Elsevier Inc. All rights reserved.

  5. Optimization of Image Quality and Dose in Digital Mammography.

    PubMed

    Fausto, Agnes M F; Lopes, M C; de Sousa, M C; Furquim, Tânia A C; Mol, Anderson W; Velasco, Fermin G

    2017-04-01

    Nowadays, the optimization in digital mammography is one of the most important challenges in diagnostic radiology. The new digital technology has introduced additional elements to be considered in this scenario. A major goal of mammography is related to the detection of structures on the order of micrometers (μm) and the need to distinguish the different types of tissues, with very close density values. The diagnosis in mammography faces the difficulty that the breast tissues and pathological findings have very close linear attenuation coefficients within the energy range used in mammography. The aim of this study was to develop a methodology for optimizing exposure parameters of digital mammography based on a new Figure of Merit: FOM ≡ (IQFinv)(2)/AGD, considering the image quality and dose. The study was conducted using the digital mammography Senographe DS/GE, and CDMAM and TORMAM phantoms. The characterization of clinical practice, carried out in the mammography system under study, was performed considering different breast thicknesses, the technical parameters of exposure, and processing options of images used by the equipment's automatic exposure system. The results showed a difference between the values of the optimized parameters and those ones chosen by the automatic system of the mammography unit, specifically for small breast. The optimized exposure parameters showed better results than those obtained by the automatic system of the mammography, for the image quality parameters and its impact on detection of breast structures when analyzed by radiologists.

  6. Clinical Optimization of Current Digital Mammography Systems (Breast Cancer)

    DTIC Science & Technology

    1994-01-20

    AD-A280 249 ’ •) AD_______ GRANT NO: DAMD17-93-J-3008 TITLE: CLINICAL OPTIMIZATION OF CURRENT DIGITAL MAMMOGRAPHY SYSTEMS (BREAST CANCER ) PRINCIPAL...Current Digital Mammography Systems (Breast Cancer ) Grant No. 6 . _ _ _ _ _ _ __ D A M D 1 7 - 9 3 - J - 3 0 0 8 AUTH•OR(S) Matthew T. Freedman, M.D...will be continuing our research with a 42 micron film digitizer when a machine arrives at our site early in 1994. Breast Cancer , Mammography, Digital

  7. Wavelet denoising for quantum noise removal in chest digital tomosynthesis.

    PubMed

    Gomi, Tsutomu; Nakajima, Masahiro; Umeda, Tokuo

    2015-01-01

    Quantum noise impairs image quality in chest digital tomosynthesis (DT). A wavelet denoising processing algorithm for selectively removing quantum noise was developed and tested. A wavelet denoising technique was implemented on a DT system and experimentally evaluated using chest phantom measurements including spatial resolution. Comparison was made with an existing post-reconstruction wavelet denoising processing algorithm reported by Badea et al. (Comput Med Imaging Graph 22:309-315, 1998). The potential DT quantum noise decrease was evaluated using different exposures with our technique (pre-reconstruction and post-reconstruction wavelet denoising processing via the balance sparsity-norm method) and the existing wavelet denoising processing algorithm. Wavelet denoising processing algorithms such as the contrast-to-noise ratio (CNR), root mean square error (RMSE) were compared with and without wavelet denoising processing. Modulation transfer functions (MTF) were evaluated for the in-focus plane. We performed a statistical analysis (multi-way analysis of variance) using the CNR and RMSE values. Our wavelet denoising processing algorithm significantly decreased the quantum noise and improved the contrast resolution in the reconstructed images (CNR and RMSE: pre-balance sparsity-norm wavelet denoising processing versus existing wavelet denoising processing, P<0.05; post-balance sparsity-norm wavelet denoising processing versus existing wavelet denoising processing, P<0.05; CNR: with versus without wavelet denoising processing, P<0.05). The results showed that although MTF did not vary (thus preserving spatial resolution), the existing wavelet denoising processing algorithm caused MTF deterioration. A balance sparsity-norm wavelet denoising processing algorithm for removing quantum noise in DT was demonstrated to be effective for certain classes of structures with high-frequency component features. This denoising approach may be useful for a variety of clinical

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

    PubMed

    Kamal, Izdihar; Chelliah, Kanaga K; Mustafa, Nawal

    2015-05-01

    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. 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. 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. 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.

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

    PubMed Central

    Kamal, Izdihar; Chelliah, Kanaga K.; Mustafa, Nawal

    2015-01-01

    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. PMID:26052465

  10. Breast cancer detection using single-reading of breast tomosynthesis (3D-mammography) compared to double-reading of 2D-mammography: Evidence from a population-based trial.

    PubMed

    Houssami, Nehmat; Bernardi, Daniela; Pellegrini, Marco; Valentini, Marvi; Fantò, Carmine; Ostillio, Livio; Tuttobene, Paolina; Luparia, Andrea; Macaskill, Petra

    2017-04-01

    Most population breast cancer (BC) screening programs use double-reading of 2D-mammography. We recently reported the screening with tomosynthesis or standard mammography-2 (STORM-2) trial, showing that double-read tomosynthesis (pseudo-3D-mammography) detected more BC than double-read 2D-mammography. In this study, we compare screen-detection measures for single-reading of 3D-mammography with those for double-reading of 2D-mammography, to inform screening practice. This is a secondary analysis based on STORM-2 which prospectively compared 3D-mammography and 2D-mammography in sequential screen-readings. Asymptomatic women ≥49 years who attended population-based screening (Trento, 2013-2015) were recruited. Participants recalled at any screen-read from parallel double-reading arms underwent further testing and/or biopsy. Single-reading of 3D-mammography, integrated with acquired or synthetized 2D-mammograms, was compared to double-reading of 2D-mammograhy alone for screen-detection measures: number of detected BCs, cancer detection rate (CDR), number and percentage of false-positive recall (FPR). Paired binary data were compared using McNemar's test. Screening detected 90, including 74 invasive, BCs in 85 of 9672 participants. CDRs for single-reading using integrated 2D/3D-mammography (8.2 per 1000 screens; 95% CI 6.5-10.2) or 2D synthetic/3D-mammography (8.4 per 1000 screens; 95% CI: 6.7-10.4) were significantly higher than CDR for double-reading of 2D-mammography (6.3 per 1000 screens; 95% CI: 4.8-8.1), P<0.001 both comparisons. FPR% for single-read 2D/3D-mammography (2.60%; 95% CI: 2.29-2.94), or single-read 2D synthetic/3D-mammography (2.76%; 95% CI: 2.45-3.11), were significantly lower than FPR% for double-read 2D-mammography (3.42%; 95% CI: 3.07-3.80), P<0.001 and P=0.002 respectively. Single-reading of 3D-mammography (integrated 2D/3D or 2Dsynthetic/3D) detected more BC, and had lower FPR, compared to current practice of double-reading 2D-mammography alone

  11. Lung cancer detection with digital chest tomosynthesis: first round results from the SOS observational study.

    PubMed

    Bertolaccini, Luca; Viti, Andrea; Tavella, Chiara; Priotto, Roberto; Ghirardo, Donatella; Grosso, Maurizio; Terzi, Alberto

    2015-04-01

    Baseline results of the Studio OSservazionale (SOS), observational study, a single-arm observational study of digital chest tomosynthesis for lung cancer detection in an at-risk population demonstrated a detection rate of lung cancer comparable to that of studies that used low dose CT scan (LDCT). We present the results of the first round. Totally 1,703 out of 1,843 (92%) subjects who had a baseline digital chest tomosynthesis underwent a first round reevaluation after 1 year. At first round chest digital tomosynthesis, 13 (0.7%) subjects had an indeterminate nodule larger than 5 mm and underwent low-dose CT scan for nodule confirmation. PET/CT study was obtained in 10 (0.5%) subjects and 2 subjects had a low-dose CT follow up. Surgery, either video-assisted thoracoscopic or open surgery for indeterminate pulmonary nodules was performed in 10 (0.2%) subjects. A lung cancer was diagnosed and resected in five patients. The lung cancer detection rate at first round was 0.3% (5/1,703). The detection rate of lung cancer at first round for tomosynthesis is comparable to rates reported for CT. In addition, results of first round digital chest tomosynthesis confirm chest tomosynthesis as a possible first-line lung cancer-screening tool.

  12. Anatomical decomposition in dual energy chest digital tomosynthesis

    NASA Astrophysics Data System (ADS)

    Lee, Donghoon; Kim, Ye-seul; Choi, Sunghoon; Lee, Haenghwa; Choi, Seungyeon; Kim, Hee-Joung

    2016-03-01

    Lung cancer is the leading cause of cancer death worldwide and the early diagnosis of lung cancer has recently become more important. For early screening lung cancer, computed tomography (CT) has been used as a gold standard for early diagnosis of lung cancer [1]. The major advantage of CT is that it is not susceptible to the problem of misdiagnosis caused by anatomical overlapping while CT has extremely high radiation dose and cost compared to chest radiography. Chest digital tomosynthesis (CDT) is a recently introduced new modality for lung cancer screening with relatively low radiation dose compared to CT [2] and also showing high sensitivity and specificity to prevent anatomical overlapping occurred in chest radiography. Dual energy material decomposition method has been proposed for better detection of pulmonary nodules as means of reducing the anatomical noise [3]. In this study, possibility of material decomposition in CDT was tested by simulation study and actual experiment using prototype CDT. Furthermore organ absorbed dose and effective dose were compared with single energy CDT. The Gate v6 (Geant4 application for tomographic emission), and TASMIP (Tungsten anode spectral model using the interpolating polynomial) code were used for simulation study and simulated cylinder shape phantom consisted of 4 inner beads which were filled with spine, rib, muscle and lung equivalent materials. The patient dose was estimated by PCXMC 1.5 Monte Carlo simulation tool [4]. The tomosynthesis scan was performed with a linear movement and 21 projection images were obtained over 30 degree of angular range with 1.5° degree of angular interval. The proto type CDT system has same geometry with simulation study and composed of E7869X (Toshiba, Japan) x-ray tube and FDX3543RPW (Toshiba, Japan) detector. The result images showed that reconstructed with dual energy clearly visualize lung filed by removing unnecessary bony structure. Furthermore, dual energy CDT could enhance

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

    PubMed

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

    2015-07-01

    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. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

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

    NASA Astrophysics Data System (ADS)

    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.

  15. Feasibility of Amorphous Selenium Based Photon Counting Detectors for Digital Breast Tomosynthesis

    SciTech Connect

    Chen, J.; O'Connor, P.; Lehnert, J., De Geronimo, G., Dolazza, E., Tousignant, O., Laperriere, L., Greenspan, J., Zhao, W.

    2009-02-27

    Amorphous selenium (a-Se) has been incorporated successfully in direct conversion flat panel x-ray detectors, and has demonstrated superior image quality in screening mammography and digital breast tomosynthesis (DBT) under energy integration mode. The present work explores the potential of a-Se for photon counting detectors in DBT. We investigated major factors contributing to the variation in the charge collected by a pixel upon absorption of each x-ray photon. These factors included x-ray photon interaction, detector geometry, charge transport, and the pulse shaping and noise properties of the photon counting readout circuit. Experimental measurements were performed on a linear array test structure constructed by evaporating an a-Se layer onto an array of 100 {mu}m pitch strip electrodes, which are connected to a 32 channel low noise photon counting integrated circuit. The measured pulse height spectrum (PHS) under polychromatic xray exposure was interpreted quantitatively using the factors identified. Based on the understanding of a-Se photon counting performance, design parameters were proposed for a 2D detector with high quantum efficiency and count rate that could meet the requirements of photon counting detector for DBT.

  16. Workflow improvements for digital breast tomosynthesis: computerized generation of enhanced synthetic images

    NASA Astrophysics Data System (ADS)

    Fotin, Sergei V.; Yin, Yin; Haldankar, Hrishikesh; Hoffmeister, Jeffrey W.; Periaswamy, Senthil

    2016-03-01

    In a typical 2D mammography workflow scenario, a computer-aided detection (CAD) algorithm is used as a second reader producing marks for a radiologist to review. In the case of 3D digital breast tomosynthesis (DBT), the display of CAD detections at multiple reconstruction heights would lead to an increased image browsing and interpretation time. We propose an alternative approach in which an algorithm automatically identifies suspicious regions of interest from 3D reconstructed DBT slices and then merges the findings with the corresponding 2D synthetic projection image which is then reviewed. The resultant enhanced synthetic 2D image combines the benefits of a familiar 2D breast view with superior appearance of suspicious locations from 3D slices. Moreover, clicking on 2D suspicious locations brings up the display of the corresponding 3D regions in a DBT volume allowing navigation between 2D and 3D images. We explored the use of these enhanced synthetic images in a concurrent read paradigm by conducting a study with 5 readers and 30 breast exams. We observed that the introduction of the enhanced synthetic view reduced radiologist's average interpretation time by 5.4%, increased sensitivity by 6.7% and increased specificity by 15.6%.

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

    NASA Astrophysics Data System (ADS)

    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.

  18. Contrast-Enhanced Digital Mammography and Angiogenesis

    SciTech Connect

    Rosado-Mendez, I.; Palma, B. A.; Villasenor, Y.; Benitez-Bribiesca, L.; Brandan, M. E.

    2007-11-26

    Angiogenesis could be a means for pouring contrast media around tumors. In this work, optimization of radiological parameters for contrast-enhanced subtraction techniques in mammography has been performed. A modification of Lemacks' analytical formalism was implemented to model the X-ray absorption in the breast with contrast medium and detection by a digital image receptor. Preliminary results of signal-to-noise ratio analysis show the advantage of subtracting two images taken at different energies, one prior and one posterior to the injection of contrast medium. Preliminary experimental results using a custom-made phantom have shown good agreement with calculations. A proposal is presented for the clinical application of the optimized technique, which aims at finding correlations between angiogenesis indicators and dynamic variables of contrast medium uptake.

  19. Digital mammography performed with computed radiography technology.

    PubMed

    Jouan, B

    1999-07-01

    Introduced by Fuji Photo Film Japan in the early 1980s, computed radiography (CR) technology has developed considerably since then to become the mature widely installed technology it is today (about 7500 systems worldwide). Various mammographic examinations require high performance results to which CR complies on demand or following some procedures such as geometrical magnification carried out during the examination. The basic CR principles and digital image processing as well as technical improvements are detailed in this study, which also includes a synthesis of the articles on CR mammographic applications referenced in the bibliography, focusing on strong points, limits and current methods of surpassing these limits. New CR technology development perspectives in mammography and computed assisted diagnosis (CAD) algorithms will allow wider use of this method in the near future.

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

    PubMed

    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.

  1. Radiologists' interpretive efficiency and variability in true- and false-positive detection when screen-reading with tomosynthesis (3D-mammography) relative to standard mammography in population screening.

    PubMed

    Svahn, Tony M; Macaskill, Petra; Houssami, Nehmat

    2015-12-01

    We examined interpretive efficiency and variability in true- and false-positive detection (TP, FP) for radiologists screen-reading with digital breast tomosynthesis as adjunct to full-field digital mammography (2D/3D) relative to 2D alone in population-based screening studies. A systematic literature search was performed to identify screening studies that provided radiologist-specific data for TP and FP detection. Radiologist interpretive efficiency (trade-off between TPs and FPs) was calculated using the FP:TP ratio which expresses the number of FP recalls for each screen-detected breast cancer. We modeled a pooled FP:TP ratio to assess variability in radiologists' interpretive efficiency at study-level using random effects logistic regression. FP:TP ratio improved (ratio decreased) for 2D/3D screen-reading (relative to 2D) for a majority of radiologists (18 of 22) across all studies. Variability in radiologists' FP:TP ratio was consistently lower in all studies for 2D/3D screen-reading, as suggested by lower variance in ratios. Study-level pooled FP:TP ratio for 2D- and 2D/3D-mammography respectively, were 5.96 (95%CI: 4.08 to 8.72) and 3.17 (95%CI: 2.25 to 4.47) for the STORM trial; 10.25 (95%CI: 6.42 to 16.35) and 7.07 (95%CI: 4.99 to 10.02) for the Oslo trial; and 20.84 (95%CI: 13.95 to 31.12) and 8.37 (95%CI: 5.87 to 11.93) for the Houston study. This transfers into study-level improved interpretative efficiencies of 48%, 30% and 55%, respectively, for 2D/3D screen-reading (relative to 2D). In summary, study-level FP:TP trade-off improved using 2D/3D-mammography for all studies, which was also seen for most individual radiologists. There was variability in the FP:TP trade-off between readers and studies for 2D-as well as for 2D/3D-interpretations but variability in radiologists' interpretive efficiency was relatively lower using 2D/3D-mammography.

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

    PubMed Central

    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 < .001). With tomosynthesis, the false-positive rate decreased from 85% (989 of 1160) to 74% (864 of 1160) (P < .01) for cases that were rated BI-RADS category 3 or higher and from 57% (663 of

  3. Digital breast tomosynthesis versus supplemental diagnostic mammographic views for evaluation of noncalcified breast lesions.

    PubMed

    Zuley, Margarita L; 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

    To compare the diagnostic performance of breast tomosynthesis versus supplemental mammography views in classification of masses, distortions, and asymmetries. 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. Average probability-of-malignancy-based area under the ROC curve was 0.87 for tomosynthesis versus 0.83 for supplemental views (P < .001). With tomosynthesis, the false-positive rate decreased from 85% (989 of 1160) to 74% (864 of 1160) (P < .01) for cases that were rated BI-RADS category 3 or higher and from 57% (663 of 1160) to 48% (559 of 1160) for cases rated BI

  4. Satellite teleradiology test bed for digital mammography

    NASA Astrophysics Data System (ADS)

    Barnett, Bruce G.; Dudding, Kathryn E.; Abdel-Malek, Aiman A.; Mitchell, Robert J.

    1996-05-01

    Teleradiology offers significant improvement in efficiency and patient compliance over current practices in traditional film/screen-based diagnosis. The increasing number of women who need to be screened for breast cancer, including those in remote rural regions, make the advantages of teleradiology especially attractive for digital mammography. At the same time, the size and resolution of digital mammograms are among the most challenging to support in a cost effective teleradiology system. This paper will describe a teleradiology architecture developed for use with digital mammography by GE Corporate Research and Development in collaboration with Massachusetts General Hospital under National Cancer Institute (NCI/NIH) grant number R01 CA60246-01. The testbed architecture is based on the Digital Imaging and Communications in Medicine (DICOM) standard, created by the American College of Radiology and National Electrical Manufacturers Association. The testbed uses several Sun workstations running SunOS, which emulate a rural examination facility connected to a central diagnostic facility, and uses a TCP-based DICOM application to transfer images over a satellite link. Network performance depends on the product of the bandwidth times the round- trip time. A satellite link has a round trip of 513 milliseconds, making the bandwidth-delay a significant problem. This type of high bandwidth, high delay network is called a Long Fat Network, or LFN. The goal of this project was to quantify the performance of the satellite link, and evaluate the effectiveness of TCP over an LFN. Four workstations have Sun's HSI/S (High Speed Interface) option. Two are connected by a cable, and two are connected through a satellite link. Both interfaces have the same T1 bandwidth (1.544 Megabits per second). The only difference was the round trip time. Even with large window buffers, the time to transfer a file over the satellite link was significantly longer, due to the bandwidth-delay. To

  5. Digital tomosynthesis of the chest: current and emerging applications.

    PubMed

    Chou, Shinn-Huey S; Kicska, Greg A; Pipavath, Sudhakar N; Reddy, Gautham P

    2014-01-01

    Digital tomosynthesis (DTS) of the chest is a technique whose basic components are similar to those of digital radiography, but that also provides some of the benefits of computed tomography (CT). The major advantages of DTS over conventional chest radiography are improved visibility of the pulmonary parenchyma and depiction of abnormalities such as pulmonary nodules. Calcifications, vessels, airways, and chest wall abnormalities are also much more readily visualized at DTS than at chest radiography. DTS could potentially be combined with chest radiography to follow up known nodules, confirm or rule out suspected nodules seen at radiography, or evaluate individuals who are at high risk for lung cancer or pulmonary metastases. DTS generates coronal "slices" through the chest whose resolution is superior to that of coronal reconstructed CT images, but it is limited by its suboptimal depth resolution and susceptibility to motion; consequently, potential pitfalls in recognizing lesions adjacent to the pleura, diaphragm, central vessels, and mediastinum can occur. However, the radiation dose and projected cost of chest DTS are lower than those of standard chest CT. Besides pulmonary nodule detection, specific applications of DTS that are under investigation include evaluation of pulmonary tuberculous and nontuberculous mycobacterial disease, cystic fibrosis, interstitial lung disease, and asbestos-related thoracic diseases. A basic understanding of chest DTS and of the emerging applications of this technique can prove useful to the radiologist. Online supplemental material is available for this article.

  6. Accelerating reconstruction of reference digital tomosynthesis using graphics hardware.

    PubMed

    Yan, Hui; Ren, Lei; Godfrey, Devon J; Yin, Fang-Fang

    2007-10-01

    The successful implementation of digital tomosynthesis (DTS) for on-board image guided radiation therapy (IGRT) requires fast DTS image reconstruction. Both target and reference DTS image sets are required to support an image registration application for IGRT. Target images are usually DTS image sets reconstructed from on-board projections, which can be accomplished quickly using the conventional filtered backprojection algorithm. Reference images are DTS image sets reconstructed from digitally reconstructed radiographs (DRRs) previously generated from conventional planning CT data. Generating a set of DRRs from planning CT is relatively slow using the conventional ray-casting algorithm. In order to facilitate DTS reconstruction within a clinically acceptable period of time, we implemented a high performance DRR reconstruction algorithm on a graphics processing unit of commercial PC graphics hardware. The performance of this new algorithm was evaluated and compared with that which is achieved using the conventional software-based ray-casting algorithm. DTS images were reconstructed from DRRs previously generated by both hardware and software algorithms. On average, the DRR reconstruction efficiency using the hardware method is improved by a factor of 67 over the software method. The image quality of the DRRs was comparable to those generated using the software-based ray-casting algorithm. Accelerated DRR reconstruction significantly reduces the overall time required to produce a set of reference DTS images from planning CT and makes this technique clinically practical for target localization for radiation therapy.

  7. Optimal x-ray energy for digital mammography

    SciTech Connect

    Logan, C.M.; Hernandez, J.M.; Kinney, J.H.; Lewis, D.L.

    1992-11-01

    Screening mammography is a radiological procedure requiring the highest possible image quality at the lowest possible dose. It is widely recognized that digital image acquisition, computer assisted diagnosis, and scientific visualization can provide substantial improvement in mammography. For such systems, much of what is accepted as best practice with today`s film/screen/lightbox systems will become inappropriate. A complete system design is required. We have constructed a model of the breast imaging process. These results show that molybdenum-anode, molybdenum-filtered x-ray spectra are ill-suited for digital mammography. An x-ray spectrum rich in 22-to 25-keV photons is needed.

  8. Optimizing configuration parameters of a stationary digital breast tomosynthesis system based on carbon nanotube x-ray sources

    NASA Astrophysics Data System (ADS)

    Tucker, Andrew; Qian, Xin; Gidcumb, Emily; Spronk, Derrek; Sprenger, Frank; Kuo, Johnny; Ng, Susan; Lu, Jianping; Zhou, Otto

    2012-03-01

    The stationary Digital Breast Tomosynthesis System (s-DBT) has the advantage over the conventional DBT systems as there is no motion blurring in the projection images associated with the x-ray source motion. We have developed a prototype s-DBT system by retrofitting a Hologic Selenia Dimensions rotating gantry tomosynthesis system with a distributed carbon nanotube (CNT) x-ray source array. The linear array consists of 31 x-ray generating focal spots distributed over a 30 degree angle. Each x-ray beam can be electronically activated allowing the flexibility and easy implementation of novel tomosynthesis scanning with different scanning parameters and configurations. Here we report the initial results of investigation on the imaging quality of the s-DBT system and its dependence on the acquisition parameters including the number of projections views, the total angular span of the projection views, the dose distribution between different projections, and the total dose. A mammography phantom is used to visually assess image quality. The modulation transfer function (MTF) of a line wire phantom is used to evaluate the system spatial resolution. For s-DBT the in-plan system resolution, as measured by the MTF, does not change for different configurations. This is in contrast to rotating gantry DBT systems, where the MTF degrades for increased angular span due to increased focal spot blurring associated with the x-ray source motion. The overall image quality factor, a composite measure of the signal difference to noise ratio (SdNR) for mass detection and the z-axis artifact spread function for microcalcification detection, is best for the configuration with a large angular span, an intermediate number of projection views, and an even dose distribution. These results suggest possible directions for further improvement of s-DBT systems for high quality breast cancer imaging.

  9. Triple-energy contrast enhanced digital mammography

    NASA Astrophysics Data System (ADS)

    Puong, Sylvie; Milioni de Carvalho, Pablo; Muller, Serge

    2010-04-01

    With the injection of iodine, Contrast Enhanced Digital Mammography (CEDM) provides functional information about breast tumour angiogenesis that can potentially help in cancer diagnosis. In order to generate iodine images in which the gray level is proportional to the iodine thickness, temporal and dual-energy approaches have already been considered. The dual-energy method offers the advantage of less patient motion artifacts and better comfort during the exam. However, this approach requires knowledge of the breast thickness at each pixel. Generally, as compression is applied, the breast thickness at each pixel is taken as the compression thickness. Nevertheless, in the breast border region, this assumption is not correct anymore and this causes inaccuracies in the iodine image. Triple-Energy CEDM could overcome these limitations by providing supplemental information in the form of a third image acquired with a different spectrum than the other two. This precludes the need of a priori knowledge of the breast thickness. Moreover, with Triple-Energy CEDM, breast thickness and glandularity maps could potentially be derived. In this study, we first focused on the method to recombine the three images in order to generate the iodine image, analyzing the performance of either quadratic, cubic or conic recombination functions. Then, we studied the optimal acquisition spectra in order to maximize the iodine SDNR in the recombined image for a given target total glandular dose. The concept of Triple-Energy CEDM was validated on simulated textured images and poly-energetic images acquired with a conventional X-ray mammography tube.

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

    PubMed

    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

  11. Characterizing X-ray detectors for prototype digital breast tomosynthesis systems

    NASA Astrophysics Data System (ADS)

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

    2016-03-01

    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 (R2>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 of x

  12. Breast Tomosynthesis

    MedlinePlus

    ... mammography, that uses a low-dose x-ray system and computer reconstructions to create three-dimensional images of the ... Breast tomosynthesis uses a low-dose x-ray system, electronics and a computer to convert x-ray images of the breast ...

  13. Gaussian frequency blending algorithm with matrix inversion tomosynthesis (MITS) and filtered back projection (FBP) for better digital breast tomosynthesis reconstruction

    NASA Astrophysics Data System (ADS)

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

    2006-03-01

    Breast cancer is a major problem and the most common cancer among women. The nature of conventional mammpgraphy makes it very difficult to distinguish a cancer from overlying breast tissues. Digital Tomosynthesis refers to a three-dimensional imaging technique that allows reconstruction of an arbitrary set of planes in the breast from limited-angle series of projection images as the x-ray source moves. Several tomosynthesis algorithms have been proposed, including Matrix Inversion Tomosynthesis (MITS) and Filtered Back Projection (FBP) that have been investigated in our lab. MITS shows better high frequency response in removing out-of-plane blur, while FBP shows better low frequency noise propertities. This paper presents an effort to combine MITS and FBP for better breast tomosynthesis reconstruction. A high-pass Gaussian filter was designed and applied to three-slice "slabbing" MITS reconstructions. A low-pass Gaussian filter was designed and applied to the FBP reconstructions. A frequency weighting parameter was studied to blend the high-passed MITS with low-passed FBP frequency components. Four different reconstruction methods were investigated and compared with human subject images: 1) MITS blended with Shift-And-Add (SAA), 2) FBP alone, 3) FBP with applied Hamming and Gaussian Filters, and 4) Gaussian Frequency Blending (GFB) of MITS and FBP. Results showed that, compared with FBP, Gaussian Frequency Blending (GFB) has better performance for high frequency content such as better reconstruction of micro-calcifications and removal of high frequency noise. Compared with MITS, GFB showed more low frequency breast tissue content.

  14. Geometric estimation method for x-ray digital intraoral tomosynthesis

    NASA Astrophysics Data System (ADS)

    Li, Liang; Yang, Yao; Chen, Zhiqiang

    2016-06-01

    It is essential for accurate image reconstruction to obtain a set of parameters that describes the x-ray scanning geometry. A geometric estimation method is presented for x-ray digital intraoral tomosynthesis (DIT) in which the detector remains stationary while the x-ray source rotates. The main idea is to estimate the three-dimensional (3-D) coordinates of each shot position using at least two small opaque balls adhering to the detector surface as the positioning markers. From the radiographs containing these balls, the position of each x-ray focal spot can be calculated independently relative to the detector center no matter what kind of scanning trajectory is used. A 3-D phantom which roughly simulates DIT was designed to evaluate the performance of this method both quantitatively and qualitatively in the sense of mean square error and structural similarity. Results are also presented for real data acquired with a DIT experimental system. These results prove the validity of this geometric estimation method.

  15. Digital tomosynthesis in lung cancer: state of the art

    PubMed Central

    Viti, Andrea; Terzi, Alberto

    2015-01-01

    Chest digital tomosynthesis (CDT) is a limited angle image tomography, which improves the visibility of anatomy compared with radiographic imaging. Due to the limited acquisition angle of CDT, it has the potential to significantly increase the temporal resolution of patient surveillance at the cost of reduced resolution in one direction. CDT is 3 times more effective in identifying pulmonary nodules compared to conventional radiography and at lower doses and cost compared with routine chest computed tomography (CT) examinations. There is only one report in which CDT was used in a single-arm observational study for lung cancer detection in at-risk population while a few studies suggested that CDT sensitivity is superior to radiography but inferior to CT in detecting lung nodules, other studies on the accuracy of CDT suggest that the specificity is much closer to CT than radiography. Therefore, large-scale randomized controlled trial would be needed to confirm benefits of CDT and identify where it is best used in the clinical setting. CDT seems to be a cost-effectiveness first-line lung cancer screening tool to detect potential lung cancer nodule. PMID:26207232

  16. Fast reconstruction of digital tomosynthesis using on-board images

    SciTech Connect

    Yan Hui; Godfrey, Devon J.; Yin Fangfang

    2008-05-15

    Digital tomosynthesis (DTS) is a method to reconstruct pseudo three-dimensional (3D) volume images from two-dimensional x-ray projections acquired over limited scan angles. Compared with cone-beam computed tomography, which is frequently used for 3D image guided radiation therapy, DTS requires less imaging time and dose. Successful implementation of DTS for fast target localization requires the reconstruction process to be accomplished within tight clinical time constraints (usually within 2 min). To achieve this goal, substantial improvement of reconstruction efficiency is necessary. In this study, a reconstruction process based upon the algorithm proposed by Feldkamp, Davis, and Kress was implemented on graphics hardware for the purpose of acceleration. The performance of the novel reconstruction implementation was tested for phantom and real patient cases. The efficiency of DTS reconstruction was improved by a factor of 13 on average, without compromising image quality. With acceleration of the reconstruction algorithm, the whole DTS generation process including data preprocessing, reconstruction, and DICOM conversion is accomplished within 1.5 min, which ultimately meets clinical requirement for on-line target localization.

  17. Fast reconstruction of digital tomosynthesis using on-board images.

    PubMed

    Yan, Hui; Godfrey, Devon J; Yin, Fang-Fang

    2008-05-01

    Digital tomosynthesis (DTS) is a method to reconstruct pseudo three-dimensional (3D) volume images from two-dimensional x-ray projections acquired over limited scan angles. Compared with cone-beam computed tomography, which is frequently used for 3D image guided radiation therapy, DTS requires less imaging time and dose. Successful implementation of DTS for fast target localization requires the reconstruction process to be accomplished within tight clinical time constraints (usually within 2 min). To achieve this goal, substantial improvement of reconstruction efficiency is necessary. In this study, a reconstruction process based upon the algorithm proposed by Feldkamp, Davis, and Kress was implemented on graphics hardware for the purpose of acceleration. The performance of the novel reconstruction implementation was tested for phantom and real patient cases. The efficiency of DTS reconstruction was improved by a factor of 13 on average, without compromising image quality. With acceleration of the reconstruction algorithm, the whole DTS generation process including data preprocessing, reconstruction, and DICOM conversion is accomplished within 1.5 min, which ultimately meets clinical requirement for on-line target localization.

  18. Monte Carlo simulation for the estimation of the glandular breast dose for a digital breast tomosynthesis system.

    PubMed

    Rodrigues, Leonardo; Magalhaes, Luis Alexandre Goncalves; Braz, Delson

    2015-12-01

    Digital breast tomosynthesis (DBT) is a screening and diagnostic modality that acquires images of the breast at multiple angles during a short scan. The Selenia Dimensions (Hologic, Bedford, Mass) DBT system can perform both full-field digital mammography and DBT. The system acquires 15 projections over a 15° angular range (from -7.5° to +7.5°). An important factor in determining the optimal imaging technique for breast tomosynthesis is the radiation dose. In breast imaging, the radiation dose of concern is that deposited in the glandular tissue of the breast because this is the tissue that has a risk of developing cancer. The concept of the normalised mean glandular dose (DgN) has been introduced as the metric for the dose in breast imaging. The DgN is difficult to measure. The Monte Carlo techniques offer an alternative method for a realistic estimation of the radiation dose. The purpose of this work was to use the Monte Carlo code MCNPX technique to generate monoenergetic glandular dose data for estimating the breast tissue dose in tomosynthesis for arbitrary spectra as well as to observe the deposited radiation dose by projection on the glandular portion of the breast in a Selenia Dimensions DBT system. A Monte Carlo simulation of the system was developed to compute the DgN in a craniocaudal view. Monoenergetic X-ray beams from 10 to 49 keV in 1-keV increments were used. The simulation utilised the assumption of a homogeneous breast composition and three compositions (0 % glandular, 50 % glandular and 100 % glandular). The glandular and adipose tissue compositions were specified according ICRU Report 44. A skin layer of 4 mm was assumed to encapsulate the breast on all surfaces. The breast size was varied using the chest wall-to-nipple distance (CND) and compressed breast thickness (t). In this work, the authors assumed a CND of 5 cm and the thicknesses ranged from 2 to 8 cm, in steps of 2 cm. The fractional energy absorption increases (up to 44.35 % between

  19. Diffusion of digital breast tomosynthesis among women in primary care: associations with insurance type.

    PubMed

    Clark, Cheryl R; Tosteson, Tor D; Tosteson, Anna N A; Onega, Tracy; Weiss, Julie E; Harris, Kimberly A; Haas, Jennifer S

    2017-04-04

    Digital breast tomosynthesis (DBT) has shown potential to improve breast cancer screening and diagnosis compared to digital mammography (DM). The FDA approved DBT use in conjunction with conventional DM in 2011, but coverage was approved by CMS recently in 2015. Given changes in coverage policies, it is important to monitor diffusion of DBT by insurance type. This study examined DBT trends and estimated associations with insurance type. From June 2011 to September 2014, DBT use in 22 primary care centers in the Dartmouth -Brigham and Women's Hospital Population-based Research Optimizing Screening through Personalized Regimens research center (PROSPR) was examined among women aged 40-89. A longitudinal repeated measures analysis estimated the proportion of DBT performed for screening or diagnostic indications over time and by insurance type. During the study period, 93,182 mammograms were performed on 48,234 women. Of these exams, 16,506 DBT tests were performed for screening (18.1%) and 2537 were performed for diagnosis (15.7%). Between 2011 and 2014, DBT utilization increased in all insurance groups. However, by the latest observed period, screening DBT was used more frequently under private insurance (43.4%) than Medicaid (36.2%), Medicare (37.8%), other (38.6%), or no insurance (32.9%; P < 0.0001). No sustained differences in use of DBT for diagnostic testing were seen by insurance type. DBT is increasingly used for breast cancer screening and diagnosis. Use of screening DBT may be associated with insurance type. Surveillance is required to ensure that disparities in breast cancer screening are minimized as DBT becomes more widely available.

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

    NASA Astrophysics Data System (ADS)

    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 p< 0.05. Results Confidence scores were higher for true positive cancer cases using DM+DBT compared with DM alone for all readers (p < 0.0001). Confidence scores for normal cases were lower (indicating greater confidence in the non-cancer diagnosis) with DM+DBT compared with DM alone for all readers (p= 0.018) and readers with no prior DBT experience (p= 0.035). 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.

  1. Combination of conspicuity improved synthetic mammograms and digital breast tomosynthesis: a promising approach for mass detection

    NASA Astrophysics Data System (ADS)

    Kim, Seong Tae; Kim, Dae Hoe; Ro, Yong Man

    2015-03-01

    In this study, a novel mass detection framework that utilizes the information from synthetic mammograms has been developed for detecting masses in digital breast tomosynthesis (DBT). In clinical study, it is demonstrated that the combination of DBT and full field digital mammography (FFDM) increases the reader performance. To reduce the radiation dose in this approach, synthetic mammogram has been developed in previous researches and it is demonstrated that synthetic mammogram can alternate the FFDM when it is used with DBT. In this study, we investigate the feasibility of the combined approach of DBT and synthetic mammogram in point of computer-aided detection (CAD). As a synthetic mammogram, two-dimensional image was generated by adopting conspicuous voxels of three-dimensional DBT volume in our study. The mass likelihood scores estimated for each mass candidates in synthetic mammogram and DBT are merged to differentiate masses and false positives (FPs) in combined approach. We compared the performance of detecting masses in the proposed combined approach and DBT alone. A clinical data set of 196 DBT volumes was used to evaluate the different detection schemes. The combined approach achieved sensitivity of 80% and 89% with 1.16 and 2.37 FPs per DBT volume. The DBT alone approach achieved same sensitivities with 1.61 and 3.46 FPs per DBT volume. Experimental results show that statistically significant improvement (p = 0.002) is achieved in combined approach compared to DBT alone. These results imply that the information fusion of synthetic mammogram and DBT is a promising approach to detect masses in DBT.

  2. Feasibility study of dose reduction in digital breast tomosynthesis using non-local denoising algorithms

    NASA Astrophysics Data System (ADS)

    Vieira, Marcelo A. C.; de Oliveira, Helder C. R.; Nunes, Polyana F.; Borges, Lucas R.; Bakic, Predrag R.; Barufaldi, Bruno; Acciavatti, Raymond J.; Maidment, Andrew D. A.

    2015-03-01

    The main purpose of this work is to study the ability of denoising algorithms to reduce the radiation dose in Digital Breast Tomosynthesis (DBT) examinations. Clinical use of DBT is normally performed in "combo-mode", in which, in addition to DBT projections, a 2D mammogram is taken with the standard radiation dose. As a result, patients have been exposed to radiation doses higher than used in digital mammography. Thus, efforts to reduce the radiation dose in DBT examinations are of great interest. However, a decrease in dose leads to an increased quantum noise level, and related decrease in image quality. This work is aimed at addressing this problem by the use of denoising techniques, which could allow for dose reduction while keeping the image quality acceptable. We have studied two "state of the art" denoising techniques for filtering the quantum noise due to the reduced dose in DBT projections: Non-local Means (NLM) and Block-matching 3D (BM3D). We acquired DBT projections at different dose levels of an anthropomorphic physical breast phantom with inserted simulated microcalcifications. Then, we found the optimal filtering parameters where the denoising algorithms are capable of recovering the quality from the DBT images acquired with the standard radiation dose. Results using objective image quality assessment metrics showed that BM3D algorithm achieved better noise adjustment (mean difference in peak signal to noise ratio < 0.1dB) and less blurring (mean difference in image sharpness ~ 6%) than the NLM for the projections acquired with lower radiation doses.

  3. Digital tomosynthesis of the thorax: the influence of respiratory motion artifacts on lung nodule detection.

    PubMed

    Kim, Sung Mok; Chung, Myung Jin; Lee, Kyung Soo; Kang, Hee; Song, In-Young; Lee, Eun Joo; Hwang, Hye Sun

    2013-07-01

    Digital tomosynthesis considerably reduces problems created by overlapping anatomy compared with chest X-ray (CXR). However, digital tomosynthesis requires a longer scan time compared with CXR, and thus may be vulnerable to motion artifacts. To compare the diagnostic performance of digital tomosynthesis in subjects with and without respiratory motion artifacts. The institutional review board approved this retrospective study, and the requirement for written informed consent was waived. A total of 46 subjects with imaging containing respiratory motion artifacts were enrolled in this study, 18 of whom were positive and 28 of whom were negative for lung nodules on computed tomography (CT). The control group was comprised of 92 age-matched subjects with imaging devoid of motion artifacts. Of these, 36 were positive and 56 were negative for lung nodules on subsequent CT scan. The size criteria of nodules were 4-10 mm. Three chest radiologists independently evaluated the radiographs and digital tomosynthesis images for the presence of pulmonary nodules. Multireader multicase receiver-operating characteristic (ROC) analyses was used for statistical comparisons. Within the control group, the areas under curve (AUC) for observer performances in detecting lung nodules on digital tomosynthesis was higher than that on CXR (P = 0.017). Within the study group, there were no significant differences in AUCs for observer performances (P = 0.576). When no motion artifacts are present, the detection performance of nodules (4-10 mm) on digital tomosynthesis is significantly better than that on CXR, whereas there is not a significant difference in cases with motion artifacts.

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

    PubMed

    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.

  5. Digital tomosynthesis aided by low-resolution exact computed tomography.

    PubMed

    Zeng, Kai; Yu, Hengyong; Zhao, Shiying; Fajardo, Laurie Lee; Ruth, Christopher; Jing, Zhenxue; Wang, Ge

    2007-01-01

    Tomosynthesis reconstructs 3-dimensional images of an object from a significantly fewer number of projections as compared with that required by computed tomography (CT). A major problem with tomosynthesis is image artifacts associated with the data incompleteness. In this article, we propose a hybrid tomosynthesis approach to achieve higher image quality as compared with competing methods. In this approach, a low-resolution CT scan is followed by a high-resolution tomosynthesis scan. Then, both scans are combined to reconstruct images. To evaluate the image quality of the proposed method, we design a new breast phantom for numerical simulation and physical experiments. The results show that images obtained by our approach are clearly better than those obtained without such a CT scan.

  6. An Object-Oriented Simulator for 3D Digital Breast Tomosynthesis Imaging System

    PubMed Central

    Cengiz, Kubra

    2013-01-01

    Digital breast tomosynthesis (DBT) is an innovative imaging modality that provides 3D reconstructed images of breast to detect the breast cancer. Projections obtained with an X-ray source moving in a limited angle interval are used to reconstruct 3D image of breast. Several reconstruction algorithms are available for DBT imaging. Filtered back projection algorithm has traditionally been used to reconstruct images from projections. Iterative reconstruction algorithms such as algebraic reconstruction technique (ART) were later developed. Recently, compressed sensing based methods have been proposed in tomosynthesis imaging problem. We have developed an object-oriented simulator for 3D digital breast tomosynthesis (DBT) imaging system using C++ programming language. The simulator is capable of implementing different iterative and compressed sensing based reconstruction methods on 3D digital tomosynthesis data sets and phantom models. A user friendly graphical user interface (GUI) helps users to select and run the desired methods on the designed phantom models or real data sets. The simulator has been tested on a phantom study that simulates breast tomosynthesis imaging problem. Results obtained with various methods including algebraic reconstruction technique (ART) and total variation regularized reconstruction techniques (ART+TV) are presented. Reconstruction results of the methods are compared both visually and quantitatively by evaluating performances of the methods using mean structural similarity (MSSIM) values. PMID:24371468

  7. An object-oriented simulator for 3D digital breast tomosynthesis imaging system.

    PubMed

    Seyyedi, Saeed; Cengiz, Kubra; Kamasak, Mustafa; Yildirim, Isa

    2013-01-01

    Digital breast tomosynthesis (DBT) is an innovative imaging modality that provides 3D reconstructed images of breast to detect the breast cancer. Projections obtained with an X-ray source moving in a limited angle interval are used to reconstruct 3D image of breast. Several reconstruction algorithms are available for DBT imaging. Filtered back projection algorithm has traditionally been used to reconstruct images from projections. Iterative reconstruction algorithms such as algebraic reconstruction technique (ART) were later developed. Recently, compressed sensing based methods have been proposed in tomosynthesis imaging problem. We have developed an object-oriented simulator for 3D digital breast tomosynthesis (DBT) imaging system using C++ programming language. The simulator is capable of implementing different iterative and compressed sensing based reconstruction methods on 3D digital tomosynthesis data sets and phantom models. A user friendly graphical user interface (GUI) helps users to select and run the desired methods on the designed phantom models or real data sets. The simulator has been tested on a phantom study that simulates breast tomosynthesis imaging problem. Results obtained with various methods including algebraic reconstruction technique (ART) and total variation regularized reconstruction techniques (ART+TV) are presented. Reconstruction results of the methods are compared both visually and quantitatively by evaluating performances of the methods using mean structural similarity (MSSIM) values.

  8. Frequently Asked Questions about Digital Mammography

    MedlinePlus

    ... is a mammography system where the x-ray film used in screen-film mammography is replaced by solid-state detectors, similar ... on a computer screen, or printed on special films to look like screen-film mammograms. Types of ...

  9. Potential Cost Savings of Contrast-Enhanced Digital Mammography.

    PubMed

    Patel, Bhavika K; Gray, Richard J; Pockaj, Barbara A

    2017-06-01

    The purpose of this article is to discuss whether the sensitivity and specificity of contrast-enhanced digital mammography (CEDM) render it a viable diagnostic alternative to breast MRI. That CEDM couples low-energy images (comparable to the diagnostic quality of standard mammography) and subtracted contrast-enhanced mammograms make it a cost-effective modality and a realistic substitute for the more costly breast MRI.

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

    PubMed Central

    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

    2012-01-01

    Purpose: 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. Methods: 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. Results: 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

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

    PubMed

    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

  12. Diagnostic performance of tomosynthesis and breast ultrasonography in women with dense breasts: a prospective comparison study.

    PubMed

    Kim, Won Hwa; Chang, Jung Min; Lee, Joongyub; Chu, A Jung; Seo, Mirinae; Gweon, Hye Mi; Koo, Hye Ryoung; Lee, Su Hyun; Cho, Nariya; Bae, Min Sun; Shin, Sung Ui; Song, Sung Eun; Moon, Woo Kyung

    2017-02-01

    To compare the diagnostic performances of tomosynthesis and ultrasonography as adjunctives to digital mammography in women with dense breasts. A total of 778 women with dense breasts underwent digital mammography with tomosynthesis and ultrasonography for screening and diagnostic purposes. The findings of tomosynthesis and ultrasonography were evaluated independently. The primary endpoint was overall diagnostic accuracy determined by area under the receiver operating characteristic curve (AUC). Secondary endpoints included sensitivity, specificity, and predictive values. Of the 778 participants, 698 women (140 breast cancers) were included in the analysis. Based on the AUC findings, the non-inferiority of tomosynthesis to ultrasonography was established in the overall group as well as in all subgroups except for that comprising women with extremely dense breast composition. There were no significant differences in AUC between tomosynthesis and ultrasonography among asymptomatic participants and participants who underwent imaging for screening (0.912 vs. 0.934 [P = 0.403] and 0.987 vs. 0.950 [P = 0.270], respectively). Tomosynthesis exhibited lower sensitivity (91.4 vs. 96.4%; P = 0.039), and higher specificity (83.9 vs. 70.4%; P < 0.001) and positive predictive value (58.7 vs. 45.0%; P < 0.001) than ultrasonography. Tomosynthesis exhibits comparable performance to ultrasonography as an adjunct to mammography for diagnosis of breast cancer, except among women with extremely dense breasts.

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

    NASA Astrophysics Data System (ADS)

    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.

  14. Mammography Positioning Standards in the Digital Era: Is the Status Quo Acceptable?

    PubMed

    Huppe, Ashley I; Overman, Kelly L; Gatewood, Jason B; Hill, Jacqueline D; Miller, Louise C; Inciardi, Marc F

    2017-09-05

    The objective of our study was to evaluate positioning of full-field digital mammography (FFDM) and digital breast tomosynthesis (DBT) compared with film-screen (FS) mammography positioning standards. A retrospective study was conducted of consecutive patients who underwent screening FFDM in 2010-2012 and DBT in 2012-2013 at an academic institution. Examinations were performed by five experienced technologists who underwent updated standardized positioning training. Positioning criteria were assessed by consensus reads among three breast radiologists and compared with FS mammography data from a 1993 study by Bassett and colleagues. One hundred seventy patients (n = 340 examinations) were analyzed, showing significant differences between FFDM and DBT examinations (p < 0.05) for medial or inferior skin folds (FFDM vs DBT: craniocaudal [CC] view, 16% [n = 56] vs 23% [n = 77]; mediolateral oblique [MLO] view, 35% [n = 118] vs 45% [n = 154]), inclusion of lateral glandular tissue on CC view (FFDM vs DBT, 73% [n = 247] vs 81% [n = 274]), and concave pectoralis muscle shape (FFDM vs DBT, 36% [n = 121] vs 28% [n = 95]). In comparison with Bassett et al. data, all positioning criteria for both FFDM and DBT examinations were significantly different (p < 0.05). The largest differences were found in visualization of the pectoralis muscle on CC views and the inframammary fold on MLO views, inclusion of posterior or lateral glandular tissue, and inclusion of skin folds, with DBT and FFDM more frequently exhibiting all criteria than originally reported Bassett et al. DBT and FFDM mammograms more frequently include posterior or lateral tissue, the inframammary fold on MLO views, the pectoralis muscle on CC views, and skin folds than FS mammograms. Inclusion of more breast tissue with newer technologies suggests traditional positioning standards, in conjunction with updated standardized positioning training, are still applicable at the expense of including more skin folds.

  15. Evaluation of respiration-correlated digital tomosynthesis in lung1

    PubMed Central

    Santoro, Joseph; Kriminski, Sergey; Lovelock, D. Michael; Rosenzweig, Kenneth; Mostafavi, Hassan; Amols, Howard I.; Mageras, Gig S.

    2010-01-01

    Digital tomosynthesis (DTS) with a linear accelerator-mounted imaging system provides a means of reconstructing tomographic images from radiographic projections over a limited gantry arc, thus requiring only a few seconds to acquire. Its application in the thorax, however, often results in blurred images from respiration-induced motion. This work evaluates the feasibility of respiration-correlated (RC) DTS for soft-tissue visualization and patient positioning. Image data acquired with a gantry-mounted kilovoltage imaging system while recording respiration were retrospectively analyzed from patients receiving radiotherapy for non-small-cell lung carcinoma. Projection images spanning an approximately 30° gantry arc were sorted into four respiration phase bins prior to DTS reconstruction, which uses a backprojection, followed by a procedure to suppress structures above and below the reconstruction plane of interest. The DTS images were reconstructed in planes at different depths through the patient and normal to a user-selected angle close to the center of the arc. The localization accuracy of RC-DTS was assessed via a comparison with CBCT. Evaluation of RC-DTS in eight tumors shows visible reduction in image blur caused by the respiratory motion. It also allows the visualization of tumor motion extent. The best image quality is achieved at the end-exhalation phase of the respiratory motion. Comparison of RC-DTS with respiration-correlated cone-beam CT in determining tumor position, motion extent and displacement between treatment sessions shows agreement in most cases within 2–3 mm, comparable in magnitude to the intraobserver repeatability of the measurement. These results suggest the method’s applicability for soft-tissue image guidance in lung, but must be confirmed with further studies in larger numbers of patients. PMID:20384261

  16. Digital breast tomosynthesis: Dose and image quality assessment.

    PubMed

    Maldera, A; De Marco, P; Colombo, P E; Origgi, D; Torresin, A

    2017-01-01

    The aim of this work was to evaluate how different acquisition geometries and reconstruction parameters affect the performance of four digital breast tomosynthesis (DBT) systems (Senographe Essential - GE, Mammomat Inspiration - Siemens, Selenia Dimensions - Hologic and Amulet Innovality - Fujifilm) on the basis of a physical characterization. Average Glandular Dose (AGD) and image quality parameters such as in-plane/in-depth resolution, signal difference to noise ratio (SDNR) and artefact spread function (ASF) were examined. Measured AGD values resulted below EUREF limits for 2D imaging. A large variability was recorded among the investigated systems: the mean dose ratio DBT/2D ranged between 1.1 and 1.9. In-plane resolution was in the range: 2.2mm(-1)-3.8mm(-1) in chest wall-nipple direction. A worse resolution was found for all devices in tube travel direction. In-depth resolution improved with increasing scan angle but was also affected by the choice of reconstruction and post-processing algorithms. The highest z-resolution was provided by Siemens (50°, FWHM=2.3mm) followed by GE (25°, FWHM=2.8mm), while the Fujifilm HR showed the lowest one, despite its wide scan angle (40°, FWHM=4.1mm). The ASF was dependent on scan angle: smaller range systems showed wider ASF curves; however a clear relationship was not found between scan angle and ASF, due to the different post processing and reconstruction algorithms. SDNR analysis, performed on Fujifilm system, demonstrated that pixel binning improves detectability for a fixed dose/projection. In conclusion, we provide a performance comparison among four DBT systems under a clinical acquisition mode. Copyright © 2016 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  17. Visibility of single spiculations in digital breast tomosynthesis

    NASA Astrophysics Data System (ADS)

    Timberg, Pontus; Dustler, Magnus; Förnvik, Daniel; Zackrisson, Sophia

    2013-03-01

    Purpose: To investigate the visibility of single spiculations in digital breast tomosynthesis (DBT). Method: Simulated spheres (6 mm diameter) with single spiculations were added to projection images acquired on a DBT system (MAMMOMAT Inspiration, Siemens). The spiculations had a cylindrical shape and were randomly, diagonally aligned (at four different positions: +/- π/4 or +/- 3π/4) at a plane parallel to the detector. They were assumed to consist of a fibroglandular tissue composition. The length of the spiculations was 5 mm while the diameter varied (0.12 - 0.28 mm). Reconstructed central slices of the lesion, separated by insertion in fatty or dense breasts (100 images in each), were used in 4-alternative forced choice (4AFC) human observer experiments. Three different reconstructions were used: filtered back projection (FBP) with 1 mm thick slices and a statistical artifact reduction reconstruction (SAR) method generating 1 and 2 mm thick slices. Five readers participated and their task was to locate the spiculation in randomly presented images from the whole image set (4 diameters × 100 images). The percent correct (PC) decision was determined in both fat and dense tissue for all spiculation diameters and reconstructions. Results: At a PC level of 95% the required diameter was about 0.17 - 0.22 mm in dense tissue, and 0.18 - 0.26 mm in fatty tissue (depending upon reconstruction). Conclusions: SAR was found to be a promising alternative to FBP. The visibility of single spiculations was determined. The required diameter depends on both tissue composition and reconstruction.

  18. Fully automated nipple detection in digital breast tomosynthesis.

    PubMed

    Chae, Seung-Hoon; Jeong, Ji-Wook; Choi, Jang-Hwan; Chae, Eun Young; Kim, Hak Hee; Choi, Young-Wook; Lee, Sooyeul

    2017-05-01

    We propose a nipple detection algorithm for use with digital breast tomosynthesis (DBT) images. DBT images have been developed to overcome the weaknesses of 2D mammograms for denser breasts by providing 3D breast images. The nipple location acts as an invaluable landmark in DBT images for aligning the right and left breasts and describing the relative location of any existing lesions. Nipples may be visible or invisible in a breast image, and therefore a nipple detection method must be able to detect the nipples for both cases. The detection method for visible nipples based on their shape is simple and highly efficient. However, it is difficult to detect invisible nipples because they do not have a prominent shape. Fibroglandular tissue in a breast is anatomically connected with the nipple. Thus, the nipple location can be detected by analyzing the location of such tissue. In this paper, we propose a method for detecting the location of both visible and invisible nipples using fibroglandular tissue and changes in the breast area. Our algorithm was applied to 138 DBT images, and its nipple detection accuracy was evaluated based on the mean Euclidean distance. The results indicate that our proposed method achieves a mean Euclidean distance of 3.10±2.58mm. The nipple location can be a very important piece of information in the process of a DBT image registration. This paper presents a method for the automatic nipple detection in a DBT image. The extracted nipple location plays an essential role in classifying any existing lesions and comparing both the right and left breasts. Thus, the proposed method can help with computer-aided detection for a more efficient DBT image analysis. Copyright © 2017 Elsevier B.V. All rights reserved.

  19. Multiscale regularized reconstruction for enhancing microcalcification in digital breast tomosynthesis

    NASA Astrophysics Data System (ADS)

    Lu, Yao; Chan, Heang-Ping; Wei, Jun; Hadjiiski, Lubomir; Zhou, Chuan

    2012-03-01

    Digital breast tomosynthesis (DBT) holds strong promise for improving the sensitivity of detecting subtle mass lesions. Detection of microcalcifications is more difficult because of high noise and subtle signals in the large DBT volume. It is important to enhance the contrast-to-noise ratio (CNR) of microcalcifications in DBT reconstruction. A major challenge of implementing microcalcification enhancement or noise regularization in DBT reconstruction is to preserve the image quality of masses, especially those with ill-defined margins and subtle spiculations. We are developing a new multiscale regularization (MSR) method for the simultaneous algebraic reconstruction technique (SART) to improve the CNR of microcalcifications without compromising the quality of masses. Each DBT slice is stratified into different frequency bands via wavelet decomposition and the regularization method applies different degrees of regularization to different frequency bands to preserve features of interest and suppress noise. Regularization is constrained by a characteristic map to avoid smoothing subtle microcalcifications. The characteristic map is generated via image feature analysis to identify potential microcalcification locations in the DBT volume. The MSR method was compared to the non-convex total pvariation (TpV) method and SART with no regularization (NR) in terms of the CNR and the full width at half maximum of the line profiles intersecting calcifications and mass spiculations in DBT of human subjects. The results demonstrated that SART regularized by the MSR method was superior to the TpV method for subtle microcalcifications in terms of CNR enhancement. The MSR method preserved the quality of subtle spiculations better than the TpV method in comparison to NR.

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

    PubMed Central

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

    2015-01-01

    Objectives: 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. Methods: 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. Results: 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. Conclusions: Feasibility of the stationary intraoral tomosynthesis is demonstrated. The results show clinical promise and suitability for more robust observer and clinical studies. PMID:26090933

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

    PubMed Central

    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 < 0.05). Conclusion: The use of digital breast 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. PMID:25684789

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

    PubMed

    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 < 0.05). Conclusion: The use of digital breast 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.

  3. ROC study of screen-film mammography and storage phosphor digital mammography: analysis of nonconcordant classifications and implications for the approval of digital mammography systems

    NASA Astrophysics Data System (ADS)

    Freedman, Matthew T.; Artz, Dorothy S.; Hogge, Jacquelyn; Zuurbier, Rebecca A.; Jafroudi, Hamid; Lo, Shih-Chung B.; Mun, Seong K.

    1997-04-01

    A recently completed ROC study of digital mammography using a 100 micron pixel storage phosphor receptor showed that digital mammography and conventional screen film mammography were essentially equivalent in areas under the ROC curve. In this study, there were 24 biopsy proven breast cancer cases, 25 benign biopsy cases and 48 clinically normal breast images each with matched screen film and storage phosphor images. Fifteen of the 24 cancer cases were 10 mm or less in size. Of these 10 presented with microcalcifications as the sign of disease. Six radiologists not involved with the research program and without prior experience with digital mammography and who met qualification criteria under the Mammography Quality Standards Act of 1992 served as readers. This poster looks at the cases in which there was variance between the radiologists ROC classification system for the digital and screen film system in order to analyze case specific discrepancies that may indicate benefits or deficits of the digital system. Aspects of the ROC ratings are also analyzed including an evaluation of the different thresholds used by radiologists on the digital and screen film systems, the distribution of ROC ratings in normal and abnormal cases, the effect of using different gold standards of proof on the results and the effect of substituting an ACR BIRADS category agreement study as proposed by the FDA compared to the ROC study outcome.

  4. The Impact of Acquisition Dose on Quantitative Breast Density Estimation with Digital Mammography: Results from ACRIN PA 4006

    PubMed Central

    Chen, Lin; Ray, Shonket; Keller, Brad M.; Pertuz, Said; McDonald, Elizabeth S.; Conant, Emily F.

    2016-01-01

    Purpose To investigate the impact of radiation dose on breast density estimation in digital mammography. Materials and Methods With institutional review board approval and Health Insurance Portability and Accountability Act compliance under waiver of consent, a cohort of women from the American College of Radiology Imaging Network Pennsylvania 4006 trial was retrospectively analyzed. All patients underwent breast screening with a combination of dose protocols, including standard full-field digital mammography, low-dose digital mammography, and digital breast tomosynthesis. A total of 5832 images from 486 women were analyzed with previously validated, fully automated software for quantitative estimation of density. Clinical Breast Imaging Reporting and Data System (BI-RADS) density assessment results were also available from the trial reports. The influence of image acquisition radiation dose on quantitative breast density estimation was investigated with analysis of variance and linear regression. Pairwise comparisons of density estimations at different dose levels were performed with Student t test. Agreement of estimation was evaluated with quartile-weighted Cohen kappa values and Bland-Altman limits of agreement. Results Radiation dose of image acquisition did not significantly affect quantitative density measurements (analysis of variance, P = .37 to P = .75), with percent density demonstrating a high overall correlation between protocols (r = 0.88–0.95; weighted κ = 0.83–0.90). However, differences in breast percent density (1.04% and 3.84%, P < .05) were observed within high BI-RADS density categories, although they were significantly correlated across the different acquisition dose levels (r = 0.76–0.92, P < .05). Conclusion Precision and reproducibility of automated breast density measurements with digital mammography are not substantially affected by variations in radiation dose; thus, the use of low-dose techniques for the purpose of density

  5. The Impact of Acquisition Dose on Quantitative Breast Density Estimation with Digital Mammography: Results from ACRIN PA 4006.

    PubMed

    Chen, Lin; Ray, Shonket; Keller, Brad M; Pertuz, Said; McDonald, Elizabeth S; Conant, Emily F; Kontos, Despina

    2016-09-01

    Purpose To investigate the impact of radiation dose on breast density estimation in digital mammography. Materials and Methods With institutional review board approval and Health Insurance Portability and Accountability Act compliance under waiver of consent, a cohort of women from the American College of Radiology Imaging Network Pennsylvania 4006 trial was retrospectively analyzed. All patients underwent breast screening with a combination of dose protocols, including standard full-field digital mammography, low-dose digital mammography, and digital breast tomosynthesis. A total of 5832 images from 486 women were analyzed with previously validated, fully automated software for quantitative estimation of density. Clinical Breast Imaging Reporting and Data System (BI-RADS) density assessment results were also available from the trial reports. The influence of image acquisition radiation dose on quantitative breast density estimation was investigated with analysis of variance and linear regression. Pairwise comparisons of density estimations at different dose levels were performed with Student t test. Agreement of estimation was evaluated with quartile-weighted Cohen kappa values and Bland-Altman limits of agreement. Results Radiation dose of image acquisition did not significantly affect quantitative density measurements (analysis of variance, P = .37 to P = .75), with percent density demonstrating a high overall correlation between protocols (r = 0.88-0.95; weighted κ = 0.83-0.90). However, differences in breast percent density (1.04% and 3.84%, P < .05) were observed within high BI-RADS density categories, although they were significantly correlated across the different acquisition dose levels (r = 0.76-0.92, P < .05). Conclusion Precision and reproducibility of automated breast density measurements with digital mammography are not substantially affected by variations in radiation dose; thus, the use of low-dose techniques for the purpose of density estimation

  6. Mammography

    MedlinePlus

    ... mammography facility. top of page What does the equipment look like? A mammography unit is a rectangular ... be notified of the results by the mammography facility. Follow-up examinations may be necessary. Your doctor ...

  7. First results with real-time selenium-based full-field digital mammography three-dimensional imaging system

    NASA Astrophysics Data System (ADS)

    Lehtimaki, Mari; Pamilo, Martti; Raulisto, Leena; Kalke, Martti

    2004-05-01

    Our goal in this paper is to evaluate the capability of real-time selenium-technology-based full-field digital mammography (FFDM) system in breast tomosynthesis. The objective of this study is to find out the present status of amorphous selenium technology in the sense of advanced applications in clinical use. We were using tuned aperture computed tomography (TACT+) 3-dimensional (3D) technology for reconstruction. Under evaluation were amorphous selenium signal-to-noise-ratio, flat panel image artefacts and acquisition time to perform full-field digital mammography 3D examination. To be able to validate the system we used a special breast phantom. We found out that 3D imaging technology provides diagnostic value and benefits over 2-dimensional (2D) imaging. 3D TACT advantages are to define if mammography finding is caused by a real abnormal lesion or by superposition of normal parenchymal structures, to be able to diagnose and analyze the findings properly, to detect changes in breast tissue which would otherwise be missed, to verify the possible multifocality of the breast cancers, to verify the correct target for biopsies and to reduce number of biopsies performed. Slice visualization and 3D volume model provide greater diagnostic information compared to 2D projection screening and diagnostic imaging.

  8. Development of a prototype chest digital tomosynthesis R/F system

    NASA Astrophysics Data System (ADS)

    Choi, Sunghoon; Lee, Haenghwa; Lee, Donghoon; Choi, Seungyeon; Shin, Jungwook; Jang, Woojin; Seo, Chang-Woo; Kim, Hee-Joung

    2017-03-01

    Digital tomosynthesis has an advantage of low radiation dose compared to conventional computed tomography (CT) by utilizing small number of projections ( 80) acquired over a limited angular range. It can produce 3D volumetric data although they may have some artifacts due to incomplete sampling. Based upon these attractive merits, we developed a prototype digital tomosynthesis R/F system especially for the purpose of applications in chest imaging. 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 precise motor controller, and a reconstruction server. For image reconstruction, users could select the reconstruction option between analytic and iterative methods. Reconstructed images of Catphan700 and LUNGMAN phantoms clearly and rapidly described the internal structures of the phantoms using graphics processing unit (GPU) programming. Contrast-to-noise ratio (CNR) values of the CTP682 module was higher in images using the simultaneous algebraic reconstruction technique (SART) than those using filtered backprojection (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 (acetal homopolymer resin), bone 50% (hydroxyapatite), and Teflon, respectively. Total elapsed times for producing 3D volume were 2.92 sec and 86.29 sec on average for FBP and SART (20 iterations), respectively. The times required for reconstruction were clinically feasible. Moreover, the total radiation dose from the system (5.68 mGy) could demonstrate a significant lowered radiation dose compared to conventional chest CT scan. Consequently, our prototype tomosynthesis R/F system represents an important advance in digital tomosynthesis applications.

  9. Radiation exposure of contrast-enhanced spectral mammography compared with full-field digital mammography.

    PubMed

    Jeukens, Cécile R L P N; Lalji, Ulrich C; Meijer, Eduard; Bakija, Betina; Theunissen, Robin; Wildberger, Joachim E; Lobbes, Marc B I

    2014-10-01

    Contrast-enhanced spectral mammography (CESM) shows promising initial results but comes at the cost of increased dose as compared with full-field digital mammography (FFDM). We aimed to quantitatively assess the dose increase of CESM in comparison with FFDM. Radiation exposure-related data (such as kilovoltage, compressed breast thickness, glandularity, entrance skin air kerma (ESAK), and average glandular dose (AGD) were retrieved for 47 CESM and 715 FFDM patients. All examinations were performed on 1 mammography unit. Radiation dose values reported by the unit were validated by phantom measurements. Descriptive statistics of the patient data were generated using a statistical software package. Dose values reported by the mammography unit were in good qualitative agreement with those of phantom measurements. Mean ESAK was 10.5 mGy for a CESM exposure and 7.46 mGy for an FFDM exposure. Mean AGD for a CESM exposure was 2.80 mGy and 1.55 mGy for an FFDM exposure. Compared with our institutional FFDM, the AGD of a single CESM exposure is increased by 1.25 mGy (+81%), whereas ESAK is increased by 3.07 mGy (+41%). Dose values of both techniques meet the recommendations for maximum dose in mammography.

  10. Observation of super-resolution in digital breast tomosynthesis

    SciTech Connect

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

    2012-12-15

    Purpose: Digital breast tomosynthesis (DBT) is a 3D x-ray imaging modality in which tomographic sections of the breast are generated from a limited range of tube angles. Because oblique x-ray incidence shifts the image of an object in subpixel detector element increments with each increasing projection angle, it is demonstrated that DBT is capable of super-resolution (i.e., subpixel resolution). Methods: By convention, DBT reconstructions are performed on planes parallel to the breast support at various depths of the breast volume. In order for resolution in each reconstructed slice to be comparable to the detector, the pixel size should match that of the detector elements; hence, the highest frequency that can be resolved in the plane of reconstruction is the alias frequency of the detector. This study considers reconstruction grids with much smaller pixelation to visualize higher frequencies. For analytical proof of super-resolution, a theoretical framework is developed in which the reconstruction of a high frequency sinusoidal input is calculated using both simple backprojection (SBP) and filtered backprojection. To study the frequency spectrum of the reconstruction, its Fourier transform is also determined. The experimental feasibility of super-resolution was investigated by acquiring images of a bar pattern phantom with frequencies higher than the detector alias frequency. Results: Using analytical modeling, it is shown that the central projection cannot resolve frequencies exceeding the detector alias frequency. The Fourier transform of the central projection is maximized at a lower frequency than the input as evidence of aliasing. By contrast, SBP reconstruction can resolve the input, and its Fourier transform is correctly maximized at the input frequency. Incorporating filters into the reconstruction smoothens pixelation artifacts in the spatial domain and reduces spectral leakage in the Fourier domain. It is also demonstrated that the existence of super

  11. Observation of super-resolution in digital breast tomosynthesis

    PubMed Central

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

    2012-01-01

    Purpose: Digital breast tomosynthesis (DBT) is a 3D x-ray imaging modality in which tomographic sections of the breast are generated from a limited range of tube angles. Because oblique x-ray incidence shifts the image of an object in subpixel detector element increments with each increasing projection angle, it is demonstrated that DBT is capable of super-resolution (i.e., subpixel resolution). Methods: By convention, DBT reconstructions are performed on planes parallel to the breast support at various depths of the breast volume. In order for resolution in each reconstructed slice to be comparable to the detector, the pixel size should match that of the detector elements; hence, the highest frequency that can be resolved in the plane of reconstruction is the alias frequency of the detector. This study considers reconstruction grids with much smaller pixelation to visualize higher frequencies. For analytical proof of super-resolution, a theoretical framework is developed in which the reconstruction of a high frequency sinusoidal input is calculated using both simple backprojection (SBP) and filtered backprojection. To study the frequency spectrum of the reconstruction, its Fourier transform is also determined. The experimental feasibility of super-resolution was investigated by acquiring images of a bar pattern phantom with frequencies higher than the detector alias frequency. Results: Using analytical modeling, it is shown that the central projection cannot resolve frequencies exceeding the detector alias frequency. The Fourier transform of the central projection is maximized at a lower frequency than the input as evidence of aliasing. By contrast, SBP reconstruction can resolve the input, and its Fourier transform is correctly maximized at the input frequency. Incorporating filters into the reconstruction smoothens pixelation artifacts in the spatial domain and reduces spectral leakage in the Fourier domain. It is also demonstrated that the existence of super

  12. Quantification of breast arterial calcification using full field digital mammography.

    PubMed

    Molloi, Sabee; Xu, Tong; Ducote, Justin; Iribarren, Carlos

    2008-04-01

    Breast arterial calcification is commonly detected on some mammograms. Previous studies indicate that breast arterial calcification is evidence of general atherosclerotic vascular disease and it may be a useful marker of coronary artery disease. It can potentially be a useful tool for assessment of coronary artery disease in women since mammography is widely used as a screening tool for early detection of breast cancer. However, there are currently no available techniques for quantification of calcium mass using mammography. The purpose of this study was to determine whether it is possible to quantify breast arterial calcium mass using standard digital mammography. An anthropomorphic breast phantom along with a vessel calcification phantom was imaged using a full field digital mammography system. Densitometry was used to quantify calcium mass. A calcium calibration measurement was performed at each phantom thickness and beam energy. The known (K) and measured (M) calcium mass on 5 and 9 cm thickness phantoms were related by M=0.964K -0.288 mg (r=0.997 and SEE=0.878 mg) and M=1.004K+0.324 mg (r=0.994 and SEE = 1.32 mg), respectively. The results indicate that accurate calcium mass measurements can be made without correction for scatter glare as long as careful calcium calibration is made for each breast thickness. The results also indicate that composition variations and differences of approximately 1 cm between calibration phantom and breast thickness introduce only minimal error in calcium measurement. The uncertainty in magnification is expected to cause up to 5% and 15% error in calcium mass for 5 and 9 cm breast thicknesses, respectively. In conclusion, a densitometry technique for quantification of breast arterial calcium mass was validated using standard full field digital mammography. The results demonstrated the feasibility and potential utility of the densitometry technique for accurate quantification of breast arterial calcium mass using standard digital

  13. Quantification of breast arterial calcification using full field digital mammography

    PubMed Central

    Molloi, Sabee; Xu, Tong; Ducote, Justin; Iribarren, Carlos

    2008-01-01

    Breast arterial calcification is commonly detected on some mammograms. Previous studies indicate that breast arterial calcification is evidence of general atherosclerotic vascular disease and it may be a useful marker of coronary artery disease. It can potentially be a useful tool for assessment of coronary artery disease in women since mammography is widely used as a screening tool for early detection of breast cancer. However, there are currently no available techniques for quantification of calcium mass using mammography. The purpose of this study was to determine whether it is possible to quantify breast arterial calcium mass using standard digital mammography. An anthropomorphic breast phantom along with a vessel calcification phantom was imaged using a full field digital mammography system. Densitometry was used to quantify calcium mass. A calcium calibration measurement was performed at each phantom thickness and beam energy. The known (K) and measured (M) calcium mass on 5 and 9 cm thickness phantoms were related by M=0.964K−0.288 mg (r=0.997 and SEE=0.878 mg) and M=1.004K+0.324 mg (r=0.994 and SEE=1.32 mg), respectively. The results indicate that accurate calcium mass measurements can be made without correction for scatter glare as long as careful calcium calibration is made for each breast thickness. The results also indicate that composition variations and differences of approximately 1 cm between calibration phantom and breast thickness introduce only minimal error in calcium measurement. The uncertainty in magnification is expected to cause up to 5% and 15% error in calcium mass for 5 and 9 cm breast thicknesses, respectively. In conclusion, a densitometry technique for quantification of breast arterial calcium mass was validated using standard full field digital mammography. The results demonstrated the feasibility and potential utility of the densitometry technique for accurate quantification of breast arterial calcium mass using standard digital

  14. Quantification of breast arterial calcification using full field digital mammography

    SciTech Connect

    Molloi, Sabee; Xu Tong; Ducote, Justin; Iribarren, Carlos

    2008-04-15

    Breast arterial calcification is commonly detected on some mammograms. Previous studies indicate that breast arterial calcification is evidence of general atherosclerotic vascular disease and it may be a useful marker of coronary artery disease. It can potentially be a useful tool for assessment of coronary artery disease in women since mammography is widely used as a screening tool for early detection of breast cancer. However, there are currently no available techniques for quantification of calcium mass using mammography. The purpose of this study was to determine whether it is possible to quantify breast arterial calcium mass using standard digital mammography. An anthropomorphic breast phantom along with a vessel calcification phantom was imaged using a full field digital mammography system. Densitometry was used to quantify calcium mass. A calcium calibration measurement was performed at each phantom thickness and beam energy. The known (K) and measured (M) calcium mass on 5 and 9 cm thickness phantoms were related by M=0.964K-0.288 mg (r=0.997 and SEE=0.878 mg) and M=1.004K+0.324 mg (r=0.994 and SEE=1.32 mg), respectively. The results indicate that accurate calcium mass measurements can be made without correction for scatter glare as long as careful calcium calibration is made for each breast thickness. The results also indicate that composition variations and differences of approximately 1 cm between calibration phantom and breast thickness introduce only minimal error in calcium measurement. The uncertainty in magnification is expected to cause up to 5% and 15% error in calcium mass for 5 and 9 cm breast thicknesses, respectively. In conclusion, a densitometry technique for quantification of breast arterial calcium mass was validated using standard full field digital mammography. The results demonstrated the feasibility and potential utility of the densitometry technique for accurate quantification of breast arterial calcium mass using standard digital

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

    PubMed

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

    2017-06-22

    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 (p<0.001) and a mean reading time of 154 s versus 34 s for the fastest strategy (single reading of S-2D alone). The AUCs for the other five strategies did not differ from each other. Double reading of tomosynthesis+ 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 (p<0.001). • Double reading of S-2D plus tomosynthesis increased reading time.

  16. Performance of a carbon nanotube field emission X-ray source array for stationary digital breast tomosynthesis

    NASA Astrophysics Data System (ADS)

    Gidcumb, Emily Morgan

    This work describes the performance of a stationary digital breast tomosynthesis (s-DBT) X-ray tube based on carbon nanotube (CNT) cathodes, and the imaging system developed around it. The s-DBT system has the potential to improve the detection and diagnosis of breast cancer over commercially available digital breast tomosynthesis (DBT) systems. DBT is growing in popularity in the United States, and around the world, as a potential replacement for traditional 2D mammography. The main advantage of DBT over 2D mammography lies in the pseudo-3D nature of the technique allowing the removal of overlapping breast tissue within the image. s-DBT builds on this advantage by removing blur from focal spot motion. Introductions to breast imaging techniques and the DBT modality are given, followed by an introduction to carbon nanotube field emission, the foundation of the s-DBT technology. Details of the s-DBT X-ray tube design and system integration are discussed including specific design parameters, system requirements, and the development process. Also included are summaries of the X-ray tube and system performance over time, and results from characterization measurements. Specific focus is given to the development and completion of a fabrication procedure for tungsten gate mesh, characterization of the CNT cathodes, and improving the system's spatial resolution with use of the focusing electrodes. The tungsten gate mesh is an essential component for extracting electrons from CNTs. A successful deep reactive ion etching fabrication procedure was developed, and the improved gate mesh allowed for higher cathode current and longer pulse widths to be employed in the s-DBT system. Characterization of the CNT cathodes revealed their high-current capacity and the ability to produce relatively long pulse widths, mimicking a 2D imaging modality. This work confirmed that the cathodes are well suited for the task of breast imaging, and explored possible improvements. Lastly, it was

  17. Characterization of lesions in dense breasts: Does tomosynthesis help?

    PubMed

    Rangarajan, Krithika; Hari, Smriti; Thulkar, Sanjay; Sharma, Sanjay; Srivastava, Anurag; Parshad, Rajinder

    2016-01-01

    Mammography in dense breasts is challenging due to lesion obscuration by tissue overlap. Does tomosynthesis offers a solution? To study the impact of digital breast tomosynthesis (DBT) in characterizing lesions in breasts of different mammographic densities. Prospective blinded study comparing mammography in two views with Mammography + Tomosynthesis. Tomosynthesis was performed in 199 patients who were assigned Breast imaging reporting and data system (BIRADS) categories 0, 3, 4, or 5 on two-dimensional (2D) mammogram. Mammograms were first categorized into one of 4 mammographic breast densities in accordance with the American College of Radiology (ACR). Three radiologists independently analyzed these images and assigned a BIRADS category first based on 2D mammogram alone, and then assigned a fresh BIRADS category after taking mammography and tomosynthesis into consideration. A composite gold-standard was used in the study (histopathology, ultrasound, follow-up mammogram, magnetic resonance imaging). Each lesion was categorized into 3 groups-superior categorization with DBT, no change in BIRADS, or inferior BIRADS category based on comparison with the gold-standard. The percentage of lesions in each group was calculated for different breast densities. There were 260 lesions (ages 28-85). Overall, superior categorization was seen in 21.2% of our readings on addition of DBT to mammography. DBT was most useful in ACR Densities 3 and 4 breasts where it led to more appropriate categorization in 27 and 42% of lesions, respectively. DBT also increased diagnostic confidence in 54.5 and 63.6% of lesions in ACR Densities 3 and 4, respectively. In a diagnostic setting, the utility of tomosynthesis increases with increasing breast density. This helps in identifying the sub category of patients where DBT can actually change management.

  18. Characterization of lesions in dense breasts: Does tomosynthesis help?

    PubMed Central

    Rangarajan, Krithika; Hari, Smriti; Thulkar, Sanjay; Sharma, Sanjay; Srivastava, Anurag; Parshad, Rajinder

    2016-01-01

    Context: Mammography in dense breasts is challenging due to lesion obscuration by tissue overlap. Does tomosynthesis offers a solution? Aims: To study the impact of digital breast tomosynthesis (DBT) in characterizing lesions in breasts of different mammographic densities. Settings and Design: Prospective blinded study comparing mammography in two views with Mammography + Tomosynthesis. Methods and Material: Tomosynthesis was performed in 199 patients who were assigned Breast imaging reporting and data system (BIRADS) categories 0, 3, 4, or 5 on two-dimensional (2D) mammogram. Mammograms were first categorized into one of 4 mammographic breast densities in accordance with the American College of Radiology (ACR). Three radiologists independently analyzed these images and assigned a BIRADS category first based on 2D mammogram alone, and then assigned a fresh BIRADS category after taking mammography and tomosynthesis into consideration. A composite gold-standard was used in the study (histopathology, ultrasound, follow-up mammogram, magnetic resonance imaging). Each lesion was categorized into 3 groups—superior categorization with DBT, no change in BIRADS, or inferior BIRADS category based on comparison with the gold-standard. The percentage of lesions in each group was calculated for different breast densities. Results: There were 260 lesions (ages 28–85). Overall, superior categorization was seen in 21.2% of our readings on addition of DBT to mammography. DBT was most useful in ACR Densities 3 and 4 breasts where it led to more appropriate categorization in 27 and 42% of lesions, respectively. DBT also increased diagnostic confidence in 54.5 and 63.6% of lesions in ACR Densities 3 and 4, respectively. Conclusions: In a diagnostic setting, the utility of tomosynthesis increases with increasing breast density. This helps in identifying the sub category of patients where DBT can actually change management. PMID:27413268

  19. Digital Mammography with a Mosaic of CCD-Arrays

    NASA Technical Reports Server (NTRS)

    Jalink, Antony, Jr. (Inventor); McAdoo, James A. (Inventor)

    1996-01-01

    The present invention relates generally to a mammography device and method and more particularly to a novel digital mammography device and method to detect microcalcifications of precancerous tissue. A digital mammography device uses a mosaic of electronic digital imaging arrays to scan an x-ray image. The mosaic of arrays is repositioned several times to expose different portions of the image, until the entire image is scanned. The data generated by the arrays during each exposure is stored in a computer. After the final exposure, the computer combines data of the several partial images to produce a composite of the original x-ray image. An aperture plate is used to reduce scatter and the overall exposure of the patient to x-rays. The novelty of this invention is that it provides a digital mammography device with large field coverage, high spatial resolution, scatter rejection, excellent contrast characteristics and lesion detectability under clinical conditions. This device also shields the patient from excessive radiation, can detect extremely small calcifications and allows manipulation and storage of the image.

  20. Automatic segmentation of mammogram and tomosynthesis images

    NASA Astrophysics Data System (ADS)

    Sargent, Dusty; Park, Sun Young

    2016-03-01

    Breast cancer is a one of the most common forms of cancer in terms of new cases and deaths both in the United States and worldwide. However, the survival rate with breast cancer is high if it is detected and treated before it spreads to other parts of the body. The most common screening methods for breast cancer are mammography and digital tomosynthesis, which involve acquiring X-ray images of the breasts that are interpreted by radiologists. The work described in this paper is aimed at optimizing the presentation of mammography and tomosynthesis images to the radiologist, thereby improving the early detection rate of breast cancer and the resulting patient outcomes. Breast cancer tissue has greater density than normal breast tissue, and appears as dense white image regions that are asymmetrical between the breasts. These irregularities are easily seen if the breast images are aligned and viewed side-by-side. However, since the breasts are imaged separately during mammography, the images may be poorly centered and aligned relative to each other, and may not properly focus on the tissue area. Similarly, although a full three dimensional reconstruction can be created from digital tomosynthesis images, the same centering and alignment issues can occur for digital tomosynthesis. Thus, a preprocessing algorithm that aligns the breasts for easy side-by-side comparison has the potential to greatly increase the speed and accuracy of mammogram reading. Likewise, the same preprocessing can improve the results of automatic tissue classification algorithms for mammography. In this paper, we present an automated segmentation algorithm for mammogram and tomosynthesis images that aims to improve the speed and accuracy of breast cancer screening by mitigating the above mentioned problems. Our algorithm uses information in the DICOM header to facilitate preprocessing, and incorporates anatomical region segmentation and contour analysis, along with a hidden Markov model (HMM) for

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

    SciTech Connect

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

    2010-10-11

    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{sup 3} were segmented from the DBT images and corresponding 2.5 cm{sup 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<0.001) for contrast and r = -0.52 (p<0.001) for homogeneity; the corresponding DM correlations were r = 0.26 (p = 0.002) and r = -0.33 (p<0.001). Multiple linear regression of the texture features versus breast PD also demonstrated significantly stronger associations in DBT (R{sup 2} = 0.39) compared to DM (R{sup 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

  2. Technology evaluation center assessment synopsis: full-field digital mammography.

    PubMed

    Rothenberg, Barbara M; Ziegler, Kathleen M; Aronson, Naomi

    2006-08-01

    Full-field digital mammography (FFDM) is proposed as an alternative to screen-film mammography (SFM). The ability to separate and optimize the acquisition, storage, and display of images may allow greater visualization of breast cancers at equal or lower radiation doses, especially in younger women and those with denser breasts. This is a synopsis of a systematic review by the Blue Cross Blue Shield Association Technology Evaluation Center. This updated systematic review primarily incorporated the results of the ACR Imaging Network(R) Digital Mammographic Imaging Screening Trial (DMIST), which provided results on 42,760 asymptomatic women who underwent both FFDM and SFM and showed with reasonable certainty that there was no difference in the accuracy of the 2 modalities for asymptomatic women in general, with some advantages of FFDM in certain subgroups. There were no strong, new studies on the use of digital mammography compared with film mammography in a diagnostic population. However, the DMIST results indicated that tumors detected by FFDM, but not by SFM, were likely to be invasive carcinomas or medium-grade to high-grade ductal carcinoma in situ. On the basis of the suppositions that these are the cancers of greatest interest and the ones more likely to be found in a diagnostic population and that the diagnostic population may be younger on average than the screening population, it was concluded that there is sufficient evidence to support the use of FFDM for diagnostic purposes.

  3. LATIN AMERICAN IMAGE QUALITY SURVEY IN DIGITAL MAMMOGRAPHY STUDIES.

    PubMed

    Mora, Patricia; Khoury, Helen; Bitelli, Regina; Quintero, Ana Rosa; Garay, Fernando; Aguilar, Juan García; Gamarra, Mirtha; Ubeda, Carlos

    2016-03-23

    Under International Atomic Energy Agency regional programmeTSA3 Radiological Protection of Patients in Medical Exposures, Latin American countries evaluated the image quality and glandular doses for digital mammography equipment with the purpose of seeing the performance and compliance with international recommendations. Totally, 24 institutions participated from Brazil, Chile, Costa Rica, El Salvador, Mexico, Paraguay and Venezuela. Signal difference noise ratio results showed for CR poor compliance with tolerances; better results were obtained for full-field digital mammography equipment. Mean glandular dose results showed that the majority of units have values below the acceptable dose levels. This joint Latin American project identified common problems: difficulty in working with digital images and lack of specific training by medical physicists from the region. Image quality is a main issue not being satisfied in accordance with international recommendations; optimisation processes in which the doses are increased should be very carefully done in order to improve early detection of any cancer signs.

  4. Measurements of system sharpness for two digital breast tomosynthesis systems

    NASA Astrophysics Data System (ADS)

    Marshall, N. W.; Bosmans, H.

    2012-11-01

    The aim of this work was to propose system sharpness parameters for digital breast tomosynthesis (DBT) systems that include the influence of focus size and focus motion for use in quality assurance protocols. X-ray focus size was measured using a multiple pinhole test object, while detector presampling modulation transfer function (MTF) was measured from projection images of a 10 cm × 10 cm, 1 mm thick steel edge, for the Siemens Inspiration and Hologic Selenia Dimensions DBT systems. The height of the edge above the table was then varied from 1 to 78 mm. The MTF expected from theory for the projection images was calculated from the measured detector MTF, focus size MTF and focus motion MTF and was compared against measured curves. Two methods were used to measure the in-plane MTF in the DBT volume: a tungsten wire of diameter 25 µm and an Al edge 0.2 mm thick, both imaged with a 15 mm thick poly(methyl methacrylate) (PMMA) plate. The in-depth point spread function (PSF) was measured using an angled tungsten wire. The full 3D MTF was estimated with a 0.5 mm diameter aluminium bead held in a 45 mm thick PMMA phantom, with the bead 15 and 65 mm above the table. Inspiration DBT projection images are saved at native detector resolution (85 µm), while the Dimensions re-bins projections to 140 µm pixels (2 × 2 binning); both systems used 2 × 2 binning of projection data before reconstruction. The 50% point for the MTF (MTF0.50) measured in the DBT projection images for the tube-travel direction fell as a function of height above the table from 3.60 to 0.90 mm-1 for the Inspiration system and from 2.50 to 1.20 mm-1 for the Dimensions unit. The maximum deviation of measured MTF0.50 from the calculated value was 13%. MTF0.50 measured in-plane (tube-travel direction) fell as a function of height above the table from 1.66 to 0.97 mm-1 for the Inspiration system and from 2.21 to 1.31 mm-1 for the Dimensions system. The full-width half-maximum for the in-depth PSF was 3

  5. Measurements of system sharpness for two digital breast tomosynthesis systems.

    PubMed

    Marshall, N W; Bosmans, H

    2012-11-21

    The aim of this work was to propose system sharpness parameters for digital breast tomosynthesis (DBT) systems that include the influence of focus size and focus motion for use in quality assurance protocols. X-ray focus size was measured using a multiple pinhole test object, while detector presampling modulation transfer function (MTF) was measured from projection images of a 10 cm × 10 cm, 1 mm thick steel edge, for the Siemens Inspiration and Hologic Selenia Dimensions DBT systems. The height of the edge above the table was then varied from 1 to 78 mm. The MTF expected from theory for the projection images was calculated from the measured detector MTF, focus size MTF and focus motion MTF and was compared against measured curves. Two methods were used to measure the in-plane MTF in the DBT volume: a tungsten wire of diameter 25 µm and an Al edge 0.2 mm thick, both imaged with a 15 mm thick poly(methyl methacrylate) (PMMA) plate. The in-depth point spread function (PSF) was measured using an angled tungsten wire. The full 3D MTF was estimated with a 0.5 mm diameter aluminium bead held in a 45 mm thick PMMA phantom, with the bead 15 and 65 mm above the table. Inspiration DBT projection images are saved at native detector resolution (85 µm), while the Dimensions re-bins projections to 140 µm pixels (2 × 2 binning); both systems used 2 × 2 binning of projection data before reconstruction. The 50% point for the MTF (MTF(0.50)) measured in the DBT projection images for the tube-travel direction fell as a function of height above the table from 3.60 to 0.90 mm(-1) for the Inspiration system and from 2.50 to 1.20 mm(-1) for the Dimensions unit. The maximum deviation of measured MTF(0.50) from the calculated value was 13%. MTF(0.50) measured in-plane (tube-travel direction) fell as a function of height above the table from 1.66 to 0.97 mm(-1) for the Inspiration system and from 2.21 to 1.31 mm(-1) for the Dimensions system. The full-width half-maximum for the in

  6. Bilateral contrast-enhanced dual-energy digital mammography: feasibility and comparison with conventional digital mammography and MR imaging in women with known breast carcinoma.

    PubMed

    Jochelson, Maxine S; Dershaw, D David; Sung, Janice S; Heerdt, Alexandra S; Thornton, Cynthia; Moskowitz, Chaya S; Ferrara, Jessica; Morris, Elizabeth A

    2013-03-01

    To determine feasibility of performing bilateral dual-energy (DE) contrast agent-enhanced (CE) digital mammography and to evaluate its performance compared with conventional digital mammography and breast magnetic resonance (MR) imaging in women with known breast cancer. This study was approved by the institutional review board and was HIPAA compliant. Written informed consent was obtained. Patient accrual began in March 2010 and ended in August 2011. Mean patient age was 49.6 years (range, 25-74 years). Feasibility was evaluated in 10 women with newly diagnosed breast cancer who were injected with 1.5 mL per kilogram of body weight of iohexol and imaged between 2.5 and 10 minutes after injection. Once feasibility was confirmed, 52 women with newly diagnosed cancer who had undergone breast MR imaging gave consent to undergo DE CE digital mammography. Positive findings were confirmed with pathologic findings. Feasibility was confirmed with no adverse events. Visualization of tumor enhancement was independent of timing after contrast agent injection for up to 10 minutes. MR imaging and DE CE digital mammography both depicted 50 (96%) of 52 index tumors; conventional mammography depicted 42 (81%). Lesions depicted by using DE CE digital mammography ranged from 4 to 67 mm in size (median, 17 mm). DE CE digital mammography depicted 14 (56%) of 25 additional ipsilateral cancers compared with 22 (88%) of 25 for MR imaging. There were two false-positive findings with DE CE digital mammography and 13 false-positive findings with MR imaging. There was one contralateral cancer, which was not evident with either modality. Bilateral DE CE digital mammography was feasible and easily accomplished. It was used to detect known primary tumors at a rate comparable to that of MR imaging and higher than that of conventional digital mammography. DE CE digital mammography had a lower sensitivity for detecting additional ipsilateral cancers than did MR imaging, but the specificity was

  7. Quantitative evaluation of anatomical noise in chest digital tomosynthesis, digital radiography, and computed tomography

    NASA Astrophysics Data System (ADS)

    Lee, D.; Choi, S.; Lee, H.; Kim, D.; Choi, S.; Kim, H.-J.

    2017-04-01

    Lung cancer is currently the worldwide leading cause of death from cancer. Thus, detection of lung cancer at its early stages is critical for improving the survival rate of patients. Chest digital tomosynthesis (CDT) is a recently developed imaging modality, combining many advantages of digital radiography (DR) and computed tomography (CT). This method has the potential to be widely used in the clinical setting. In this study, we introduce a developed CDT R/F system and compare its image quality with those of DR and CT, especially with respect to anatomical noise and lung nodule conspicuity, for LUNGMAN phantoms. The developed CDT R/F system consists of a CsI scintillator flat panel detector, X-ray tube, and tomosynthesis data acquisition geometry. For CDT R/F imaging, 41 projections were acquired at different angles, over the ± 20° angular range, in a linear translation geometry. To evaluate the clinical effectiveness of the CDT R/F system, the acquired images were compared with CT (Philips brilliance CT 64, Philips healthcare, U.S.) and DR (ADR-M, LISTEM, Korea) phantom images in terms of the anatomical noise power spectrum (aNPS). DR images exhibited low conspicuity for a small-size lung nodule, while CDT R/F and CT exhibited relatively high sensitivity for all lung nodule sizes. The aNPS of the CDT R/F system was better than that of DR, by resolving anatomical overlapping problems. In conclusion, the developed CDT R/F system is likely to contribute to early diagnosis of lung cancer, while requiring a relatively low patient dose, compared with CT.

  8. Mean glandular dose estimation using MCNPX for a digital breast tomosynthesis system with tungsten/aluminum and tungsten/aluminum+silver x-ray anode-filter combinations

    SciTech Connect

    Ma, Andy K. W.; Darambara, Dimitra G.; Stewart, Alexander; Gunn, Spencer; Bullard, Edward

    2008-12-15

    Breast cancer screening with x-ray mammography, using one or two projection images of the breast, is an indispensible tool in the early detection of breast cancer in women. Digital breast tomosynthesis (DBT) is a 3D imaging technique that promises higher sensitivity and specificity in breast cancer screening at a similar radiation dose to conventional two-view screening mammography. In DBT a 3D volume is reconstructed with anisotropic voxels from a limited number of x-ray projection images acquired over a limited angle. Although the benefit of early cancer detection through screening mammography outweighs the potential risks associated with radiation, the radiation dosage to women in terms of mean glandular dose (MGD) is carefully monitored. This work studies the MGD arising from a prototype DBT system under various parameters. Two anode/filter combinations (W/Al and W/Al+Ag) were investigated; the tube potential ranges from 20 to 50 kVp; and the breast size varied between 4 and 10 cm chest wall-to-nipple distance and between 3 and 7 cm compressed breast thickness. The dosimetric effect of breast positioning with respect to the imaging detector was also reviewed. It was found that the position of the breast can affect the MGD by as much as 5% to 13% depending on the breast size.

  9. The effect of the amount of peritumoral adipose tissue in the detection of additional tumors with digital breast tomosynthesis and ultrasound.

    PubMed

    García-Barquín, Paula; Páramo, María; Elizalde, Arlette; Pina, Luis; Etxano, Jon; Fernandez-Montero, Alejandro; Caballeros, Meylin

    2017-06-01

    Background Digital breast tomosynthesis (DBT) and ultrasound (US) can detect additional cancers after negative mammography. However, not all cancers are visible by both techniques. Purpose To study the role of the amount of peritumoral fat in the detection of additional cancers with DBT or US. Material and Methods One reader retrospectively reviewed 142 breast cancers in 109 women who underwent mammography, DBT, US, and magnetic resonance imaging (MRI). Two readers in consensus evaluated the additional cancers detected by US, DBT, or MRI, and classified them into four groups according to the amount of peritumoral adipose tissue: group I, >75% of peritumoral fat; group II, 50-74%; group III, 25-49%, and group IV, 0-24%. The detection of additional cancers by US and DBT with respect to the other imaging techniques was evaluated. Results Seventy-eight cancers were detected by mammography and the remaining 64 cancers were detected by DBT, US, or MRI. US and DBT detected 46 (71.8%) and 25 (39.06%) additional tumors, respectively. Statistical significance was only found in group IV ( P < 0.01). Conclusion US detected more tumors than DBT in lesions surrounded by a small amount of fat. No significant differences were found between US and DBT in the detection of additional cancers in the other groups.

  10. Increased Cancer Detection Rate and Variations in the Recall Rate Resulting from Implementation of 3D Digital Breast Tomosynthesis into a Population-based Screening Program

    PubMed Central

    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

  11. Modeling the Anisotropic Resolution and Noise Properties of Digital Breast Tomosynthesis Image Reconstructions

    DTIC Science & Technology

    2012-01-01

    functions for oblique incidence is derived in individual projections. The anisotropy of the transfer functions over the detector area is then...incidence on transfer functions , it is shown that oblique incidence yields sub- pixel translational shifts in the image of the object with each...Digital breast tomosynthesis (DBT), oblique x-ray incidence, phosphor, modulation transfer function (MTF), detective quantum efficiency (DQE), super

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

    PubMed

    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.

  13. Comparison of mean glandular dose values provided by a digital breast tomosynthesis system in Brazil.

    PubMed

    Beraldo Oliveira, Bruno; Paixão, Lucas; Donato da Silva, Sabrina; Teixeira, Maria Helena Araújo; Nogueira, Maria do Socorro

    2015-06-01

    Studies are needed to determine the radiation dose of patients that are undergoing Digital breast tomosynthesis (DBT) procedures. Mean glandular dose (DG) values were derived from the incident air kerma (Ki) measurements and tabulated conversion coefficients. Ki values were obtained through an ionization chamber positioned in a Hologic Selenia Dimensions system using appropriate exposure parameters. This work contributes to determine the reliable radiation dose received by the patients and compare DG values provided by this DBT system images.

  14. Experience with a proposed teleradiology system for digital mammography

    NASA Astrophysics Data System (ADS)

    Saulnier, Emilie T.; Mitchell, Robert J.; Abdel-Malek, Aiman A.; Dudding, Kathryn E.

    1995-05-01

    Teleradiology offers significant improvement in efficiency and effectiveness over current practices in traditional film/screen-based diagnosis. In the context of digital mammography, the increasing number of women who need to be screened for breast cancer, including those in remote rural regions, make the advantages of teleradiology especially attractive for digital mammography. At the same time, the size and resolution of digital mammograms are among the most challenging to support in a cost effective teleradiology system. This paper describes a teleradiology architecture developed for use with digital mammography by GE Corporate Research and Development in collaboration with Massachusetts General Hospital under National Cancer Institute (NCI/NIH) grant number R01 CA60246-01. Experience with a testbed prototype is described. The telemammography architecture is intended to consist of a main mammography diagnostic site serving several remote screening sites. As patient exams become available, they are forwarded by an image server to the diagnostic site over a WAN communications link. A radiologist at the diagnostic site views a patient exam as it arrives, interprets it, and then relays a report back to the technician at the remote site. A secondary future scenario consists of mobile units which forward images to a remote site, which then forwards them to the main diagnostic site. The testbed architecture is based on the Digital Imaging and Communications in Medicine (DICOM) standard, created by the American College of Radiology (ACR) and National Electrical Manufacturers Association (NEMA). A specification of vendor-independent data formats and data transfer services for digital medical images, DICOM specifies a protocol suite starting at the application layer downward, including the TCP/IP layers. The current DICOM definition does not provide an information element that is specifically tailored to mammography, so we have used the DICOM secondary capture data format

  15. Identification of error making patterns in lesion detection on digital breast tomosynthesis using computer-extracted image features

    NASA Astrophysics Data System (ADS)

    Wang, Mengyu; Zhang, Jing; Grimm, Lars J.; Ghate, Sujata V.; Walsh, Ruth; Johnson, Karen S.; Lo, Joseph Y.; Mazurowski, Maciej A.

    2016-03-01

    Digital breast tomosynthesis (DBT) can improve lesion visibility by eliminating the issue of overlapping breast tissue present in mammography. However, this new modality likely requires new approaches to training. The issue of training in DBT is not well explored. We propose a computer-aided educational approach for DBT training. Our hypothesis is that the trainees' educational outcomes will improve if they are presented with cases individually selected to address their weaknesses. In this study, we focus on the question of how to select such cases. Specifically, we propose an algorithm that based on previously acquired reading data predicts which lesions will be missed by the trainee for future cases (i.e., we focus on false negative error). A logistic regression classifier was used to predict the likelihood of trainee error and computer-extracted features were used as the predictors. Reader data from 3 expert breast imagers was used to establish the ground truth and reader data from 5 radiology trainees was used to evaluate the algorithm performance with repeated holdout cross validation. Receiver operating characteristic (ROC) analysis was applied to measure the performance of the proposed individual trainee models. The preliminary experimental results for 5 trainees showed the individual trainee models were able to distinguish the lesions that would be detected from those that would be missed with the average area under the ROC curve of 0.639 (95% CI, 0.580-0.698). The proposed algorithm can be used to identify difficult cases for individual trainees.

  16. Improvement of image performance in digital breast tomosynthesis (DBT) by incorporating a compressed-sensing (CS)-based deblurring scheme

    NASA Astrophysics Data System (ADS)

    Kim, Kyuseok; Park, Yeonok; Cho, Heemoon; Cho, Hyosung; Je, Uikyu; Park, Chulkyu; Lim, Hyunwoo; Park, Soyoung; Woo, Taeho; Choi, Sungil

    2016-10-01

    In this work, we investigated a compressed-sensing (CS)-based deblurring scheme incorporated with the total-variation (TV) regularization penalty for image deblurring of high accuracy and adopted it into the image reconstruction in conventional digital breast tomosynthesis (DBT). We implemented the proposed algorithm and performed a systematic simulation to demonstrate its viability for improving the image performance in DBT as well as two-dimensional (2D) mammography. In the simulation, blurred noisy projection images of a 3D numerical breast phantom were generated by convolving their original (or exact) version by a designed 2D Gaussian filter kernel (standard deviation=2 in pixel unit, kernel size=11×11), followed by adding Gaussian noise (mean=0, variance=0.05), and deblurred by using the algorithm before performing the DBT reconstruction procedure. Here the projection images were taken with a half tomographic angle of θ=20° and an angle step of Δθ=2°. We investigated the image performance of the reconstructed DBT images quantitatively in terms of the modulation and the slice-sensitive profile (SSP).

  17. A dual-axis tilt acquisition geometry for digital musculoskeletal tomosynthesis

    NASA Astrophysics Data System (ADS)

    Levakhina, Yulia M.; Duschka, Robert L.; Vogt, Florian M.; Barkhausen, Joerg; Buzug, Thorsten M.

    2013-07-01

    Digital tomosynthesis (DT) is a limited angle tomographic x-ray technique. It is an attractive low-dose alternative to computed tomography (CT) in many imaging applications. However, the DT dataset is incomplete, which leads to out-of-focus artifacts and limited axial resolution. In this paper, a novel dual-axis tilt acquisition geometry is proposed and evaluated. This geometry solves some issues in tomosynthesis with the traditional scanning geometry by scanning the object with a set of perpendicular arcs. In this geometry the acquisition in the additional perpendicular direction is done using a tiltable object supporting platform. The proposed geometry allows for capturing more singularities of the Radon transform, filling the Fourier space with more data and better approximating the Tuy-Smith conditions. In order to evaluate the proposed system, several studies have been carried out. To validate the simulation setup the performance of the traditional scanning geometry has been simulated and compared to known results from the literature. It has also been shown that the possible improvement of the image quality in the traditional geometry is limited. These limitations can be partially overcome by using the proposed dual-axis tilt geometry. The novel geometry is superior and with the same number of projections better reconstructed images can be obtained. All studies have been made using a software tomosynthesis simulator. A micro-CT reconstruction of a bone has been used as a software phantom. Simultaneous algebraic reconstruction has been used to reconstruct simulated projections. As a conclusion, acquiring data outside the standard arc allows for improving performance of musculoskeletal tomosynthesis. With the proposed dual-axis acquisition geometry a performance gain is achieved without an increase in dose and major modifications to the instrumentation of existing tomosynthesis devices.

  18. A dual-axis tilt acquisition geometry for digital musculoskeletal tomosynthesis.

    PubMed

    Levakhina, Yulia M; Duschka, Robert L; Vogt, Florian M; Barkhausen, Joerg; Buzug, Thorsten M

    2013-07-21

    Digital tomosynthesis (DT) is a limited angle tomographic x-ray technique. It is an attractive low-dose alternative to computed tomography (CT) in many imaging applications. However, the DT dataset is incomplete, which leads to out-of-focus artifacts and limited axial resolution. In this paper, a novel dual-axis tilt acquisition geometry is proposed and evaluated. This geometry solves some issues in tomosynthesis with the traditional scanning geometry by scanning the object with a set of perpendicular arcs. In this geometry the acquisition in the additional perpendicular direction is done using a tiltable object supporting platform. The proposed geometry allows for capturing more singularities of the Radon transform, filling the Fourier space with more data and better approximating the Tuy-Smith conditions. In order to evaluate the proposed system, several studies have been carried out. To validate the simulation setup the performance of the traditional scanning geometry has been simulated and compared to known results from the literature. It has also been shown that the possible improvement of the image quality in the traditional geometry is limited. These limitations can be partially overcome by using the proposed dual-axis tilt geometry. The novel geometry is superior and with the same number of projections better reconstructed images can be obtained. All studies have been made using a software tomosynthesis simulator. A micro-CT reconstruction of a bone has been used as a software phantom. Simultaneous algebraic reconstruction has been used to reconstruct simulated projections. As a conclusion, acquiring data outside the standard arc allows for improving performance of musculoskeletal tomosynthesis. With the proposed dual-axis acquisition geometry a performance gain is achieved without an increase in dose and major modifications to the instrumentation of existing tomosynthesis devices.

  19. The influence of software filtering in digital mammography image quality

    NASA Astrophysics Data System (ADS)

    Michail, C.; Spyropoulou, V.; Kalyvas, N.; Valais, I.; Dimitropoulos, N.; Fountos, G.; Kandarakis, I.; Panayiotakis, G.

    2009-05-01

    Breast cancer is one of the most frequently diagnosed cancers among women. Several techniques have been developed to help in the early detection of breast cancer such as conventional and digital x-ray mammography, positron and single-photon emission mammography, etc. A key advantage in digital mammography is that images can be manipulated as simple computer image files. Thus non-dedicated commercially available image manipulation software can be employed to process and store the images. The image processing tools of the Photoshop (CS 2) software usually incorporate digital filters which may be used to reduce image noise, enhance contrast and increase spatial resolution. However, improving an image quality parameter may result in degradation of another. The aim of this work was to investigate the influence of three sharpening filters, named hereafter sharpen, sharpen more and sharpen edges on image resolution and noise. Image resolution was assessed by means of the Modulation Transfer Function (MTF).In conclusion it was found that the correct use of commercial non-dedicated software on digital mammograms may improve some aspects of image quality.

  20. Metal and calcification artifact reduction for digital breast tomosynthesis

    NASA Astrophysics Data System (ADS)

    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.

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

    NASA Astrophysics Data System (ADS)

    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.

  2. kV x-ray dual digital tomosynthesis for image guided lung SBRT

    NASA Astrophysics Data System (ADS)

    Partain, Larry; Boyd, Douglas; Kim, Namho; Hernandez, Andrew; Daly, Megan; Boone, John

    2016-03-01

    Two simulated sets of digital tomosynthesis images of the lungs, each acquired at a 90 degree angle from the other, with 19 projection images used for each set and SART iterative reconstructed, gives dual tomosynthesis slice image quality approaching that of spiral CT, and with a data acquisition time that is 3% of that of cone beam CT. This fast kV acquisition, should allow near real time tracking of lung tumors in patients receiving SBRT, based on a novel TumoTrakTM multi-source X-ray tube design. Until this TumoTrakTM prototype is completed over the next year, its projected performance was simulated from the DRR images created from a spiral CT data set from a lung cancer patient. The resulting dual digital tomosynthesis reconstructed images of the lung tumor were exceptional and approached that of the gold standard Feldkamp CT reconstruction of breath hold, diagnostic, spiral, multirow, CT data. The relative dose at 46 mAs was less than 10% of what it would have been if the digital tomosynthesis had been done at the 472 mAs of the CT data set. This is for a 0.77 fps imaging rate sufficient to resolve respiratory motion in many free breathing patients during SBRT. Such image guidance could decrease the magnitudes of targeting error margins by as much as 20 mm or more in the craniocaudal direction for lower lobe lesions while markedly reducing dose to normal lung, heart and other critical structures. These initial results suggest a wide range of topics for future work.

  3. Rates and causes of disagreement in interpretation of full-field digital mammography and film-screen mammography in a diagnostic setting.

    PubMed

    Venta, L A; Hendrick, R E; Adler, Y T; DeLeon, P; Mengoni, P M; Scharl, A M; Comstock, C E; Hansen, L; Kay, N; Coveler, A; Cutter, G

    2001-05-01

    This study was performed to determine the rates and causes of disagreements in interpretation between full-field digital mammography and film-screen mammography in a diagnostic setting. Patients undergoing diagnostic mammography were invited to participate in the digital mammography study. Three views, selected by the radiologist interpreting the film-screen mammography, were obtained in both film-screen mammography and digital mammography. Radiologists independently assigned a Breast Imaging Reporting and Data System (BI-RADS) category to the film-screen mammography and the digital mammography images. The BI-RADS categories were grouped into the general categories of agreement, partial agreement, or disagreement. A third and different radiologist reviewed all cases of disagreement, reached a decision as to management, and determined the primary cause of disagreement. Six radiologists reviewed digital mammography and film-screen mammography diagnostic images in a total of 1147 breasts in 692 patients. Agreement between digital mammography and final film-screen mammography assessment was present in 937 breasts (82%), partial agreement in 159 (14%), and disagreement in 51 (4%), for a kappa value of 0.29. The primary causes of disagreement were differences in management approach of the radiologists (52%), information derived from sonography or additional film-screen mammograms (34%), and technical differences between the two mammographic techniques (10%). Significant disagreement between film-screen mammography and digital mammography affecting follow-up management was present in only 4% of breasts. The most frequent cause of disagreement in interpretation was a difference in management approach between radiologists (interobserver variability). This source of variability was larger than that due to differences in lesion visibility between film-screen mammography and digital mammography.

  4. Digital Mammography in Young Women: Is a Single View Sufficient?

    PubMed Central

    2016-01-01

    Introduction Single view mammography may be a less time consuming, more comfortable and radiation reduced alternative for young women, but there are no studies examining this approach after the implementation of digital mammography into clinical practice. Materials and Methods Retrospective analysis of all mammographies performed in women younger than 40 years during a 24 month period. The sample consisted of 109 women with 212 examined breasts. All patients initially received standard two- view mammography. In the study setting the MLO- views were read by a single viewer and compared to a composite reference standard. Results In this sample 7 malignant findings were present and the review of the MLO-view detected 6 of them (85%). In patients with dense breasts 4 out of 5 malignant findings were found on the single-view (sensitivity 80%) and all 2 malignant findings were detected in patients with low breast density (sensitivity 100%). There were 7 false positive findings (3.3%). i.e. in total 8 out of 212 examined breasts were therefore misinterpreted (3.8%). Conclusion Single view digital mammography detects the vast majority of malignant findings, especially in low density breast tissue and the rate of false-positive findings is within acceptable limits. Therefore this approach may be used in different scenarios (for example in increasing patient throughput, in resource poor settings, reducing radiation burden in the young or in combination with ultrasound to use the strengths of both methods). More research on this topic is needed to establish its potential role in breast imaging. PMID:27134963

  5. A task-based quality control metric for digital mammography

    NASA Astrophysics Data System (ADS)

    Maki Bloomquist, A. K.; Mainprize, J. G.; Mawdsley, G. E.; Yaffe, M. J.

    2014-11-01

    A reader study was conducted to tune the parameters of an observer model used to predict the detectability index (dʹ ) of test objects as a task-based quality control (QC) metric for digital mammography. A simple test phantom was imaged to measure the model parameters, namely, noise power spectrum, modulation transfer function and test-object contrast. These are then used in a non-prewhitening observer model, incorporating an eye-filter and internal noise, to predict dʹ. The model was tuned by measuring dʹ of discs in a four-alternative forced choice reader study. For each disc diameter, dʹ was used to estimate the threshold thicknesses for detectability. Data were obtained for six types of digital mammography systems using varying detector technologies and x-ray spectra. A strong correlation was found between measured and modeled values of dʹ, with Pearson correlation coefficient of 0.96. Repeated measurements from separate images of the test phantom show an average coefficient of variation in dʹ for different systems between 0.07 and 0.10. Standard deviations in the threshold thickness ranged between 0.001 and 0.017 mm. The model is robust and the results are relatively system independent, suggesting that observer model dʹ shows promise as a cross platform QC metric for digital mammography.

  6. A task-based quality control metric for digital mammography.

    PubMed

    Bloomquist, A K Maki; Mainprize, J G; Mawdsley, G E; Yaffe, M J

    2014-11-07

    A reader study was conducted to tune the parameters of an observer model used to predict the detectability index (dʹ ) of test objects as a task-based quality control (QC) metric for digital mammography. A simple test phantom was imaged to measure the model parameters, namely, noise power spectrum,modulation transfer function and test-object contrast. These are then used ina non-prewhitening observer model, incorporating an eye-filter and internal noise, to predict dʹ. The model was tuned by measuring dʹ of discs in a four-alternative forced choice reader study. For each disc diameter, dʹ was used to estimate the threshold thicknesses for detectability. Data were obtained for six types of digital mammography systems using varying detector technologies and x-ray spectra. A strong correlation was found between measured and modeled values of dʹ, with Pearson correlation coefficient of 0.96. Repeated measurements from separate images of the test phantom show an average coefficient of variation in dʹ for different systems between 0.07 and 0.10. Standard deviations in the threshold thickness ranged between 0.001 and 0.017 mm. The model is robust and the results are relatively system independent, suggesting that observer model dʹ shows promise as a cross platform QC metric for digital mammography.

  7. Theoretical analysis of high-resolution digital mammography

    NASA Astrophysics Data System (ADS)

    Suryanarayanan, Sankararaman; Karellas, Andrew; Vedantham, Srinivasan; Sechopoulos, Ioannis

    2006-06-01

    The performance of a high-resolution charge coupled device-based full-field digital mammography imager was analysed using a mathematical framework based on an adaptation of cascaded linear systems theory described by other investigators. This work has been conducted in order to understand the impact of various design parameters on the physical performance characteristics of the imager. Specifically, the effect of pixel size, scintillator thickness and packing density, x-ray spectra, air kerma, dark current, charge integration time, and pixel fill-factor on the frequency dependent detective quantum efficiency was studied using a charge-coupled device as a reference platform. The imaging system was modelled as a series of physical processes with gain and spatial spreading. For each stage, the signal and noise power spectra were computed and propagated through the imaging chain as inputs to subsequent stages. Good agreement between experimental and theoretical predictions was obtained for various x-ray spectral conditions that were investigated. The modulation transfer function, MTF(f) and detective quantum efficiency DQE(f) characteristics obtained in this study are encouraging and comparable to other digital mammography systems. The results of this study strongly suggest the feasibility of large area scintillator-based digital mammography imagers with pixel sizes below 100 µm.

  8. Monte Carlo simulation of x-ray scatter based on patient model from digital breast tomosynthesis

    NASA Astrophysics Data System (ADS)

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

    2006-03-01

    We are developing a breast specific scatter correction method for digital beast tomosynthesis (DBT). The 3D breast volume was initially reconstructed from 15 projection images acquired from a GE prototype tomosynthesis system without correction of scatter. The voxel values were mapped to the tissue compositions using various segmentation schemes. This voxelized digital breast model was entered into a Monte Carlo package simulating the prototype tomosynthesis system. One billion photons were generated from the x-ray source for each projection in the simulation and images of scattered photons were obtained. A primary only projection image was then produced by subtracting the scatter image from the corresponding original projection image which contains contributions from the both primary photons and scatter photons. The scatter free projection images were then used to reconstruct the 3D breast using the same algorithm. Compared with the uncorrected 3D image, the x-ray attenuation coefficients represented by the scatter-corrected 3D image are closer to those derived from the measurement data.

  9. ROC curve analysis of lesion detectability on phantoms: comparison of digital spot mammography with conventional spot mammography.

    PubMed

    Yip, W M; Pang, S Y; Yim, W S; Kwok, C S

    2001-07-01

    Although conventional screen--film mammography has excellent spatial resolution and is commonly used as a screening tool, certain inherent limitations prevent its further improvement. New digital mammography techniques, despite lower spatial resolution than screen--film mammography, may overcome these limitations. This study compared lesion detectability between charge coupled device-based digital spot mammography and conventional spot mammography. A total of 100 sets of images of specially designed breast phantoms was acquired, with variable background achieved by overlapping several layers of grapefruit fibre on a 4 cm thick lucite slab, using both modalities. 75 sets were "normal" images and 25 sets were images with simulated lesions. Four radiologists assessed the images according to a five-point confidence scale. The results were used to construct receiver operating characteristic curves. No statistical difference was observed between the two sets of curves for individual radiologists as well as pooled data. The lower spatial resolution of digital mammography was compensated for by its higher contrast sensitivity relative to conventional spot mammography.

  10. Digital Mammography with a Mosaic of CCD Arrays

    NASA Technical Reports Server (NTRS)

    Jalink, Antony, Jr. (Inventor); McAdoo, James A. (Inventor)

    1998-01-01

    A digital mammography device uses a mosaic of electronic digital imaging arrays to scan an x-ray image is discussed. The mosaic of arrays is repositioned several times to expose different portions of the image, until the entire image is scanned. The data generated by the arrays during each exposure is stored in a computer. After the final exposure, the computer combines data of the several partial images to produce a composite of the original x-ray image. An aperture plate is used to reduce scatter and the overall exposure of the patient to x-rays.

  11. A comparative study of computed radiography-based mammography using digital phosphor storage plate and full field digital mammography.

    PubMed

    Chelliah, Kanaga Kumari; Tamanang, Sulaiman; Bt Elias, Laila Suryani; Ying, Kho Ying

    2013-01-01

    Two digital mammography systems, based on different physical concepts, have been introduced in the last few years namely the full-field digital mammography (FFDM) system and computed radiography-based mammography using digital storage phosphor plate (DSPM). The objective of this study was to compare the image quality for DSPM and FFDM using a grading scale based on previously published articles. This comparative diagnostic study was done for 5-month duration at the Breast Clinic. The system used was the Lorad Selenia FFDM system and the Mammomat 3000 Nova DSPM system. The craniocaudal and mediolateral oblique projections were done on both breast on 58 asymptomatic women using both DSPM and FFDM. The mammograms were evaluated for eight criteria of image quality: Tissue coverage, compression, exposure, contrast, resolution, noise, artifact, and sharpness by two independent radiologists. Wilcoxon Signed Rank Test and Weighted Kappa. FFDM was rated significantly better (P < 0.05) for five aspects: Tissue coverage, compression, contrast, exposure, and resolution and equal to DSPM for sharpness, noise, and artifact. FFDM was superior in five aspects and equal to DSPM for three aspects of image quality.

  12. A comparison of the performance of digital mammography systems.

    PubMed

    Monnin, P; Gutierrez, D; Bulling, S; Guntern, D; Verdun, F R

    2007-03-01

    An objective analysis of image quality parameters was performed for six digital mammography systems. The presampled modulation transfer function (MTF), normalized noise power spectrum (NNPS), and detective quantum efficiency (DQE) for the systems were determined at different doses, for 28 kVp with a Mo/Mo or W/Al target/filter combination and 2 mm of additional aluminium filtration. The flat-panel units have higher MTF and DQE in the mid to high frequency range than standard CR systems. The highest DQE, over the whole dose range, is for the slit-scanning direct photon counting system. Dual-side read CR can overcome the inherent x-ray absorption and signal collection limitations of standard CR mammography, improving the low-frequency DQE by 40%, to the same level as full-field systems, but it does not improve the poor spatial resolution of phosphor.

  13. A comparison of the performance of digital mammography systems

    SciTech Connect

    Monnin, P.; Gutierrez, D.; Bulling, S.; Guntern, D.; Verdun, F. R.

    2007-03-15

    An objective analysis of image quality parameters was performed for six digital mammography systems. The presampled modulation transfer function (MTF), normalized noise power spectrum (NNPS), and detective quantum efficiency (DQE) for the systems were determined at different doses, for 28 kVp with a Mo/Mo or W/Al target/filter combination and 2 mm of additional aluminium filtration. The flat-panel units have higher MTF and DQE in the mid to high frequency range than standard CR systems. The highest DQE, over the whole dose range, is for the slit-scanning direct photon counting system. Dual-side read CR can overcome the inherent x-ray absorption and signal collection limitations of standard CR mammography, improving the low-frequency DQE by 40%, to the same level as full-field systems, but it does not improve the poor spatial resolution of phosphor.

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

    NASA Astrophysics Data System (ADS)

    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.

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

    PubMed

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

    2016-02-27

    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.

  16. Automatic Exposure Control Device for Digital Mammography

    DTIC Science & Technology

    2004-08-01

    developing innovative approaches for controlling DM exposures. These approaches entail using the digital detector and an artificial neural network to...of interest that determine the exposure parameters for the fully exposed image; and (2) to use an artificial neural network to select exposure

  17. Automatic Exposure Control Device for Digital Mammography

    DTIC Science & Technology

    2001-08-01

    developing innovative approaches for controlling DM exposures. These approaches entail using the digital detector and an artificial neural network to...34 regions of interest that determine the exposure parameters for the fully exposed image; and (2) to use an artificial neural network to select exposure

  18. Advantages of gridless full-field digital mammography

    NASA Astrophysics Data System (ADS)

    Nykanen, Kirsi; Siltanen, Samuli

    2003-06-01

    The purpose of the study was to find out whether the image quality in full-field digital mammography can be improved while lowering the patient dose by removing the anti-scatter grid. Moreover, a fast approximate computational algorithm was developed for determining the scattered field in a real mammogram. The method is non-iterative, robust against noise, and works without modification for any scatter-to-primary ratio. Furthermore, it is computationally effective since it is based on fast Fourier transform (FFT). It was found out that the wide dynamic range of digital detectors leads to decrease in patient dose from 10.9% up to 46.6% at breast thickness of 2cm and from 0.8% up to 40.8% at breast thickness of 4cm depending on the efficiency of the removed grid. At constant patient dose the increase in contrast-to-noise ratio is 5.8% - 36.9% and 0.4%-30.0% accordingly at those two breast thickness. The convolution-based X-ray scatter model was considered. The developed scatter removal method was demonstrated with simulated mammograms and applied to clinical full-field digital mammograms acquired with a high-end digital flat panel detector based on amorphous selenium. Errors in reconstructed scattered fields were 0.3% in case of an ideal simulated mammogram and 7.4% in case of a real simulated mammogram (3cm breast). Applications where the scattered field needs to be determined include 3-D mammography and dual-energy breast imaging. In screening mammography gray-scale optimization eliminates the effect of scattering.

  19. [Value of digital breast tomosynthesis (DBT) in the diagnosis of breast lesions].

    PubMed

    Yang, L; Li, J; Zhou, C W

    2017-01-23

    Objective: To assess the value of digital breast tomosynthesis (DBT) in the diagnosis of breast lesions. Methods: Two hundred and fifty-three breast lesions in 250 patients were selected in this study. All lesions were confirmed pathologically. Preoperative diagnosis was performed independently with full-field digital mammography (FFDM), DBT and DBT plus FFDM, respectively. The diagnostic value of DBT for breast lesions was evaluated based on the pathological diagnosis as the gold standard. The diagnostic performance of DBT and FFDM for breast lesions was compared between the groups with different ages, mammary gland densities and hormone levels. The sensitivity of DBT and FFDM was compared between the groups with different pathological types and different sizes of breast cancer. The correlation between the longest diameter of breast cancers and pathological measurements shown on DBT and FFDM was analyzed. Results: The areas under ROC curves were 0.890, 0.833 and 0.890 for DBT, FFDM and DBT plus FFDM, respectively. The areas under ROC curves for DBT or DBT plus FFDM were significantly greater than that for FFDM (P<0.05). In the group with breast density>50%, group with age ≤50 and non-menopause group, all the areas under ROC curves for DBT or DBT plus FFDM were all significantly larger than that for FFDM (P<0.05). No significant differences were observed in the group with breast density ≤50%, group with age>50 and menopause group (P>0.05). The sensitivity for both DBT and FFDM in the diagnosis of carcinoma in situ was 90.9% (10/11). The sensitivity for DBT and FFDM in the diagnosis of non-carcinoma in situ was 92.3% (120/130) and 83.8% (109/130), respectively. The sensitivity in the groups with the longest diameter of foci >0 mm but ≤10 mm, >10 mm but ≤20 mm, >20 mm but ≤30 mm, and >30 mm but ≤40 mm were 51.7% (4/7), 93.8% (61/65), 96.7% (30/31) and 100% (11/11), respectively, for DBT, and were 51.7% (4/7), 78.5% (51/65), 93.5% (29/31), and 100% (11

  20. Optimization of exposure parameters in digital tomosynthesis considering effective dose and image quality

    NASA Astrophysics Data System (ADS)

    Choi, Seungyeon; Choi, Sunghoon; Kim, Ye-seul; Lee, Haenghwa; Lee, Donghoon; Jeon, Pil-Hyun; Jang, Dong-Hyuk; Kim, Hee-Joung

    2016-03-01

    Digital tomosynthesis system (DTS), which scans an object in a limited angle, has been considered as an innovative imaging modality which can present lower patient dose than computed tomography and solve the problem of poor depth resolution in conventional digital radiography. Although it has many powerful advantages, only breast tomosynthesis system has been adopted in many hospitals. In order to reduce the patient dose while maintaining image quality, the acquisition conditions need to be studied. In this study, we analyzed effective dose and image qualities of chest phantom using commercialized universal chest digital tomosynthesis (CDT) R/F system to study the optimized exposure parameters. We set 10 different acquisition conditions including the default acquisition condition by user manual of Shimadzu (100 kVp with 0.5 mAs). The effective dose was calculated from PCXMC software version 1.5.1 by utilizing the total X-ray exposure measured by ion chamber. The image quality was evaluated by signal difference to noise ratio (SDNR) in the regions of interest (ROIs) pulmonary arteries at different axial in-plane. We analyzed a figure of merit (FOM) which considers both the effective dose and the SDNR in order to determine the optimal acquisition condition. The results indicated that the most suitable acquisition parameters among 10 conditions were condition 7 and 8 (120 kVp with 0.04 mAs and 0.1 mAs, respectively), which indicated lower effective dose while maintaining reasonable SDNRs and FOMs for three specified regions. Further studies are needed to be conducted for detailed outcomes in CDT acquisition conditions.

  1. TU-CD-207-04: Radiation Exposure Comparisons of CESM with 2D FFDM and 3D Tomosynthesis Mammography

    SciTech Connect

    James, J; Boltz, T; Pavlicek, W

    2015-06-15

    Purpose: While mammography is considered the standard for front-line breast cancer screening, image sensitivity and specificity can be affected by factors like dense breast tissue. Contrast-enhanced spectral mammography (CESM) shows promising initial results for dense breasts but comes at the cost of increased dose compared with full-field-digital-mammography (FFDM). The goal of this study is to quantitatively assess the dose increase of CESM in comparison with 2D-FFDM and 3D-Tomo at varying breast thickness. Methods: The experiments were conducted on a Hologic-Selenia-Dimensions system that performed 2D-FFDM, 3D-Tomo and CESM (high and low energies) on regular (50/50) and dense (70/30) breast tissue-mimicking phantoms. Both the phantoms had 6, 1-cm thick slabs (total thickness 6cm), compressed at 20-lbs using an 18×24 paddle. A single exposure was performed for each of the 3 mammo techniques with the following settings: AEC-Auto; Focal Spot-Large; kVp-Auto; mAs- Auto, Target/Filter combination-Auto; AEC Sensor/Exposure compensation Step-2/0. Average glandular dose (AGD) in mGy was obtained and compared as a function of breast thickness (1 – 6 cm) for both the phantom types. Results: The study shows that dose from the total CESM from 50/50 phantom at a breast thickness of a) 4.5 cm was 37.5% higher than 2D-FFDM and 30% higher than 3D-Tomo, b) 6 cm was 36.2% higher than 2D-FFDM and 41% higher than 3D-Tomo. For a dense breast tissue of 70/30 phantom, it was found that CESM dose at a breast thickness of: a) 4.5 cm was 33.3% higher than 2D-FFDM and 28.8% higher than 3D-Tomo, b) 6 cm was 35.4% higher than 2D-FFDM and 48.0% higher than 3D-Tomo. The overall CESM dose for the dense breast phantom was 12.5% higher at 4.5cm and 35% higher at 6 cm compared to the 50/50 phantom. Conclusion: This quantitative comparison study showed that CESM technique has an increased radiation dose compared to conventional 2D-FFDM and 3D-Tomo.

  2. Validation of MTF measurement for digital mammography quality control

    SciTech Connect

    Carton, Ann-Katherine; Vandenbroucke, Dirk; Struye, Luc; Maidment, Andrew D.A.; Kao, Y.-H.; Albert, Michael; Bosmans, Hilde; Marchal, Guy

    2005-06-15

    The modulation transfer function (MTF) describes the spatial resolution properties of imaging systems. In this work, the accuracy of our implementation of the edge method for calculating the presampled MTF was examined. Synthetic edge images with known MTF were used as gold standards for determining the robustness of the edge method. These images simulated realistic data from clinical digital mammography systems, and contained intrinsic system factors that could affect the MTF accuracy, such as noise, scatter, and flat-field nonuniformities. Our algorithm is not influenced by detector dose variations for MTF accuracy up to 1/2 the sampling frequency. We investigated several methods for noise reduction, including truncating the supersampled line spread function (LSF), windowing the LSF, applying a local exponential fit to the LSF, and applying a monotonic constraint to the supersampled edge spread function. Only the monotonic constraint did not introduce a systematic error; the other methods could result in MTF underestimation. Overall, our edge method consistently computed MTFs which were in good agreement with the true MTF. The edge method was then applied to images from a commercial storage-phosphor based digital mammography system. The calculated MTF was affected by the size (sides of 2.5, 5, or 10 cm) and the composition (lead or tungsten) of the edge device. However, the effects on the MTF were observed only with regard to the low frequency drop (LFD). Scatter nonuniformity was dependent on edge size, and could lead to slight underestimation of LFD. Nevertheless, this negative effect could be minimized by using an edge of 5 cm or larger. An edge composed of lead is susceptible to L-fluorescence, which causes overestimation of the LFD. The results of this work are intended to underline the need for clear guidelines if the MTF is to be given a more crucial role in acceptance tests and routine assessment of digital mammography systems: the MTF algorithm and edge

  3. Bone mineral imaging using a digital magnification mammography system

    NASA Astrophysics Data System (ADS)

    Toyofuku, Fukai; Tokumori, Kenji; Higashida, Yoshiharu; Arimura, Hidetaka; Morishita, Junji; Ohki, Masafumi

    2008-03-01

    The measurement of bone mineral content is important for diagnosis of demineralization diseases such as osteoporosis. A reliable method of obtaining bone mineral images using a digital magnification mammography system has been developed. The full-field digital phase contrast mammography (PCM) system, which has a molybdenum target of 0.1mm focal spot size, was used with 1.75 x magnification. We have performed several phantom experiments using aluminum step wedges (0.2 mm - 6.0 mm in thickness) and a bone mineral standard phantom composed of calcium carbonate and polyurethane (CaCO 3 concentration: 26.7 - 939.0 mg/cm 3) within a water or Lucite phantom. X-ray spectra on the exposure field are measured using a CdTe detector for evaluation of heel effect. From the equations of x-ray attenuation and the thickness of the subjects, quantitative images of both components were obtained. The quantitative images of the two components were obtained for different tube voltages of 24 kV to 39 kV. The relative accuracy was less than 2.5% for the entire aluminum thickness of 0.5 to 6.0 mm at 5 cm water thickness. Accuracy of bone mineral thickness was within 3.5% for 5cm water phantom. The magnified quantitative images of a hand phantom significantly increased the visibility of fine structures of bones. The digital magnification mammography system is useful not only for measurement of bone mineral content, but also high-resolution quantitative imaging of trabecular structure.

  4. Validation of MTF measurement for digital mammography quality control.

    PubMed

    Carton, Ann-Katherine; Vandenbroucke, Dirk; Struye, Luc; Maidment, Andrew D A; Kao, Yen-Hong; Albert, Michael; Bosmans, Hilde; Marchal, Guy

    2005-06-01

    The modulation transfer function (MTF) describes the spatial resolution properties of imaging systems. In this work, the accuracy of our implementation of the edge method for calculating the presampled MTF was examined. Synthetic edge images with known MTF were used as gold standards for determining the robustness of the edge method. These images simulated realistic data from clinical digital mammography systems, and contained intrinsic system factors that could affect the MTF accuracy, such as noise, scatter, and flat-field nonuniformities. Our algorithm is not influenced by detector dose variations for MTF accuracy up to 1/2 the sampling frequency. We investigated several methods for noise reduction, including truncating the supersampled line spread function (LSF), windowing the LSF, applying a local exponential fit to the LSF, and applying a monotonic constraint to the supersampled edge spread function. Only the monotonic constraint did not introduce a systematic error; the other methods could result in MTF underestimation. Overall, our edge method consistently computed MTFs which were in good agreement with the true MTF. The edge method was then applied to images from a commercial storage-phosphor based digital mammography system. The calculated MTF was affected by the size (sides of 2.5, 5, or 10 cm) and the composition (lead or tungsten) of the edge device. However, the effects on the MTF were observed only with regard to the low frequency drop (LFD). Scatter nonuniformity was dependent on edge size, and could lead to slight underestimation of LFD. Nevertheless, this negative effect could be minimized by using an edge of 5 cm or larger. An edge composed of lead is susceptible to L-fluorescence, which causes overestimation of the LFD. The results of this work are intended to underline the need for clear guidelines if the MTF is to be given a more crucial role in acceptance tests and routine assessment of digital mammography systems: the MTF algorithm and edge

  5. [New mammography technologies and their impact on radiation dose].

    PubMed

    Chevalier del Rio, M

    2013-12-01

    This article reviews new mammography technologies resulting from advances in digital detectors and processing techniques. Most are just starting to be commercialized or are in the clinical trial phase. The results of clinical trials with the new 2D techniques (contrast-enhanced techniques or stereotactic techniques) show they are useful for diagnosing cancer. However, the greater complexity of the image acquisition process suggests that their use will be limited to particular cases such as inconclusive lesions or women with high risk for developing breast cancer. Among the 3D technologies (breast tomography and breast tomosynthesis), only breast tomosynthesis has been implemented in clinical practice, so it is the only technique for which it is possible to know the sensitivity, specificity, and radiation dose delivered. This article describes the principles underlying the way breast tomosynthesis works and the techniques used for image acquisition and reconstruction. It also summarizes the main results obtained in clinical studies, which generally show that breast tomosynthesis increases the breast cancer detection rate while decreasing the recall rate and number of biopsies taken. The protocol for breast tomosynthesis approved by the Food and Drug Administration (USA) consists of two conventional mammography projections for each breast and two tomosynthesis projections for each breast. This means multiplying the risks of inducing cancer and death associated with 2D mammography by a factor between 2 and 3 (2.6-3.3 and 0.7-0.9 per 100,000 women exposed when 50 years old, respectively). The protocol for breast tomosynthesis examinations is one of the aspects that is essential to determine when including tomosynthesis in screening programs and routine breast imaging.

  6. Accuracy of Soft-Copy Digital Mammography versus That of Screen-Film Mammography according to Digital Manufacturer: ACRIN DMIST Retrospective Multireader Study1

    PubMed Central

    Hendrick, R. Edward; Cole, Elodia B.; Pisano, Etta D.; Acharyya, Suddhasatta; Marques, Helga; Cohen, Michael A.; Jong, Roberta A.; Mawdsley, Gordon E.; Kanal, Kalpana M.; D'Orsi, Carl J.; Rebner, Murray; Gatsonis, Constantine

    2008-01-01

    Purpose: To retrospectively compare the accuracy for cancer diagnosis of digital mammography with soft-copy interpretation with that of screen-film mammography for each digital equipment manufacturer, by using results of biopsy and follow-up as the reference standard. Materials and Methods: The primary HIPAA-compliant Digital Mammographic Imaging Screening Trial (DMIST) was approved by the institutional review board of each study site, and informed consent was obtained. The approvals and consent included use of data for future HIPAA-compliant retrospective research. The American College of Radiology Imaging Network DMIST collected screening mammography studies performed by using both digital and screen-film mammography in 49 528 women (mean age, 54.6 years; range, 19–92 years). Digital mammography systems from four manufacturers (Fischer, Fuji, GE, and Hologic) were used. For each digital manufacturer, a cancer-enriched reader set of women screened with both digital and screen-film mammography in DMIST was constructed. Each reader set contained all cancer-containing studies known for each digital manufacturer at the time of reader set selection, together with a subset of negative and benign studies. For each reader set, six or 12 experienced radiologists attended two randomly ordered reading sessions 6 weeks apart. Each radiologist identified suspicious findings and rated suspicion of breast cancer in identified lesions by using a seven-point scale. Results were analyzed according to digital manufacturer by using areas under the receiver operating characteristic curve (AUCs), sensitivity, and specificity for soft-copy digital and screen-film mammography. Results for Hologic digital are not presented owing to the fact that few cancer cases were available. The implemented design provided 80% power to detect average AUC differences of 0.09, 0.08, and 0.06 for Fischer, Fuji, and GE, respectively. Results: No significant difference in AUC, sensitivity, or specificity

  7. Digital breast tomosynthesis utilization in the United States: a survey of physician members of the Society of Breast Imaging.

    PubMed

    Hardesty, Lara A; Kreidler, Sarah M; Glueck, Deborah H

    2014-06-01

    To assess utilization of digital breast tomosynthesis (DBT) and examine criteria for offering DBT to patients. We created an online survey for physician members of the Society of Breast Imaging to assess their use of DBT. The questions covered availability of DBT at the participant's practice, whether DBT was used for clinical care or research, clinical decision rules guiding patient selection for DBT, costs associated with DBT, plans to obtain DBT, and breast imaging practice characteristics. Fisher's exact tests and logistic regression were used to compare DBT users and nonusers. In all, 670 members responded (response rate = 37%). Of these, 200 (30.0%) respondents reported using DBT, with 89% of these using DBT clinically. Participants were more likely to report DBT use if they worked at an academic practice (odds ratio [OR], 2.07; 95% confidence interval [CI], 1.41 to 3.03; P < .001), a practice with more than 3 breast imagers (OR, 2.36; 95% CI, 1.62 to 3.43; P < .001), or a practice with 7 or more mammography units (OR, 3.05; 95% CI, 2.11 to 4.39; P < .001). Criteria used to select patients to undergo DBT varied, with 107 (68.2%) using exam type (screening versus diagnostic), 25 (15.9%) using mammographic density, and 25 (15.9%) using breast cancer risk. Fees for DBT ranged from $25 to $250. In addition, 62.3% of nonusers planned to obtain DBT. DBT is becoming more common but remains a limited resource. Clinical guidelines would assist practices in deciding whether to adopt DBT and in standardizing which patients should receive DBT. Copyright © 2014 American College of Radiology. Published by Elsevier Inc. All rights reserved.

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

    SciTech Connect

    Sechopoulos, Ioannis

    2013-01-15

    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.

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

    PubMed Central

    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

  10. Predicting contrast detail performance from objective measurements in digital mammography

    NASA Astrophysics Data System (ADS)

    Young, Kenneth C.; Alsager, Abdulaziz; Dance, David R.; Oduko, Jennifer M.; Gundogdu, Ozcan; Spyrou, Nicholas M.

    2009-02-01

    European Guidelines for quality control in digital mammography specify minimum and achievable standards of image quality in terms of threshold contrast, based on readings of images of the CDMAM test object by human observers. However the methodology is time-consuming and has large inter- and intra-observer error. To overcome these problems a software program is available to automatically read CDMAM images. An alternative approach would be to predict threshold contrast from measurements of DQE and MTF using a model of the imaging process. A simple signal-matched noise-integration model has been used to predict the contrast detail response of five different types of commercial digital mammography system (Siemens Inspiration, GE Senographe DS, and three types of Konica Minolta computerised radiography system). Measurements were made of the MTF and DQE of each detector and the noise equivalent apertures calculated. For each system sets of 16 images of the CDMAM test object were acquired at a range of dose levels and contrast-detail plots obtained using human observers and automated reading. The theoretically and experimentally determined threshold contrasts were compared. An encouragingly good level of agreement was found between the experimental data and theoretical predictions.

  11. Simulation of mammograms and tomosynthesis imaging with cone beam breast CT images

    NASA Astrophysics Data System (ADS)

    Han, Tao; Shaw, Chris C.; Chen, Lingyun; Lai, Chao-jen; Liu, Xinming; Wang, Tianpeng

    2008-03-01

    The use of mammography techniques for the screening and diagnosis of breast cancers has been limited by the overlapping of cancer symptoms with normal tissue structures. To overcome this problem, two methods have been developed and actively investigated recently: digital tomosynthesis mammography and cone beam breast CT. Comparison study with these three techniques will be helpful to understand their difference and further might be supervise the direction of breast imaging. This paper describes and discusses about a technique using a general-purpose PC cluster to develop a parallel computer simulation model to simulate mammograms and tomosynthesis imaging with cone beam CT images of a mastectomy breast specimen. The breast model used in simulating mammography and tomosynthesis was developed by re-scaling the CT numbers of cone beam CT images from 80kVp to 20 kev. The compression of breast was simulated by deformation of the breast model. Re-projection software with parallel computation was developed and used to compute projection images of this simulated compressed breast for a stationary detector and a linearly shifted x-ray source. The resulting images were then used to reconstruct tomosynthesis mammograms using shift-and-add algorithms. It was found that MCs in cone beam CT images were not visible in regular mammograms but faintly visible in tomosynthesis images. The scatter signal and noise property needs to be simulated and incorporated in the future.

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

    NASA Astrophysics Data System (ADS)

    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.

  13. Physical characteristics of GE Senographe Essential and DS digital mammography detectors

    SciTech Connect

    Ghetti, Caterina; Borrini, Adriano; Ortenzia, Ornella; Rossi, Raffaella; Ordonez, Pedro L.

    2008-02-15

    The purpose of this study was to investigate physical characteristics of two full field digital mammography (FFDM) systems (GE Senographe Essential and DS). Both are indirect conversion (x ray to light) a-Si flat panels coupled with a CsI(Tl) scintillator. The examined systems have the same pixel size (100 {mu}m) but a different field of view: a conventional size 23x19.2 cm{sup 2} and a large field 24x30.7 cm{sup 2}, specifically designed to image large breasts. In the GE Senographe Essential model relevant improvements in flat panel design were implemented and new deposition tools for metal, a-Si, and CsI(Tl) were introduced by GE. These changes in detector design are expected to be beneficial for advanced applications such as breast tomosynthesis. The presampling modulation transfer function (MTF), normalized noise power spectrum (NNPS), and detective quantum efficiency (DQE) were measured for a wide range of exposure (25-240 {mu}Gy) with a RQA-M2 technique (28 kVp with a Mo/Mo target/filter combination and 2 mm of additional aluminum filtration). At 1, 2, and at 4 lp/mm MTF is equal to 0.9, 0.76, and 0.46 for the conventional field detector and to 0.85, 0.59, and 0.24 for the large field detector. The latter detector exhibits an improved NNPS due to a lower electronic noise and a better DQE that reaches 60%. In addition a contrast-detail analysis was performed with CDMAM 3.4 phantom and CDCOM software: GE Senographe DS showed statistically significant poorer detection ability in comparison with the GE Senographe Essential. These results could have been expected, at least qualitatively, considering the relative DQE of the two systems.

  14. Digital breast tomosynthesis image reconstruction using 2D and 3D total variation minimization.

    PubMed

    Ertas, Metin; Yildirim, Isa; Kamasak, Mustafa; Akan, Aydin

    2013-10-31

    Digital breast tomosynthesis (DBT) is an emerging imaging modality which produces three-dimensional radiographic images of breast. DBT reconstructs tomographic images from a limited view angle, thus data acquired from DBT is not sufficient enough to reconstruct an exact image. It was proven that a sparse image from a highly undersampled data can be reconstructed via compressed sensing (CS) techniques. This can be done by minimizing the l1 norm of the gradient of the image which can also be defined as total variation (TV) minimization. In tomosynthesis imaging problem, this idea was utilized by minimizing total variation of image reconstructed by algebraic reconstruction technique (ART). Previous studies have largely addressed 2-dimensional (2D) TV minimization and only few of them have mentioned 3-dimensional (3D) TV minimization. However, quantitative analysis of 2D and 3D TV minimization with ART in DBT imaging has not been studied. In this paper two different DBT image reconstruction algorithms with total variation minimization have been developed and a comprehensive quantitative analysis of these two methods and ART has been carried out: The first method is ART + TV2D where TV is applied to each slice independently. The other method is ART + TV3D in which TV is applied by formulating the minimization problem 3D considering all slices. A 3D phantom which roughly simulates a breast tomosynthesis image was designed to evaluate the performance of the methods both quantitatively and qualitatively in the sense of visual assessment, structural similarity (SSIM), root means square error (RMSE) of a specific layer of interest (LOI) and total error values. Both methods show superior results in reducing out-of-focus slice blur compared to ART. Computer simulations show that ART + TV3D method substantially enhances the reconstructed image with fewer artifacts and smaller error rates than the other two algorithms under the same configuration and parameters and it

  15. Digital breast tomosynthesis image reconstruction using 2D and 3D total variation minimization

    PubMed Central

    2013-01-01

    Background Digital breast tomosynthesis (DBT) is an emerging imaging modality which produces three-dimensional radiographic images of breast. DBT reconstructs tomographic images from a limited view angle, thus data acquired from DBT is not sufficient enough to reconstruct an exact image. It was proven that a sparse image from a highly undersampled data can be reconstructed via compressed sensing (CS) techniques. This can be done by minimizing the l1 norm of the gradient of the image which can also be defined as total variation (TV) minimization. In tomosynthesis imaging problem, this idea was utilized by minimizing total variation of image reconstructed by algebraic reconstruction technique (ART). Previous studies have largely addressed 2-dimensional (2D) TV minimization and only few of them have mentioned 3-dimensional (3D) TV minimization. However, quantitative analysis of 2D and 3D TV minimization with ART in DBT imaging has not been studied. Methods In this paper two different DBT image reconstruction algorithms with total variation minimization have been developed and a comprehensive quantitative analysis of these two methods and ART has been carried out: The first method is ART + TV2D where TV is applied to each slice independently. The other method is ART + TV3D in which TV is applied by formulating the minimization problem 3D considering all slices. Results A 3D phantom which roughly simulates a breast tomosynthesis image was designed to evaluate the performance of the methods both quantitatively and qualitatively in the sense of visual assessment, structural similarity (SSIM), root means square error (RMSE) of a specific layer of interest (LOI) and total error values. Both methods show superior results in reducing out-of-focus slice blur compared to ART. Conclusions Computer simulations show that ART + TV3D method substantially enhances the reconstructed image with fewer artifacts and smaller error rates than the other two algorithms under the same

  16. Primary Non-Hodgkin Lymphoma of the Breast: Ultrasonography, Elastography, Digital Mammography, Contrast-Enhanced Digital Mammography, and Pathology Findings.

    PubMed

    Gkali, Christina An; Chalazonitis, Athanasios N; Feida, Eleni; Giannos, Aris; Sotiropoulou, Maria; Dimitrakakis, Constantine; Loutradis, Dimitrios

    2015-12-01

    Lymphomas constitute approximately 0.15% of malignant mammary neoplasms. Less than 0.5% of all malignant lymphomas involve the breast primarily. Primary non-Hodgkin breast lymphoma is usually right sided. The combined therapy approach, with chemotherapy and radiotherapy, is the most successful treatment. Mastectomy offers no benefit in the treatment of primary non-Hodgkin breast lymphoma. To the author's knowledge, this is the first published case of primary non-Hodgkin breast lymphoma reported with conventional ultrasonography, elastography (both freehand and acoustic radiation force impulse imaging), digital mammography, contrast-enhanced digital mammography, and pathology findings. A 45-year-old woman presented with a lump in the right breast for 2 months. There was no evidence of systemic lymphoma or leukemia when the breast lesion was detected. Imaging findings were negative for lymphoma. Ipsilateral lymph nodes were not palpable. The mass was resected, and histopathology findings were diagnostic of non-Hodgkin lymphoma. Immunohistochemistry was confirmatory of non-Hodgkin lymphoma, diffuse large cell type of B-cell lineage. Although primary and secondary lymphomas of the breast are rare entities, they should be considered in the differential diagnosis of breast malignancies.

  17. Analysis of factors that affect DQE in digital mammography

    NASA Astrophysics Data System (ADS)

    Takamura, Miho; Higaki, Akiko; Kodera, Yoshie

    2005-04-01

    The international standard IEC 62220-1 about DQE measurement of digital X-ray equipment was published in 2003, but mammography systems aren"t applied to this IEC standard because the factor affect measurement is complicated. Especially, the influence to the pre-sampling MTF by edge method when X-ray beam is oblique to detector. The influence of nonuniformity of x-ray intensity by the heel effect on digital Wiener spectrum (WS) doesn"t become clear. A 0.1mm-thick tungsten edge was imaged in the position where X-ray beam was perpendicular to detector plane and in 6cm from chest wall, respectively. And the pre-sampling MTFs were obtained from these edge images. The calculation area of the digital WS within irradiation area was moved in parallel direction to X-ray tube axis, and the digital WS were calculated. The pre-sampling MTFs and the digital WS are calculated by the method based on the IEC proposal. We used MAMMOMAT3000(SIEMENS), MGU-100B(TOSHIBA), M-IV(LORAD) and Senographe DMR+(GE) as X-ray generator. Images were obtained by FCR PROFECT CS (Fujifilm medical). In all equipments and both arrangement directions of the edge test device, pre-sampling MTFs are almost the same, even if the arrangement places of the edge test device varied. In all equipments, when the calculation area was moved about 10cm, the digital WS of the anode side was higher 7.2-17.9% than those of the cathode side. It was found that the dose of anode side was lower about 20% than cathode side from the profile of an exposure image. We think that digital WS modified the nonuniformity of the dose by the heel effect is obtained by multiplying the digital WS by the compensation coefficient obtained by the dose profile, in low spatial frequency.

  18. Validation of MTF measurement for digital mammography quality control.

    PubMed

    Carton, Ann-Katherine; Vandenbroucke, Dirk; Struye, Luc; Maidment, Andrew D A; Kao, Yen-Hong; Albert, Michael; Bosmans, Hilde; Marchal, Guy

    2005-06-01

    The modulation transfer function (MTF) describes the spatial resolution properties of imaging systems. In this work, the accuracy of our implementation of the edge method for calculating the presampled MTF was examined. Synthetic edge images with known MTF were used as gold standards for determining the robustness of the edge method. These images simulated realistic data from clinical digital mammography systems, and contained intrinsic system factors that could affect the MTF accuracy, such as noise, scatter, and flat-field nonuniformities. Our algorithm is not influenced by detector dose variations for MTF accuracy up to 1∕2 the sampling frequency. We investigated several methods for noise reduction, including truncating the supersampled line spread function (LSF), windowing the LSF, applying a local exponential fit to the LSF, and applying a monotonic constraint to the supersampled edge spread function. Only the monotonic constraint did not introduce a systematic error; the other methods could result in MTF underestimation. Overall, our edge method consistently computed MTFs which were in good agreement with the true MTF. The edge method was then applied to images from a commercial storage-phosphor based digital mammography system. The calculated MTF was affected by the size (sides of 2.5, 5, or 10cm) and the composition (lead or tungsten) of the edge device. However, the effects on the MTF were observed only with regard to the low frequency drop (LFD). Scatter nonuniformity was dependent on edge size, and could lead to slight underestimation of LFD. Nevertheless, this negative effect could be minimized by using an edge of 5cm or larger. An edge composed of lead is susceptible to L-fluorescence, which causes overestimation of the LFD. The results of this work are intended to underline the need for clear guidelines if the MTF is to be given a more crucial role in acceptance tests and routine assessment of digital mammography systems: the MTF algorithm and edge

  19. A comparison of digital tomosynthesis and chest radiography in evaluating airway lesions using computed tomography as a reference.

    PubMed

    Choo, Ji Yung; Lee, Ki Yeol; Yu, Ami; Kim, Je-Hyeong; Lee, Seung Heon; Choi, Jung Won; Kang, Eun-Young; Oh, Yu Whan

    2016-09-01

    To compare the diagnostic performance of digital tomosynthesis (DTS) and chest radiography for detecting airway abnormalities, using computed tomography (CT) as a reference. We evaluated 161 data sets from 149 patients (91 with and 70 without airway abnormalities) who had undergone radiography, DTS, and CT to detect airway problems. Radiographs and DTS were evaluated to localize and score the severity of the airway abnormalities, and to score the image quality using CT as a reference. Receiver operating characteristics (ROC), McNemar's test, weighted kappa, and the paired t-test were used for statistical analysis. The sensitivity of DTS was higher (reader 1, 93.51 %; reader 2, 94.29 %) than chest radiography (68.83 %; 71.43 %) in detecting airway lesions. The diagnostic accuracy of DTS (90.91 %; 94.70 %) was also significantly better than that of radiography (78.03 %; 82.58 %, all p < 0.05). DTS image quality was significantly better than chest radiography (1.83, 2.74; p < 0.05) in the results of both readers. The inter-observer agreement with respect to DTS findings was moderate and superior when compared to radiography findings. DTS is a more accurate and sensitive modality than radiography for detecting airway lesions that are easily obscured by soft tissue structures in the mediastinum. • Digital tomosynthesis offers new diagnostic options for airway lesions. • Digital tomosynthesis is more sensitive and accurate than radiography for airway lesions. • Digital tomosynthesis shows better image quality than radiography. • Assessment of lesion severity, via tomosynthesis is comparable to computed tomography.

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

    SciTech Connect

    Baptista, Mariana Di Maria, Salvatore; Barros, Sílvia; Vaz, Pedro; Figueira, Catarina; Sarmento, Marta; Orvalho, Lurdes

    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

  1. [Investigation of quality control and average glandular dose and image quality in digital mammography in Hokkaido].

    PubMed

    Kurowarabi, Kunio; Abe, Hiroko; Horita, Hiroshi; Kaneta, Kazuyuki

    2011-01-01

    A questionnaire survey about mammography in Hokkaido was mailed to 121 facilities from August to September 2009. We surveyed the conditions of digital mammography with regard to quality control (QC) and average glandular dose at 79 facilities in Hokkaido in 2009, and the results of the survey were compared with those of 2004. We found that digital mammography techniques were widely used across Hokkaido and that computed radiography (CR) systems were quite widespread, with 70% of facilities having them. The average glandular dose ranged from 1.04 to 2.3 mGy (mean: 1.73 mGy) for digital equipment. The results revealed several problems. Although the use of 1-, 2-, and 3-megapixel (MP) liquid crystal displays (LCDs) was not uncommon, 5-MP LCDs were used in most cases when reading digital mammograms. Facilities that have mammography equipment are unlikely to have quality control instruments for mammography. Although daily QC is performed in most facilities, further quality control for digital mammography should be developed, including that for monitors. In a second study, we evaluated the 1 Shot Phantom M Plus (1 Shot Phantom), which enables objective evaluation by providing for one physical measurement rather than a subjective visual analysis. The results indicated that the 1 Shot Phantom was very useful for digital mammography systems in daily QC testing because it enabled objectivity.

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

    NASA Astrophysics Data System (ADS)

    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.

  3. Near monochromatic X-rays for digital slot-scan mammography: initial findings.

    PubMed

    Diekmann, Felix; Diekmann, S; Richter, K; Bick, U; Fischer, T; Lawaczeck, R; Press, W-R; Schön, K; Weinmann, H-J; Arkadiev, V; Bjeoumikhov, A; Langhoff, N; Rabe, J; Roth, P; Tilgner, J; Wedell, R; Krumrey, M; Linke, U; Ulm, G; Hamm, B

    2004-09-01

    X-ray spectra are composed of a broad bremsspectrum and anode-characteristic emission lines. In mammography typically molybdenum (Mo), rhodium (Rh) or tungsten (W) anodes are used in combination with Mo, Rh or aluminium filters. Only the photons with energies between 17 and 22 keV of the resulting spectrum are suitable for the soft tissue imaging needed for mammography. The aim of this article is to present first results obtained with a monochromator module mounted at the exit of the X-ray tube of a conventional clinical mammography unit. The experimental setup consists of a Siemens Mammomat 300, an X-ray monochromator module and a linear array detector for image acquisition. The technique is similar to the slot-scan technique known from digital mammography. The experimental machine allows to obtain images both with polychromatic and monochromatic X-rays. Initial evaluation of the system was performed by examination of a contrast-detail phantom (CD-MAM-phantom, Nijmegen, The Netherlands). Images done with the new monochromatic technique were compared to images of the phantom done with polychromatic spectra, with film-screen mammography as well as with digital mammography. The new technique with monochromatic slot-scan mammography resulted in correct identification of 93% of the phantom. Digital slot-scan mammography with polychromatic beam resulted in correct identification of 87%, digital full-field mammography in 83% and conventional film-screen mammography in 70% of the phantom. The results suggest that monochromatization has a potential for improving image quality or decreasing dose in X-ray mammography.

  4. Characterization of scatter in digital mammography from physical measurements

    SciTech Connect

    Leon, Stephanie M. Wagner, Louis K.; Brateman, Libby F.

    2014-06-15

    Purpose: That scattered radiation negatively impacts the quality of medical radiographic imaging is well known. In mammography, even slight amounts of scatter reduce the high contrast required for subtle soft-tissue imaging. In current clinical mammography, image contrast is partially improved by use of an antiscatter grid. This form of scatter rejection comes with a sizeable dose penalty related to the concomitant elimination of valuable primary radiation. Digital mammography allows the use of image processing as a method of scatter correction that might avoid effects that negatively impact primary radiation, while potentially providing more contrast improvement than is currently possible with a grid. For this approach to be feasible, a detailed characterization of the scatter is needed. Previous research has modeled scatter as a constant background that serves as a DC bias across the imaging surface. The goal of this study was to provide a more substantive data set for characterizing the spatially-variant features of scatter radiation at the image detector of modern mammography units. Methods: This data set was acquired from a model of the radiation beam as a matrix of very narrow rays or pencil beams. As each pencil beam penetrates tissue, the pencil widens in a predictable manner due to the production of scatter. The resultant spreading of the pencil beam at the detector surface can be characterized by two parameters: mean radial extent (MRE) and scatter fraction (SF). The SF and MRE were calculated from measurements obtained using the beam stop method. Two digital mammography units were utilized, and the SF and MRE were found as functions of target, filter, tube potential, phantom thickness, and presence or absence of a grid. These values were then used to generate general equations allowing the SF and MRE to be calculated for any combination of the above parameters. Results: With a grid, the SF ranged from a minimum of about 0.05 to a maximum of about 0

  5. 75 FR 68200 - Medical Devices; Radiology Devices; Reclassification of Full-Field Digital Mammography System

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-05

    ... controls). The device type is intended to produce planar digital x-ray images of the entire breast; this... digital x-ray images of the entire breast. This generic type of device may include digital mammography... 892.1715. The final rule uses the term ``planar'' instead of ``full- field'' to describe digital x-ray...

  6. Integrated wavelets for enhancement of microcalcifications in digital mammography.

    PubMed

    Heinlein, Peter; Drexl, Johann; Schneider, Wilfried

    2003-03-01

    This paper presents a new algorithm for enhancement of microcalcifications in mammograms. The main novelty is the application of techniques we have developed for construction of filterbanks derived from the continuous wavelet transform. These discrete wavelet decompositions, called integrated wavelets, are optimally designed for enhancement of multiscale structures in images. Furthermore, we use a model based approach to refine existing methods for general enhancement of mammograms resulting in a more specific enhancement of microcalcifications. We present results of our method and compare them with known algorithms. Finally, we want to indicate how these techniques can also be applied to the detection of microcalcifications. Our algorithm was positively evaluated in a clinical study. It has been implemented in a mammography workstation designed for soft-copy reading of digital mammograms developed by IMAGETOOL, Germany.

  7. Computer-aided detection system for clustered microcalcifications in digital breast tomosynthesis using joint information from volumetric and planar projection images

    NASA Astrophysics Data System (ADS)

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

    2015-11-01

    We propose a novel approach for the detection of microcalcification clusters (MCs) using joint information from digital breast tomosynthesis (DBT) volume and planar projection (PPJ) image. A data set of 307 DBT views was collected with IRB approval using a prototype DBT system. The system acquires 21 projection views (PVs) from a wide tomographic angle of 60° (60°-21PV) at about twice the dose of a digital mammography (DM) system, which allows us the flexibility of simulating other DBT acquisition geometries using a subset of the PVs. In this study, we simulated a 30° DBT geometry using the central 11 PVs (30°-11PV). The narrower tomographic angle is closer to DBT geometries commercially available or under development and the dose is matched approximately to that of a DM. We developed a new joint-CAD system for detection of clustered microcalcifications. The DBT volume was reconstructed with a multiscale bilateral filtering regularized method and a PPJ image was generated from the reconstructed volume. Task-specific detection strategies were designed to combine information from the DBT volume and the PPJ image. The data set was divided into a training set (127 views with MCs) and an independent test set (104 views with MCs and 76 views without MCs). The joint-CAD system outperformed the individual CAD systems for DBT volume or PPJ image alone; the differences in the test performances were statistically significant (p  <  0.05) using JAFROC analysis.

  8. SU-E-J-56: Static Gantry Digital Tomosynthesis From the Beam’s-Eye-View

    SciTech Connect

    Partain, L; Kwon, J; Boyd, D; Rottmann, J; Berbeco, R; Zentai, G

    2015-06-15

    Purpose We have designed a novel TumoTrak™ x-ray system that delivers 19 distinct kV views with the linac gantry stationary. It images MV treatment beam above and below the patient with a kV tomosysthesis slice image from the therapy beam’s-eye-view. Results will be high quality images without MLC shadowing for notable improvements relative to conventional fluoroscopic MV imaging and fluoroscopic kV imaging. Methods A complete design has a kV electron beam multisource X-ray tube that fits around the MV treatment beam path, with little interference with normal radiotherapy and unblocked by the multi-leaf-collimator. To simulate digital tomosynthesis, we used cone-beam CT projection data from a lung SBRT patient. These data were acquired at 125 kVp and 11 fps (0.4 mAs per projection). We chose 19 projections evenly spaced over 27° around one of the treatment angles (240°). Digital tomosynthesis reconstruction of a slice through the tumor was performed using iterative reconstruction. The visibility of the lesion was assessed for the reconstructed digital tomosynthesis (DTS), using fluoroscopy MV images acquired during radiation therapy, and a kV single projection image acquired at the same angle as the treatment field (240°). Results The fluoroscopic DTS images provide the best tumor contrast, surpassing the conventional radiographic and the in-treatment MV portal images. The electron beam multisource X-ray tube design has been completed and the tube is being fabricated. The estimated time to cycle through all 19 projections is 700 ms, enabling high frame-rate imaging. While the initial proposed use case is for image guided and gated treatment delivery, the enhanced imaging will also deliver superior radiographic images for patient setup. Conclusion The proposed device will deliver high quality planar images from the beam’s-eye-view without MLC obstruction. The prototype has been designed and is being assembled with first imaging scheduled for May 2015. L

  9. The utility of digital linear tomosynthesis imaging of total hip joint arthroplasty with suspicion of loosening: a prospective study in 40 patients.

    PubMed

    Göthlin, Jan H; Geijer, Mats

    2013-01-01

    The clinical utility of digital linear tomosynthesis in musculoskeletal applications has been validated in only a few reports. Technical performance and utility in hip prosthesis imaging have been discussed in technical reports, but no clinical evaluation has been reported. The purpose of the current study was to assess the added clinical utility of digital linear tomosynthesis compared to radiography in loosening of total hip joint arthroplasty. In a prospective study, radiography and digital tomosynthesis were performed in 40 consecutive patients with total hip arthroplasty referred for suspect prosthesis loosening. Tomosynthesis images were compared to anterior-posterior (AP) and cross-table lateral radiographs regarding demarcation and extent of demineralization and osteolysis. Further noted were skeletal fractures, cement fractures, fragmentation, and artifacts interfering with the diagnosis. Tomosynthesis was superior to radiography with sharper delineation of demineralization and osteolysis in the AP projection. A limitation was the inability to generate lateral tomosynthesis images, with inferior assessment of the area anterior and posterior to the acetabular cup compared to cross-table radiographs. Artifacts interfering with diagnosis were found in one hip. Tomosynthesis improved evaluation of total hip arthroplasty in the AP projection but was limited by the lack of lateral projections.

  10. The Utility of Digital Linear Tomosynthesis Imaging of Total Hip Joint Arthroplasty with Suspicion of Loosening: A Prospective Study in 40 Patients

    PubMed Central

    Göthlin, Jan H.

    2013-01-01

    Aim. The clinical utility of digital linear tomosynthesis in musculoskeletal applications has been validated in only a few reports. Technical performance and utility in hip prosthesis imaging have been discussed in technical reports, but no clinical evaluation has been reported. The purpose of the current study was to assess the added clinical utility of digital linear tomosynthesis compared to radiography in loosening of total hip joint arthroplasty. Materials and Methods. In a prospective study, radiography and digital tomosynthesis were performed in 40 consecutive patients with total hip arthroplasty referred for suspect prosthesis loosening. Tomosynthesis images were compared to anterior-posterior (AP) and cross-table lateral radiographs regarding demarcation and extent of demineralization and osteolysis. Further noted were skeletal fractures, cement fractures, fragmentation, and artifacts interfering with the diagnosis. Results. Tomosynthesis was superior to radiography with sharper delineation of demineralization and osteolysis in the AP projection. A limitation was the inability to generate lateral tomosynthesis images, with inferior assessment of the area anterior and posterior to the acetabular cup compared to cross-table radiographs. Artifacts interfering with diagnosis were found in one hip. Conclusion. Tomosynthesis improved evaluation of total hip arthroplasty in the AP projection but was limited by the lack of lateral projections. PMID:24078921

  11. Scatter correction in digital mammography based on image deconvolution.

    PubMed

    Ducote, J L; Molloi, S

    2010-03-07

    X-ray scatter is a major cause of nonlinearity in densitometry measurements using digital mammography. Previous scatter correction techniques have primarily used a single scatter point spread function to estimate x-ray scatter. In this study, a new algorithm to correct x-ray scatter based on image convolution was implemented using a spatially variant scatter point spread function which is energy and thickness dependent. The scatter kernel was characterized in terms of its scattering fraction (SF) and scatter radial extent (k) on uniform Lucite phantoms with thickness of 0.8-8.0 cm. The algorithm operates on a pixel-by-pixel basis by grouping pixels of similar thicknesses into a series of mask images that are individually deconvolved using Fourier image analysis with a distinct kernel for each image. The algorithm was evaluated with three Lucite step phantoms and one anthropomorphic breast phantom using a full-field digital mammography system at energies of 24, 28, 31 and 49 kVp. The true primary signal was measured with a multi-hole collimator. The effect on image quality was also evaluated. For all 16 studies, the average mean percentage error in estimating the true primary signal was found to be -2.13% and the average rms percentage error was 2.60%. The image quality was seen to improve at every energy up to 25% at 49 kVp. The results indicate that a technique based on a spatially variant scatter point spread function can accurately estimate x-ray scatter.

  12. Physical characteristics of a full-field digital mammography system

    NASA Astrophysics Data System (ADS)

    Suryanarayanan, Sankararaman; Karellas, Andrew; Vedantham, Srinivasan

    2004-11-01

    The physical performance characteristics of a flat-panel clinical full-field digital mammography (FFDM) system were investigated for a variety of mammographic X-ray spectral conditions. The system was investigated using 26 kVp: Mo/Mo, 28 kVp: Mo/Rh, and 30 kVp: Rh/Rh, with polymethyl methacrylate (PMMA) "tissue equivalent material" of thickness 20, 45, and 60 mm for each of three X-ray spectra, resulting in nine different spectral conditions. The experimental results were compared with a theoretical cascaded linear systems-based model that has been developed independently by other investigators. The FFDM imager (Senographe 2000D, GE Medical Systems, Milwaukee, WI) uses an amorphous silicon (aSi:H) photodiode (100 μm pixel) array directly coupled to a cesium iodide (CsI) scintillator. The spatial resolution of the digital mammography system was determined by measuring the presampling modulation transfer function (MTF). The noise power spectra (NPS) of the system were measured under the different mammographic X-ray spectral conditions at an exposure of approximately 10 mR to the detector from which corresponding detective quantum efficiencies (DQE) were determined. The experimental results provide additional information on the performance of the mammographic system for a broader range of experimental conditions than have been reported in the past. The flat-panel imager exhibits favorable physical quality characteristics under the conditions investigated. The experimental results were compared with theoretical estimates under various spectral conditions and demonstrated good agreement.

  13. Evaluation of automatic exposure control options in digital mammography.

    PubMed

    Zhou, Yifang; Scott, Alexander; Allahverdian, Janet; Frankel, Steve

    2014-01-01

    To quantify the trade-offs of dose and image quality among pre-loaded automatic exposure control (AEC) options in digital mammography, two AEC tables from the Hologic Selenia digital mammography system were compared: the default AEC "table 0" and AEC "table 1". Realistically-shaped phantoms consisting of tissue-equivalent material of various thicknesses (4.5 cm-7 cm) were imaged to obtain a figure of merit (FOM), the squared contrast-to-noise ratio per mean glandular dose. To relate the results to pathological findings and to evaluate the overall performance, the measured contrast-to-noise ratios were applied to simulated lesions on the anthropomorphic breast phantom images, producing various lesion configurations which were blindly scored. It was found that the AEC table 1 improves the low contrast FOM by 11% to 20% for the breast thicknesses of 4.5-6 cm. However, for the 7 cm thick breast, the AEC table 1 decreases the low contrast FOM by 17%. For microcalcifications, the AEC table 1 improves the FOM slightly for the breast thicknesses of 4.5--6 cm and decreases it by 18% at a thickness of 7 cm. The lesion simulation showed enhanced contrast due to the AEC table 1 for the breast thicknesses of 5 cm, 6 cm, and 7 cm, but the enhancement gradually reduces as the thickness increases. The lesion reading showed that the microcalcification detection was scored significantly higher from the AEC table 1 for the thicknesses 5 cm, 6 cm, and 7 cm. The corresponding improvement of mass detection scores was also observed but not consistently significant over the thickness range.

  14. Effects of digital mammography uptake on downstream breast-related care among older women

    PubMed Central

    Hubbard, Rebecca A.; Zhu, Weiwei; Onega, Tracy L.; Fishman, Paul; Henderson, Louise M.; Tosteson, Anna N.A.; Buist, Diana S.M.

    2012-01-01

    Background Digital mammography is the dominant modality for breast cancer screening in the US. No previous studies have investigated how introducing digital mammography affects downstream breast-related care. Objective Compare breast-related health care use following a screening mammogram before and after introduction of digital mammography. Research design and subjects Longitudinal study of screening mammograms from 14 radiology facilities contributing data to the Breast Cancer Surveillance Consortium performed in the one year before and four years after each facility introduced digital mammography, along with linked Medicare claims. We included 30,211 mammograms for women age 66 years and older without breast cancer. Measures Rates of false-positive recall and short-interval follow-up based on radiologists’ assessments and recommendations; rates of follow-up mammography, ultrasound, and breast biopsy use based on Medicare claims. Results False-positive recall rates increased following the introduction of digital mammography. Follow-up mammography use was significantly higher across all four years after a facility began using digital compared to the year before (year one odds ratio [OR] = 1.7, 95% confidence interval [CI]: 1.4, 2.1). Among women with false-positive mammography results, use of ultrasound decreased significantly in the second through fourth years after digital mammography began (year two OR = 0.4, 95% confidence interval [CI]: 0.3, 0.6). Conclusions Introduction of a new technology led to changes in health care use that persisted for at least four years. Comparative effectiveness research on new technologies should consider not only diagnostic performance but also downstream utilization attributable to this apparent learning curve. PMID:23132199

  15. Preoperative digital mammography imaging in conservative mastectomy and immediate reconstruction

    PubMed Central

    Angrigiani, Claudio; Hammond, Dennis; Nava, Maurizio; Gonzalez, Eduardo; Rostagno, Roman; Gercovich, Gustavo

    2016-01-01

    Background Digital mammography clearly distinguishes gland tissue density from the overlying non-glandular breast tissue coverage, which corresponds to the existing tissue between the skin and the Cooper’s ligaments surrounding the gland (i.e., dermis and subcutaneous fat). Preoperative digital imaging can determine the thickness of this breast tissue coverage, thus facilitating planning of the most adequate surgical techniques and reconstructive procedures for each case. Methods This study aimed to describe the results of a retrospective study of 352 digital mammograms in 176 patients with different breast volumes who underwent preoperative conservative mastectomies. The breast tissue coverage thickness and its relationship with the breast volume were evaluated. Results The breast tissue coverage thickness ranged from 0.233 to 4.423 cm, with a mean value of 1.952 cm. A comparison of tissue coverage and breast volume revealed a non-direct relationship between these factors. Conclusions Preoperative planning should not depend only on breast volume. Flap evaluations based on preoperative imaging measurements might be helpful when planning a conservative mastectomy. Accordingly, we propose a breast tissue coverage classification (BTCC). PMID:26855903

  16. Comparative Effectiveness of Digital Versus Film-Screen Mammography in Community Practice in the United States

    PubMed Central

    Kerlikowske, Karla; Hubbard, Rebecca A.; Miglioretti, Diana L.; Geller, Berta M.; Yankaskas, Bonnie C.; Lehman, Constance D.; Taplin, Stephen H.; Sickles, Edward A.

    2013-01-01

    Background Few studies have examined the comparative effectiveness of digital versus film-screen mammography in U.S. community practice. Objective To determine whether the interpretive performance of digital and film-screen mammography differs. Design Prospective cohort study. Setting Mammography facilities in the Breast Cancer Surveillance Consortium. Participants 329 261 women aged 40 to 79 years underwent 869 286 mammograms (231 034 digital; 638 252 film-screen). Measurements Invasive cancer or ductal carcinoma in situ diagnosed within 12 months of a digital or film-screen examination and calculation of mammography sensitivity, specificity, cancer detection rates, and tumor outcomes. Results Overall, cancer detection rates and tumor characteristics were similar for digital and film-screen mammography, but the sensitivity and specificity of each modality varied by age, tumor characteristics, breast density, and menopausal status. Compared with film-screen mammography, the sensitivity of digital mammography was significantly higher for women aged 60 to 69 years (89.9% vs. 83.0%; P = 0.014) and those with estrogen receptor-negative cancer (78.5% vs. 65.8%; P = 0.016); borderline significantly higher for women aged 40 to 49 years (82.4% vs. 75.6%; P = 0.071), those with extremely dense breasts (83.6% vs. 68.1%; P= 0.051), and pre- or perimenopausal women (87.1% vs. 81.7%; P = 0.057); and borderline significantly lower for women aged 50 to 59 years (80.5% vs. 85.1%; P = 0.097). The specificity of digital and film-screen mammography was similar by decade of age, except for women aged 40 to 49 years (88.0% vs. 89.7%; P< 0.001). Limitation Statistical power for subgroup analyses was limited. Conclusion Overall, cancer detection with digital or film-screen mammography is similar in U.S. women aged 50 to 79 years undergoing screening mammography. Women aged 40 to 49 years are more likely to have extremely dense breasts and estrogen receptor-negative tumors; if they are

  17. Improving depth resolution in digital breast tomosynthesis by iterative image reconstruction

    NASA Astrophysics Data System (ADS)

    Roth, Erin G.; Kraemer, David N.; Sidky, Emil Y.; Reiser, Ingrid S.; Pan, Xiaochuan

    2015-03-01

    Digital breast tomosynthesis (DBT) is currently enjoying tremendous growth in its application to screening for breast cancer. This is because it addresses a major weakness of mammographic projection imaging; namely, a cancer can be hidden by overlapping fibroglandular tissue structures or the same normal structures can mimic a malignant mass. DBT addresses these issues by acquiring few projections over a limited angle scanning arc that provides some depth resolution. As DBT is a relatively new device, there is potential to improve its performance significantly with improved image reconstruction algorithms. Previously, we reported a variation of adaptive steepest descent - projection onto convex sets (ASD-POCS) for DBT, which employed a finite differencing filter to enhance edges for improving visibility of tissue structures and to allow for volume-of-interest reconstruction. In the present work we present a singular value decomposition (SVD) analysis to demonstrate the gain in depth resolution for DBT afforded by use of the finite differencing filter.

  18. Digital breast tomosynthesis reconstruction using spatially weighted non-convex regularization

    NASA Astrophysics Data System (ADS)

    Zheng, Jiabei; Fessler, Jeffrey A.; Chan, Heang-Ping

    2016-03-01

    Regularization is an effective strategy for reducing noise in tomographic reconstruction. This paper proposes a spatially weighted non-convex (SWNC) regularization method for digital breast tomosynthesis (DBT) image reconstruction. With a non-convex cost function, this method can suppress noise without blurring microcalcifications (MC) and spiculations of masses. To minimize the non-convex cost function, we apply a majorize-minimize separable quadratic surrogate algorithm (MM-SQS) that is further accelerated by ordered subsets (OS). We applied the new method to a heterogeneous breast phantom and to human subject DBT data, and observed improved image quality in both situations. A quantitative study also showed that the SWNC method can significantly enhance the contrast-to-noise ratio of MCs. By properly selecting its parameters, the SWNC regularizer can preserve the appearance of the mass margins and breast parenchyma.

  19. Effects of angular range on image quality of chest digital tomosynthesis

    NASA Astrophysics Data System (ADS)

    Lee, Haenghwa; Kim, Ye-seul; Choi, Sunghoon; Lee, Dong-Hoon; Choi, Seungyeon; Kim, Hee-Joung

    2016-03-01

    Chest digital tomosynthesis (CDT) is a new 3D imaging technique that can be expected to improve clinical diagnosis over conventional chest radiography. We investigated the effect of the angular range of data acquisition on the image quality using newly developed CDT system. The four different acquisition sets were studied using +/-15°, +/-20°, +/-30°, and +/-35° angular ranges with 21 projection views (PVs). The point spread function (PSF), modulation transfer function (MTF), artifact spread function (ASF), and normalized contrast-to-noise ratio (CNR) were used to evaluate the image quality. We found that increasing angular ranges improved vertical resolution. The results indicated that there was the opposite relationship of the CNR with angular range for the two tissue types. While CNR for heart tissue increased with increasing angular range, CNR for spine bone decreased. The results showed that the angular range is an important parameter for the CDT exam.

  20. Diagnostic impact of digital tomosynthesis in oncologic patients with suspected pulmonary lesions on chest radiography.

    PubMed

    Quaia, Emilio; Baratella, Elisa; Poillucci, Gabriele; Gennari, Antonio Giulio; Cova, Maria Assunta

    2016-08-01

    To assess the actual diagnostic impact of digital tomosynthesis (DTS) in oncologic patients with suspected pulmonary lesions on chest radiography (CXR). A total of 237 patients (135 male, 102 female; age, 70.8 ± 10.4 years) with a known primary malignancy and suspected pulmonary lesion(s) on CXR and who underwent DTS were retrospectively identified. Two radiologists (experience, 10 and 15 years) analysed in consensus CXR and DTS images and proposed a diagnosis according to a confidence score: 1 or 2 = definitely or probably benign pulmonary or extrapulmonary lesion, or pseudolesion; 3 = indeterminate; 4 or 5 = probably or definitely pulmonary lesion. DTS findings were proven by CT (n = 114 patients), CXR during follow-up (n = 105) or histology (n = 18). Final diagnoses included 77 pulmonary opacities, 26 pulmonary scars, 12 pleural lesions and 122 pulmonary pseudolesions. DTS vs CXR presented a higher (P < 0.05) sensitivity (92 vs 15 %), specificity (91 vs 9 %), overall accuracy (92 vs 12 %), and diagnostic confidence (area under ROC, 0.997 vs 0.619). Mean effective dose of CXR vs DTS was 0.06 vs 0.107 mSv (P < 0.05). DTS improved diagnostic accuracy and confidence in comparison to CXR alone in oncologic patients with suspected pulmonary lesions on CXR with only a slight, though significant, increase in radiation dose. • Digital tomosynthesis (DTS) improves accuracy of chest radiography (CXR) in oncologic patients. • DTS improves confidence of CXR in oncologic patients. • DTS allowed avoidance of CT in about 50 % of oncologic patients.

  1. TU-AB-209-04: Practical Examples of Model Observer Applications in Digital Breast Tomosynthesis.

    PubMed

    Bosmans, H

    2016-06-01

    Digital breast tomosynthesis (DBT), a limited-angle tomographic technique by its nature has multiple optimal system configurations, which can lead to many potential changes to the existing and new DBT systems entering the US market. With the availability of computational tools such as for modeling imaging physics, it is becoming increasingly important to conduct virtual trials for a rigorous, preclinical and task-based assessment of DBT. For such virtual assessment to be successful, it is critical to: (1) develop model-observer approaches that can account for patient data statistics stemming from realistic or real breast backgrounds as well as lesion characteristics, thereby performing given tasks effectively and (2) validate the model-observer approaches and their performance trends/levels with physical measurements from a prototype or real DBT system and a physical phantom ensemble. It is also important to understand trade-offs between patient (phantom) sample/effect size and observer performance reliability for gaining knowledge on how to choose appropriate model observers for the given tasks. In this session, a variety of model-observer approaches associated with currently available breast phantoms (either physical or virtual) and their sample size will be discussed. The presenters in this session will also discuss the limitations of each model observer approach to provide an understanding of the circumstances where each of these approaches can be more suitable than the others. The session is organized as follows: First, the development of virtual and physical phantoms that mimic breast anatomy will be presented. This will be followed by two presentations on model observers for DBT, one on the designing of model observers for signal-known-exactly (SKE) tasks and another on the development of visual search based model observers with the intent of identifying useful image features. Finally, this will be followed by practical examples where such model observers

  2. A comprehensive model for quantum noise characterization in digital mammography.

    PubMed

    Monnin, P; Bosmans, H; Verdun, F R; Marshall, N W

    2016-03-07

    A version of cascaded systems analysis was developed specifically with the aim of studying quantum noise propagation in x-ray detectors. Signal and quantum noise propagation was then modelled in four types of x-ray detectors used for digital mammography: four flat panel systems, one computed radiography and one slot-scan silicon wafer based photon counting device. As required inputs to the model, the two dimensional (2D) modulation transfer function (MTF), noise power spectra (NPS) and detective quantum efficiency (DQE) were measured for six mammography systems that utilized these different detectors. A new method to reconstruct anisotropic 2D presampling MTF matrices from 1D radial MTFs measured along different angular directions across the detector is described; an image of a sharp, circular disc was used for this purpose. The effective pixel fill factor for the FP systems was determined from the axial 1D presampling MTFs measured with a square sharp edge along the two orthogonal directions of the pixel lattice. Expectation MTFs were then calculated by averaging the radial MTFs over all possible phases and the 2D EMTF formed with the same reconstruction technique used for the 2D presampling MTF. The quantum NPS was then established by noise decomposition from homogenous images acquired as a function of detector air kerma. This was further decomposed into the correlated and uncorrelated quantum components by fitting the radially averaged quantum NPS with the radially averaged EMTF(2). This whole procedure allowed a detailed analysis of the influence of aliasing, signal and noise decorrelation, x-ray capture efficiency and global secondary gain on NPS and detector DQE. The influence of noise statistics, pixel fill factor and additional electronic and fixed pattern noises on the DQE was also studied. The 2D cascaded model and decompositions performed on the acquired images also enlightened the observed quantum NPS and DQE anisotropy.

  3. Digital information management: a progress report on the National Digital Mammography Archive

    NASA Astrophysics Data System (ADS)

    Beckerman, Barbara G.; Schnall, Mitchell D.

    2002-05-01

    Digital mammography creates very large images, which require new approaches to storage, retrieval, management, and security. The National Digital Mammography Archive (NDMA) project, funded by the National Library of Medicine (NLM), is developing a limited testbed that demonstrates the feasibility of a national breast imaging archive, with access to prior exams; patient information; computer aids for image processing, teaching, and testing tools; and security components to ensure confidentiality of patient information. There will be significant benefits to patients and clinicians in terms of accessible data with which to make a diagnosis and to researchers performing studies on breast cancer. Mammography was chosen for the project, because standards were already available for digital images, report formats, and structures. New standards have been created for communications protocols between devices, front- end portal and archive. NDMA is a distributed computing concept that provides for sharing and access across corporate entities. Privacy, auditing, and patient consent are all integrated into the system. Five sites, Universities of Pennsylvania, Chicago, North Carolina and Toronto, and BWXT Y12, are connected through high-speed networks to demonstrate functionality. We will review progress, including technical challenges, innovative research and development activities, standards and protocols being implemented, and potential benefits to healthcare systems.

  4. Physical characteristics of five clinical systems for digital mammography

    SciTech Connect

    Lazzari, B.; Belli, G.; Gori, C.; Rosselli Del Turco, M.

    2007-07-15

    The purpose of this study was to evaluate and compare the physical characteristics of five clinical systems for digital mammography (GE Senographe 2000D, Lorad Selenia M-IV, Fischer Senoscan, Agfa DM 1000, and IMS Giotto) currently in clinical use. The basic performances of the mammography systems tested were assessed on the basis of response curve, modulation transfer function (MTF), noise power spectrum, noise equivalent quanta (NEQ), and detective quantum efficiency (DQE) in an experimental setting closely resembling the clinical one. As expected, all the full field digital mammography systems show a linear response curve over a dynamic range from 3.5 to 500 {mu}Gy (0.998digital system, the presampling MTF was calculated within a range up to the Nyquist frequency (5 lp/mm for GE Senographe 2000D, 7.1 lp/mm for Lorad Selenia, 9.3 lp/mm for Fischer Senoscan, and 5.88 lp/mm for IMS Giotto detector). The NEQ becomes related to the exposure in a linear behavior starting from about 40.3 {mu}Gy for GE Senographe 2000D, 42.9 {mu}Gy for Lorad Selenia, 41.2 {mu}Gy for Agfa DM1000, <87.6 {mu}Gy for Fischer Senoscan, and 61.3 {mu}Gy for the IMS Giotto. Above those values, the systems can be considered ''quantum noise limited,'' that is the electronic noise is negligible if compared to the quantum noise. The DQE, for several emitted x-ray spectra for each system, i.e., 28 kV p Mo-Mo, Mo-Rh, Rh-Rh, W-Al anode-filter combination, hardened by 40 mm poly(methylmethacrylate) (PMMA) was evaluated. For the five different systems, the DQE at close to zero spatial frequency ranges between 0.25 and 0.63 at 131 {mu}Gy entrance surface air kerma to the detectors. The results of

  5. Physical characteristics of five clinical systems for digital mammography.

    PubMed

    Lazzari, B; Belli, G; Gori, C; Rosselli Del Turco, M

    2007-07-01

    The purpose of this study was to evaluate and compare the physical characteristics of five clinical systems for digital mammography (GE Senographe 2000D, Lorad Selenia M-IV, Fischer Senoscan, Agfa DM 1000, and IMS Giotto) currently in clinical use. The basic performances of the mammography systems tested were assessed on the basis of response curve, modulation transfer function (MTF), noise power spectrum, noise equivalent quanta (NEQ), and detective quantum efficiency (DQE) in an experimental setting closely resembling the clinical one. As expected, all the full field digital mammography systems show a linear response curve over a dynamic range from 3.5 to 500 microGy (0.998digital system, the presampling MTF was calculated within a range up to the Nyquist frequency (5 lp/mm for GE Senographe 2000D, 7.1 lp/mm for Lorad Selenia, 9.3 lp/mm for Fischer Senoscan, and 5.88 lp/mm for IMS Giotto detector). The NEQ becomes related to the exposure in a linear behavior starting from about 40.3 microGy for GE Senographe 2000D, 42.9 microGy for Lorad Selenia, 41.2 microGy for Agfa DM1000, <87.6 microGy for Fischer Senoscan, and 61.3 microGy for the IMS Giotto. Above those values, the systems can be considered "quantum noise limited," that is the electronic noise is negligible if compared to the quantum noise. The DQE, for several emitted x-ray spectra for each system, i.e., 28 kV p Mo-Mo, Mo-Rh, Rh-Rh, W-Al anode-filter combination, hardened by 40 mm poly(methylmethacrylate) (PMMA) was evaluated. For the five different systems, the DQE at close to zero spatial frequency ranges between 0.25 and 0.63 at 131 microGy entrance surface air kerma to the detectors. The results of

  6. Seamless lesion insertion in digital mammography: methodology and reader study

    NASA Astrophysics Data System (ADS)

    Pezeshk, Aria; Petrick, Nicholas; Sahiner, Berkman

    2016-03-01

    Collection of large repositories of clinical images containing verified cancer locations is costly and time consuming due to difficulties associated with both the accumulation of data and establishment of the ground truth. This problem poses a significant challenge to the development of machine learning algorithms that require large amounts of data to properly train and avoid overfitting. In this paper we expand the methods in our previous publications by making several modifications that significantly increase the speed of our insertion algorithms, thereby allowing them to be used for inserting lesions that are much larger in size. These algorithms have been incorporated into an image composition tool that we have made publicly available. This tool allows users to modify or supplement existing datasets by seamlessly inserting a real breast mass or micro-calcification cluster extracted from a source digital mammogram into a different location on another mammogram. We demonstrate examples of the performance of this tool on clinical cases taken from the University of South Florida Digital Database for Screening Mammography (DDSM). Finally, we report the results of a reader study evaluating the realism of inserted lesions compared to clinical lesions. Analysis of the radiologist scores in the study using receiver operating characteristic (ROC) methodology indicates that inserted lesions cannot be reliably distinguished from clinical lesions.

  7. Tree-structured nonlinear filters in digital mammography

    SciTech Connect

    Qian, W.; Clarke, L.P.; Kallergi, M.; Clark, R.A. )

    1994-03-01

    A new class of nonlinear filters with more robust characteristics for noise suppression and detail preservation is proposed for processing digital mammographic images. The new algorithm consists of two major filtering blocks: (a) a multistage tree-structured filter for image enhancement that uses central weighted median filters as basic sub-filtering blocks and (b) a dispersion edge detector. The design of the algorithm also included the use of linear and curved windows to determine whether variable shape windowing could improve detail preservation. First, the noise-suppressing properties of the tree-structured filter were compared to single filters, namely the median and the central weighted median with conventional square and variable shape adaptive windows; simulated images were used for this purpose. Second, the edge detection properties of the tree-structured filter cascaded with the dispersion edge detector were compared to the performance of the dispersion edge detector alone, the Sobel operator, and the single median filter cascaded with the dispersion edge detector. Selected mammographic images with representative biopsy-proven malignancies were processed with all methods and the results were visually evaluated by an expert mammographer. In all applications, the proposed filter suggested better detail preservation, noise suppression, and edge detection than all other approaches and it may prove to be a useful tool for computer-assisted diagnosis in digital mammography.

  8. Tree-structured nonlinear filters in digital mammography.

    PubMed

    Qian, W; Clarke, L P; Kallergi, M; Clark, R A

    1994-01-01

    A new class of nonlinear filters with more robust characteristics for noise suppression and detail preservation is proposed for processing digital mammographic images. The new algorithm consists of two major filtering blocks: (a) a multistage tree-structured filter for image enhancement that uses central weighted median filters as basic sub-filtering blocks and (b) a dispersion edge detector. The design of the algorithm also included the use of linear and curved windows to determine whether variable shape windowing could improve detail preservation. First, the noise-suppressing properties of the tree-structured filter were compared to single filters, namely the median and the central weighted median with conventional square and variable shape adaptive windows; simulated images were used for this purpose. Second, the edge detection properties of the tree-structured filter cascaded with the dispersion edge detector were compared to the performance of the dispersion edge detector alone, the Sobel operator, and the single median filter cascaded with the dispersion edge detector. Selected mammographic images with representative biopsy-proven malignancies were processed with all methods and the results were visually evaluated by an expert mammographer. In all applications, the proposed filter suggested better detail preservation, noise suppression, and edge detection than all other approaches and it may prove to be a useful tool for computer-assisted diagnosis in digital mammography.

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

    SciTech Connect

    Zhao, W.

    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

  10. Breast percent density: estimation on digital mammograms and central tomosynthesis projections.

    PubMed

    Bakic, Predrag R; Carton, Ann-Katherine; Kontos, Despina; Zhang, Cuiping; Troxel, Andrea B; Maidment, Andrew D A

    2009-07-01

    To evaluate inter- and intrareader agreement in breast percent density (PD) estimation on clinical digital mammograms and central digital breast tomosynthesis (DBT) projection images. This HIPAA-compliant study had institutional review board approval; all patients provided informed consent. Breast PD estimation was performed on the basis of anonymized digital mammograms and central DBT projections in 39 women (mean age, 51 years; range, 31-80 years). All women had recently detected abnormalities or biopsy-proved cancers. PD was estimated by three experienced readers on the mediolateral oblique views of the contralateral breasts by using software; each reader repeated the estimation after 2 months. Spearman correlations of inter- and intrareader and intermodality PD estimates, as well as kappa statistics between categoric PD estimates, were computed. High correlation (rho = 0.91) was observed between PD estimates on digital mammograms and those on central DBT projections, averaged over all estimations; the corresponding kappa coefficient (0.79) indicated substantial agreement. Mean interreader agreement for PD estimation on central DBT projections (rho = 0.85 +/- 0.05 [standard deviation]) was significantly higher (P < .01) than that for PD estimation on digital mammograms (rho = 0.75 +/- 0.05); the corresponding kappa coefficients indicated substantial (kappa = 0.65 +/- 0.12) and moderate (kappa = 0.55 +/- 0.14) agreement for central DBT projections and digital mammograms, respectively. High correlation between PD estimates on digital mammograms and those on central DBT projections suggests the latter could be used until a method for PD estimation based on three-dimensional reconstructed images is introduced. Moreover, clinical PD estimation is possible with reduced radiation dose, as each DBT projection was acquired by using about 22% of the dose for a single mammographic projection. (c) RSNA, 2009.

  11. Digital Breast Tomosynthesis (DBT) to Characterize MRI-Detected Additional Lesions Unidentified at Targeted Ultrasound in Newly Diagnosed Breast Cancer Patients.

    PubMed

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

    2015-09-01

    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. • Targeted US identified 114 of 164 (69.5%) additional enhancing lesions at preoperative breast MRI. • DBT identified a further 32 of the 50 lesions unidentified on targeted US. • DBT improved the characterization of additional MR findings for breast cancer staging.

  12. Applying a 2D based CAD scheme for detecting micro-calcification clusters using digital breast tomosynthesis images: an assessment

    NASA Astrophysics Data System (ADS)

    Park, Sang Cheol; Zheng, Bin; Wang, Xiao-Hui; Gur, David

    2008-03-01

    Digital breast tomosynthesis (DBT) has emerged as a promising imaging modality for screening mammography. However, visually detecting micro-calcification clusters depicted on DBT images is a difficult task. Computer-aided detection (CAD) schemes for detecting micro-calcification clusters depicted on mammograms can achieve high performance and the use of CAD results can assist radiologists in detecting subtle micro-calcification clusters. In this study, we compared the performance of an available 2D based CAD scheme with one that includes a new grouping and scoring method when applied to both projection and reconstructed DBT images. We selected a dataset involving 96 DBT examinations acquired on 45 women. Each DBT image set included 11 low dose projection images and a varying number of reconstructed image slices ranging from 18 to 87. In this dataset 20 true-positive micro-calcification clusters were visually detected on the projection images and 40 were visually detected on the reconstructed images, respectively. We first applied the CAD scheme that was previously developed in our laboratory to the DBT dataset. We then tested a new grouping method that defines an independent cluster by grouping the same cluster detected on different projection or reconstructed images. We then compared four scoring methods to assess the CAD performance. The maximum sensitivity level observed for the different grouping and scoring methods were 70% and 88% for the projection and reconstructed images with a maximum false-positive rate of 4.0 and 15.9 per examination, respectively. This preliminary study demonstrates that (1) among the maximum, the minimum or the average CAD generated scores, using the maximum score of the grouped cluster regions achieved the highest performance level, (2) the histogram based scoring method is reasonably effective in reducing false-positive detections on the projection images but the overall CAD sensitivity is lower due to lower signal-to-noise ratio

  13. Statistical iterative reconstruction to improve image quality for digital breast tomosynthesis.

    PubMed

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

    2015-09-01

    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 of 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. 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. IR improved the detectability of low-contrast and small microcalcifications, reduced cross-plane artifacts, improved spatial resolution, and lowered noise in reconstructed images. 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.

  14. Statistical iterative reconstruction to improve image quality for digital breast tomosynthesis

    SciTech Connect

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

    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.

  15. Statistical iterative reconstruction to improve image quality for digital breast tomosynthesis

    PubMed Central

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

    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. PMID:26328987

  16. Toward an international consensus strategy for periodic quality control of digital breast tomosynthesis systems

    NASA Astrophysics Data System (ADS)

    Jacobs, J.; Marshall, N.; Cockmartin, L.; Zanca, F.; van Engen, R.; Young, K.; Bosmans, H.; Samei, E.

    2010-04-01

    As a collaborative effort between scientists affiliated with the American Association of Physicists in Medicine (AAPM) and the European reference center for breast cancer screening and diagnosis (EUREF), the Working Group on Phantoms for Breast Imaging (WGPBI) aims to develop phantoms and evaluation techniques for 2D & 3D breast imaging modalities. In the first phase of this collaboration, this project aimed to develop a phantom and associated procedure for constancy testing of digital breast tomosynthesis (DBT) systems. The procedure involves daily and weekly components. The daily evaluation is performed on a simple, homogenous PMMA plate of 4 cm thickness. For the weekly part, a new phantom has been designed consisting of a 45 mm thick homogeneous slab of PMMA with a set of spherical and rectangular inserts at specific 3D positions, and a thin wire positioned at a small angle to the plane of the detector. Quality control parameters are extracted from both projection images (if available) and reconstructed planes. The homogeneous phantom for daily QC allows a trend analysis of homogeneity and the assessment of detector artifacts. With the proposed phantom concept for weekly QC, the stability of the following parameters can be evaluated: the propagation and correlation of the noise in plane and across the reconstructed tomographic planes, lag, signal difference to noise ratio (SDNR) and signal to noise ratio (SNR), the geometry and the motion, effective thickness of the reconstructed planes, homogeneity, distance accuracy, frequency dependent SNR, and artifacts. Analysis of the DICOM header provides information on the stability of the automatic exposure control (AEC), exposure settings, and several system parameters. In an on-going study, the proposed strategy is being applied to five tomosynthesis systems both in Europe and in the US. In this paper we report on the specifics of the phantom, the QC procedure, the practicalities of remote data analysis, and the

  17. A feasibility study for anatomical noise reduction in dual-energy chest digital tomosynthesis

    NASA Astrophysics Data System (ADS)

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

    2016-01-01

    Lung cancer is the leading cause of cancer death worldwide. Thus, early diagnosis is of considerable importance. For early screening of lung cancer, computed tomography (CT) has been used as the gold standard. Chest digital tomosynthesis (CDT) is a recently introduced modality for lung cancer screening with a relatively low radiation dose compared to CT. The dual energy material decomposition method has been proposed for better detection of pulmonary nodules by means of reducing anatomical noise. In this study, the possibility of material decomposition in CDT was tested by both a simulation study and an experimental study using a CDT prototype. The Geant4 application for tomographic emission (GATE) v6 and tungsten anode spectral model using interpolating polynomials (TASMIP) codes were used for the simulation study to create simulated phantom shapes consisting of five inner cylinders filled with different densities of bone and airequivalent materials. Furthermore, the CDT prototype system and human phantom chest were used for the experimental study. CDT scan in both the simulation and experimental studies was performed with linear movement and 21 projection images were obtained over a 30 degree angular range with a 1.5 degree angular interval. To obtain materialselective images, a projectionbased energy subtraction technique was applied to high and low energy images. The resultant simulation images showed that dual-energy reconstruction could achieve an approximately 32% higher contrast to noise ratio (CNR) in images and the difference in CNR value according to bone density was significant compared to single energy CDT. Additionally, image artifacts were effectively corrected in dual energy CDT simulation studies. Likewise the experimental study with dual energy produced clear images of lung fields and bone structure by removing unnecessary anatomical structures. Dual energy tomosynthesis is a new technique; therefore, there is little guidance regarding its

  18. The value of digital tomosynthesis in the diagnosis of suspected pulmonary lesions on chest radiography: analysis of diagnostic accuracy and confidence.

    PubMed

    Quaia, Emilio; Baratella, Elisa; Cioffi, Vincenzo; Bregant, Paola; Cernic, Stefano; Cuttin, Roberto; Cova, Maria Assunta

    2010-10-01

    The aim of this study was to investigate the value of digital tomosynthesis in the diagnosis of suspected pulmonary lesions on chest radiography. Two-hundred twenty-eight patients (133 men, 95 women; mean age, 70.8 ± 11.1 years) with suspected pulmonary lesions after initial analysis of chest radiography underwent digital tomosynthesis. Two independent readers (with 3 and 20 years of experience) prospectively analyzed the chest radiographic and digital tomosynthesis images on a picture archiving and communication system workstation and proposed a diagnostic confidence score for each lesion (1 or 2 = definitely or probably extrapulmonary lesion or pseudolesion, 3 = indeterminate, 4 or 5 = probably or definitely pulmonary lesion). Chest computed tomography was the reference standard examination. A total of 251 suspected pulmonary lesions were identified. In 71 patients, digital tomosynthesis and computed tomography did not confirm any lesion. In the remaining 157 patients, 180 lesions were identified, including 112 pulmonary and 68 extrapulmonary lesions. In 110 (reader 1) and 123 (reader 2) lesions, correct diagnoses were provided after analysis of the chest radiographs. All lesions were correctly classified after digital tomosynthesis except for 14 extrapulmonary lesions (both readers) that were misinterpreted as pulmonary and 10 (reader 1) and six (reader 2) pulmonary lesions that were misinterpreted as pleural. Digital radiography versus tomosynthesis differed in accuracy (reader 1, 43% vs 90%; reader 2, 49% vs 92%; P < .05) and confidence by area under the receiver-operating characteristic curve (reader 1, 0.788 vs 0.944; reader 2, 0.840 vs 0.997; P < .05). Digital tomosynthesis improved diagnostic accuracy and confidence in the diagnosis of suspected pulmonary lesions on chest radiography. Copyright © 2010 AUR. Published by Elsevier Inc. All rights reserved.

  19. Algorithmic scatter correction in dual-energy digital mammography

    SciTech Connect

    Chen, Xi; Mou, Xuanqin; Nishikawa, Robert M.; Lau, Beverly A.; Chan, Suk-tak; Zhang, Lei

    2013-11-15

    Purpose: Small calcifications are often the earliest and the main indicator of breast cancer. Dual-energy digital mammography (DEDM) has been considered as a promising technique to improve the detectability of calcifications since it can be used to suppress the contrast between adipose and glandular tissues of the breast. X-ray scatter leads to erroneous calculations of the DEDM image. Although the pinhole-array interpolation method can estimate scattered radiations, it requires extra exposures to measure the scatter and apply the correction. The purpose of this work is to design an algorithmic method for scatter correction in DEDM without extra exposures.Methods: In this paper, a scatter correction method for DEDM was developed based on the knowledge that scattered radiation has small spatial variation and that the majority of pixels in a mammogram are noncalcification pixels. The scatter fraction was estimated in the DEDM calculation and the measured scatter fraction was used to remove scatter from the image. The scatter correction method was implemented on a commercial full-field digital mammography system with breast tissue equivalent phantom and calcification phantom. The authors also implemented the pinhole-array interpolation scatter correction method on the system. Phantom results for both methods are presented and discussed. The authors compared the background DE calcification signals and the contrast-to-noise ratio (CNR) of calcifications in the three DE calcification images: image without scatter correction, image with scatter correction using pinhole-array interpolation method, and image with scatter correction using the authors' algorithmic method.Results: The authors' results show that the resultant background DE calcification signal can be reduced. The root-mean-square of background DE calcification signal of 1962 μm with scatter-uncorrected data was reduced to 194 μm after scatter correction using the authors' algorithmic method. The range of

  20. Use of Tomosynthesis in Intraoperative Digital Specimen Radiography - Is a Reduction of Breast Re-excision Rates Possible?

    PubMed

    Schulz-Wendtland, R; Dilbat, G; Bani, M R; Lux, M P; Meier-Meitinger, M; Wenkel, E; Schwab, S; Beckmann, M W; Uder, M; Adamietz, B

    2011-12-01

    Aim: A prospective clinical study was done to see whether it is possible to reduce the rate of re-excisions using digital breast tomosynthesis (DBT) compared commercial FFDM. Material and Method: Between 1/2011 and 5/2011 we diagnosed an invasive breast cancer (BI-RADS 5) in 100 patients. After histological verification we performed breast-conserving therapy with intraoperative imaging using one of 2 different systems: 1. Tomosynthesis (Siemens, Erlangen, Germany), amorphous selenium, Tungsten source, focus 0.1 mm, resolution 85 µm, pixel pitch, 8 l/mm, range: 50°, 25 projections, time for scanning > 20 s, geometry: same scanning scope, reconstruction: filtered back projection; or 2. Inspiration™ (Siemens, Erlangen, Germany), amorphous selenium, tungsten source, focus 0.1 mm, resolution 85 µm, pixel pitch, 8 l/mm as the standard. The 100 radiograms obtained with both systems were prospectively shown on a monitor to 3 radiologists. Results: Out of a total of 100 patients with histologically proven breast cancer (BI-RADS 6) no re-excision was necessary in 78 patients. A retrospective analysis (n = 22) demonstrated an increase in sensitivity of tomosynthesis compared to the Inspiration™ at a magnification of 1.0 : 1.0 of 8 % (p < 0.05), i.e., in 8 patients re-excision would not have been necessary with tomosynthesis. Conclusion: Tomosynthesis has a significant higher sensitivity (p < 0.05) compared with a commercial FFDM system. Studies with higher numbers of patients will be necessary to evaluate this method.

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

    PubMed

    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

  2. Medical devices; radiology devices; reclassification of full-field digital mammography system. Final rule.

    PubMed

    2010-11-05

    The Food and Drug Administration (FDA) is announcing the reclassification of the full-field digital mammography (FFDM) system from class III (premarket approval) to class II (special controls). The device type is intended to produce planar digital x-ray images of the entire breast; this generic type of device may include digital mammography acquisition software, full-field digital image receptor, acquisition workstation, automatic exposure control, image processing and reconstruction programs, patient and equipment supports, component parts, and accessories. The special control that will apply to the device is the guidance document entitled "Class II Special Controls Guidance Document: Full-Field Digital Mammography System." FDA is reclassifying the device into class II (special controls) because general controls along with special controls will provide a reasonable assurance of safety and effectiveness of the device. Elsewhere in this issue of the Federal Register, FDA is announcing the availability of the guidance document that will serve as the special control for this device.

  3. Which phantom is better for assessing the image quality in full-field digital mammography?: American College of Radiology Accreditation phantom versus digital mammography accreditation phantom.

    PubMed

    Song, Sung Eun; Seo, Bo Kyoung; Yie, An; Ku, Bon Kyung; Kim, Hee-Young; Cho, Kyu Ran; Chung, Hwan Hoon; Lee, Seung Hwa; Hwang, Kyu-Won

    2012-01-01

    To compare between the American College of Radiology (ACR) accreditation phantom and digital mammography accreditation phantom in assessing the image quality in full-field digital mammography (FFDM). In each week throughout the 42-week study, we obtained phantom images using both the ACR accreditation phantom and the digital mammography accreditation phantom, and a total of 42 pairs of images were included in this study. We assessed the signal-to-noise ratio (SNR) in each phantom image. A radiologist drew a square-shaped region of interest on the phantom and then the mean value of the SNR and the standard deviation were automatically provided on a monitor. SNR was calculated by an equation, measured mean value of SNR-constant coefficient of FFDM/standard deviation. Two breast radiologists scored visible objects (fibers, specks, and masses) with soft-copy images and calculated the visible rate (number of visible objects/total number of objects). We compared SNR and the visible rate of objects between the two phantoms and calculated the k-coefficient for interobserver agreement. The SNR of the ACR accreditation phantom ranged from 42.0 to 52.9 (Mean, 47.3 ± 2.79) and that of Digital Phantom ranged from 24.8 to 54.0 (Mean, 44.1 ± 9.93) (p = 0.028). The visible rates of all three types of objects were much higher in the ACR accreditation phantom than those in the digital mammography accreditation phantom (p < 0.05). Interobserver agreement for visible rates of objects on phantom images was fair to moderate agreement (k-coefficients: 0.34-0.57). The ACR accreditation phantom is superior to the digital mammography accreditation phantom in terms of SNR and visibility of phantom objects. Thus, ACR accreditation phantom appears to be satisfactory for assessing the image quality in FFDM.

  4. 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

    SciTech Connect

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

    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

  5. 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.

    PubMed

    Patel, Tushita; Peppard, Heather; Williams, Mark B

    2016-04-01

    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. 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. For 4, 6, and 8 cm tissue

  6. On imaging with or without grid in digital mammography

    NASA Astrophysics Data System (ADS)

    Chen, Han; Danielsson, Mats; Cederström, Björn

    2014-03-01

    The grids used in digital mammography to reduce scattered radiation from the breast are not perfect and lead to partial absorption of primary radiation at the same time as not all of the scattered radiation is absorbed. It has therefore lately been suggested to remove the grids and correct for effects of scattered radiation by post- processing the images. In this paper, we investigated the dose reduction that might be achieved if the gird were to be removed. Dose reduction is determined as a function of PMMA thickness by comparing the contrast-to-noise ratios (CNRs) of images acquired with and without grid at a constant exposure. We used a theoretical model validated with Monte Carlo simulations and phantom studies. To evaluate the CNR, we applied aluminum filters of two different sizes, 4x8 cm2 and 1x1 cm2. When the large Al filter was used, the resulting CNR value for the grid-less images was overestimated as a result of a difference in amount of scattered radiation in the background region and of the region covered by the filter, a difference that could be eliminated by selecting a region of interest close to the edge of the filter. The optimal CNR when the PMMA thickness was above about 4 cm was obtained with a grid, whereas removing the grid leaded to a dose saving in thinner PMMAs. The results suggest not removing grids in breast cancer screening.

  7. Task-based lens design with application to digital mammography

    NASA Astrophysics Data System (ADS)

    Chen, Liying; Barrett, Harrison H.

    2005-01-01

    Recent advances in model observers that predict human perceptual performance now make it possible to optimize medical imaging systems for human task performance. We illustrate the procedure by considering the design of a lens for use in an optically coupled digital mammography system. The channelized Hotelling observer is used to model human performance, and the channels chosen are differences of Gaussians. The task performed by the model observer is detection of a lesion at a random but known location in a clustered lumpy background mimicking breast tissue. The entire system is simulated with a Monte Carlo application according to physics principles, and the main system component under study is the imaging lens that couples a fluorescent screen to a CCD detector. The signal-to-noise ratio (SNR) of the channelized Hotelling observer is used to quantify this detectability of the simulated lesion (signal) on the simulated mammographic background. Plots of channelized Hotelling SNR versus signal location for various lens apertures, various working distances, and various focusing places are presented. These plots thus illustrate the trade-off between coupling efficiency and blur in a task-based manner. In this way, the channelized Hotelling SNR is used as a merit function for lens design.

  8. Markov random field for tumor detection in digital mammography

    SciTech Connect

    Li, H.D.; Kallergi, M.; Clarke, L.P.; Clark, R.A.; Jain, V.K.

    1995-09-01

    A technique is proposed for the detection of tumors in digital mammography. Detection is performed in two steps: segmentation and classification. In segmentation, regions of interest are first extracted from the images by adaptive thresholding. A further reliable segmentation is achieved by a modified Markov random field (MRF) model-based method. In classification, the MRF segmented regions are classified into suspicious and normal by a fuzzy binary decision tree based on a series of radiographic, density-related features. A set of normal (50) and abnormal (45) screen/film mammograms were tested. The latter contained 48 biopsy proven, malignant masses of various types and subtlety. The detection accuracy of the algorithm was evaluated by means of a free response receiver operating characteristic curve which shows the relationship between the detection of true positive masses and the number of false positive alarms per image. The results indicated that a 90% sensitivity can be achieved in the detection of different types of masses at the expense of two falsely detected signals per image. The algorithm was notably successful in the detection of minimal cancers manifested by masses {le} 10 mm in size. For the 16 such cases in their dataset, a 94% sensitivity was observed with 1.5 false alarms per image. An extensive study of the effects of the algorithm`s parameters on its sensitivity and specificity was also performed in order to optimize the method for a clinical, observer performance study.

  9. Task-based lens design with application to digital mammography

    PubMed Central

    Chen, Liying; Barrett, Harrison H.

    2006-01-01

    Recent advances in model observers that predict human perceptual performance now make it possible to optimize medical imaging systems for human task performance. We illustrate the procedure by considering the design of a lens for use in an optically coupled digital mammography system. The channelized Hotelling observer is used to model human performance, and the channels chosen are differences of Gaussians. The task performed by the model observer is detection of a lesion at a random but known location in a clustered lumpy background mimicking breast tissue. The entire system is simulated with a Monte Carlo application according to physics principles, and the main system component under study is the imaging lens that couples a fluorescent screen to a CCD detector. The signal-to-noise ratio (SNR) of the channelized Hotelling observer is used to quantify this detectability of the simulated lesion (signal) on the simulated mammographic background. Plots of channelized Hotelling SNR versus signal location for various lens apertures, various working distances, and various focusing places are presented. These plots thus illustrate the trade-off between coupling efficiency and blur in a task-based manner. In this way, the channelized Hotelling SNR is used as a merit function for lens design. PMID:15669625

  10. Task-based lens design with application to digital mammography.

    PubMed

    Chen, Liying; Barrett, Harrison H

    2005-01-01

    Recent advances in model observers that predict human perceptual performance now make it possible to optimize medical imaging systems for human task performance. We illustrate the procedure by considering the design of a lens for use in an optically coupled digital mammography system. The channelized Hotelling observer is used to model human performance, and the channels chosen are differences of Gaussians. The task performed by the model observer is detection of a lesion at a random but known location in a clustered lumpy background mimicking breast tissue. The entire system is simulated with a Monte Carlo application according to physics principles, and the main system component under study is the imaging lens that couples a fluorescent screen to a CCD detector. The signal-to-noise ratio (SNR) of the channelized Hotelling observer is used to quantify this detectability of the simulated lesion (signal) on the simulated mammographic background. Plots of channelized Hotelling SNR versus signal location for various lens apertures, various working distances, and various focusing places are presented. These plots thus illustrate the trade-off between coupling efficiency and blur in a task-based manner. In this way, the channelized Hotelling SNR is used as a merit function for lens design.

  11. Volumetric breast density affects performance of digital screening mammography.

    PubMed

    Wanders, Johanna O P; Holland, Katharina; Veldhuis, Wouter B; Mann, Ritse M; Pijnappel, Ruud M; Peeters, Petra H M; van Gils, Carla H; Karssemeijer, Nico

    2017-02-01

    To determine to what extent automatically measured volumetric mammographic density influences screening performance when using digital mammography (DM). We collected a consecutive series of 111,898 DM examinations (2003-2011) from one screening unit of the Dutch biennial screening program (age 50-75 years). Volumetric mammographic density was automatically assessed using Volpara. We determined screening performance measures for four density categories comparable to the American College of Radiology (ACR) breast density categories. Of all the examinations, 21.6% were categorized as density category 1 ('almost entirely fatty') and 41.5, 28.9, and 8.0% as category 2-4 ('extremely dense'), respectively. We identified 667 screen-detected and 234 interval cancers. Interval cancer rates were 0.7, 1.9, 2.9, and 4.4‰ and false positive rates were 11.2, 15.1, 18.2, and 23.8‰ for categories 1-4, respectively (both p-trend < 0.001). The screening sensitivity, calculated as the proportion of screen-detected among the total of screen-detected and interval tumors, was lower in higher density categories: 85.7, 77.6, 69.5, and 61.0% for categories 1-4, respectively (p-trend < 0.001). Volumetric mammographic density, automatically measured on digital mammograms, impacts screening performance measures along the same patterns as established with ACR breast density categories. Since measuring breast density fully automatically has much higher reproducibility than visual assessment, this automatic method could help with implementing density-based supplemental screening.

  12. Digital tomosynthesis for verifying spine position during radiotherapy: a phantom study.

    PubMed

    Gurney-Champion, Oliver J; Dahele, Max; Mostafavi, Hassan; Slotman, Ben J; Verbakel, Wilko F A R

    2013-08-21

    Monitoring the stability of patient position is essential during high-precision radiotherapy such as spine stereotactic body radiotherapy (SBRT). We evaluated the combination of digital tomosynthesis (DTS) and triangulation for spine position detection, using non-clinical DTS software and an anthropomorphic pelvic phantom that includes a bone-like spine structure. Kilovoltage cone beam CT projection images over 2-16° gantry rotation were used to generate single slice DTS images. Each DTS slice was registered to a digitally reconstructed DTS derived from the planning CT scan to determine 2D shifts between actual phantom and treatment plan position. Two or more DTS registrations, central axes 4-22° apart, were triangulated to determine the 3D phantom position. Using sequentially generated DTS images, the phantom position can be updated every degree with a small latency of DTS and triangulation angle. The precision of position determination was investigated as function of DTS and triangulation angle. To mimic the scenario of spine SBRT, the effect on the standard deviation of megavoltage radiation delivery during kV image acquisition was tested. In addition, the ability of the system to detect different types of movement was investigated for a variety of small sudden and gradual movements during kV image acquisition.

  13. X-ray digital intra-oral tomosynthesis for quasi-three-dimensional imaging: system, reconstruction algorithm, and experiments

    NASA Astrophysics Data System (ADS)

    Li, Liang; Chen, Zhiqiang; Zhao, Ziran; Wu, Dufan

    2013-01-01

    At present, there are mainly three x-ray imaging modalities for dental clinical diagnosis: radiography, panorama and computed tomography (CT). We develop a new x-ray digital intra-oral tomosynthesis (IDT) system for quasi-three-dimensional dental imaging which can be seen as an intermediate modality between traditional radiography and CT. In addition to normal x-ray tube and digital sensor used in intra-oral radiography, IDT has a specially designed mechanical device to complete the tomosynthesis data acquisition. During the scanning, the measurement geometry is such that the sensor is stationary inside the patient's mouth and the x-ray tube moves along an arc trajectory with respect to the intra-oral sensor. Therefore, the projection geometry can be obtained without any other reference objects, which makes it be easily accepted in clinical applications. We also present a compressed sensing-based iterative reconstruction algorithm for this kind of intra-oral tomosynthesis. Finally, simulation and experiment were both carried out to evaluate this intra-oral imaging modality and algorithm. The results show that IDT has its potentiality to become a new tool for dental clinical diagnosis.

  14. Comparative Study Of Image Enhancement Algorithms For Digital And Film Mammography

    SciTech Connect

    Delgado-Gonzalez, A.

    2008-08-11

    Here we discuss the application of edge enhancement algorithms on images obtained with a Mammography System which has a Selenium Detector and on the other hand, on images obtained from digitized film mammography. Comparative analysis of such images includes the study of technical aspects of image acquisition, storage, compression and display. A protocol for a local database has been created as a result of this study.

  15. Mammography

    SciTech Connect

    Not Available

    1980-01-01

    At the present time, thermography, ultrasound, computed tomography, ionography, and heavy particle radiography have limited roles to play in the diagnosis of breast cancer. Mammography remains the diagnostic method of choice, but its value is subject to many technical constraints. The optimization of all technical factors, including image processing and the matching of the x-ray spectrum to the recording medium is necessary. The examination should be presumed to carry some risk of carcinogenesis. The estimated values of carcinogenic risk based on data for western women over age 20 at exposure are: 6.6 breast cases per million women per rad per year. Currently, the midplane dose is a useful indicator of relative exposure of the mammary gland tissue at risk. (KRM)

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

    SciTech Connect

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

    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

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

    PubMed

    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.

  18. Sensitivity of Thoracic Digital Tomosynthesis (DTS) for the Identification of Lung Nodules.

    PubMed

    Langer, Steve G; Graner, Brian D; Schueler, Beth A; Fetterly, Kenneth A; Kofler, James M; Mandrekar, Jayawant N; Bartholmai, Brian J

    2016-02-01

    Thoracic computed tomography (CT) is considered the gold standard for detection lung pathology, yet its efficacy as a screening tool in regards to cost and radiation dose continues to evolve. Chest radiography (CXR) remains a useful and ubiquitous tool for detection and characterization of pulmonary pathology, but reduced sensitivity and specificity compared to CT. This prospective, blinded study compares the sensitivity of digital tomosynthesis (DTS), to that of CT and CXR for the identification and characterization of lung nodules. Ninety-five outpatients received a posteroanterior (PA) and lateral CXR, DTS, and chest CT at one care episode. The CXR and DTS studies were independently interpreted by three thoracic radiologists. The CT studies were used as the gold standard and read by a fourth thoracic radiologist. Nodules were characterized by presence, location, size, and composition. The agreement between observers and the effective radiation dose for each modality was objectively calculated. One hundred forty-five nodules of greatest diameter larger than 4 mm and 215 nodules less than 4 mm were identified by CT. DTS identified significantly more >4 mm nodules than CXR (DTS 32 % vs. CXR 17 %). CXR and DTS showed no significant difference in the ability to identify the smaller nodules or central nodules within 3 cm of the hilum. DTS outperformed CXR in identifying pleural nodules and those nodules located greater than 3 cm from the hilum. Average radiation dose for CXR, DTS, and CT were 0.10, 0.21, and 6.8 mSv, respectively. Thoracic digital tomosynthesis requires significantly less radiation dose than CT and nearly doubles the sensitivity of that of CXR for the identification of lung nodules greater than 4 mm. However, sensitivity and specificity for detection and characterization of lung nodules remains substantially less than CT. The apparent benefits over CXR, low cost, rapid acquisition, and minimal radiation dose of thoracic DTS suggest that it may be a

  19. Quality control for digital mammography: Part II recommendations from the ACRIN DMIST trial

    SciTech Connect

    Yaffe, Martin J.; Bloomquist, Aili K.; Mawdsley, Gordon E.

    2006-03-15

    The Digital Mammography Imaging Screening Trial (DMIST), conducted under the auspices of the American College of Radiology Imaging Network (ACRIN), is a clinical trial designed to compare the accuracy of digital versus screen-film mammography in a screening population [E. Pisano et al., ACRIN 6652--Digital vs. Screen-Film Mammography, ACRIN (2001)]. Part I of this work described the Quality Control program developed to ensure consistency and optimal operation of the digital equipment. For many of the tests, there were no failures during the 24 months imaging was performed in DMIST. When systems failed, they generally did so suddenly rather than through gradual deterioration of performance. In this part, the utility and effectiveness of those tests are considered. This suggests that after verification of proper operation, routine extensive testing would be of minimal value. A recommended set of tests is presented including additional and improved tests, which we believe meet the intent and spirit of the Mammography Quality Standards Act regulations to ensure that full-field digital mammography systems are functioning correctly, and consistently producing mammograms of excellent image quality.

  20. Dose comparison between screen/film and full-field digital mammography.

    PubMed

    Gennaro, Gisella; di Maggio, Cosimo

    2006-11-01

    The study purpose was the comparison between doses delivered by a full-field digital mammography system and a screen/film mammography unit, both using the same type of X-ray tube. Exposure parameters and breast thickness were collected for 300 screen/film (GE Senographe DMR) and 296 digital mammograms (GE Senographe 2000D). The entrance surface air kerma (ESAK) was calculated from anode/filter combination, kV(p) and mAs values and breast thickness, by simulating spectra through a program based on a catalogue of experimental X-ray spectra. The average glandular dose (AGD) was also computed. Results showed an overall reduction of average glandular dose by 27% of digital over screen/film mammography. The dose saving was about 15% for thin and thick breasts, while it was between 30% and 40% for intermediate thicknesses. Full-field digital mammography dose reduction is allowed by wider dynamic range and higher efficiency of digital detector, which can be exposed at higher energy spectra than screen/film mammography, and by the separation between acquisition and displaying processes.

  1. 21 CFR 892.1715 - Full-field digital mammography system.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Full-field digital mammography system. 892.1715 Section 892.1715 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.1715 Full-field digital...

  2. 21 CFR 892.1715 - Full-field digital mammography system.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Full-field digital mammography system. 892.1715 Section 892.1715 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.1715 Full-field digital...

  3. 21 CFR 892.1715 - Full-field digital mammography system.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Full-field digital mammography system. 892.1715 Section 892.1715 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.1715 Full-field digital...

  4. 21 CFR 892.1715 - Full-field digital mammography system.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Full-field digital mammography system. 892.1715 Section 892.1715 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.1715 Full-field digital...

  5. FDA & digital mammography: why has FDA required full field digital mammography systems to be regulated as potentially dangerous devices for more than 10 years?

    PubMed

    Nields, Morgan W

    2010-05-01

    Digital mammography is routinely used in the US to screen asymptomatic women for breast cancer and currently over 50% of US screening centers employ the technology. In spite of FDAs knowledge that digital mammography requires less radiation than film mammography and that its equivalence has been proven in a prospective randomized trial, the agency has failed to allow the technology market access via the 510(k) pre market clearance pathway. As a result of the restrictive Pre Market Approval process, only four suppliers have received FDA approval. The resulting lack of a competitive market has kept costs high, restricted technological innovation, and impeded product improvements as a result of PMA requirements. Meanwhile, at least twelve companies are on the market in the EU and the resulting competitive market has lowered costs and provided increased technological choice. A cultural change with new leadership occurred in the early 90's at FDA. The historical culture at the Center for Devices and Radiological Health of collaboration and education gave way to one characterized by a lack of reliance on outside scientific expertise, tolerance of decision making by unqualified reviewers, and an emphasis on enforcement and punishment. Digital mammography fell victim to this cultural change and as a result major innovations like breast CT and computer aided detection technologies are also withheld from the market. The medical device law, currently under review by the Institute of Medicine, should be amended by the Congress so that new technologies can be appropriately classified in accordance with the risk based assessment classification system detailed in Chapter V of the Federal Food, Drug, and Cosmetic Act. A panel of scientific experts chartered by the NIH or IOM should determine the classification appropriate for new technologies that have no historical regulatory framework. This would be binding on FDA. Unless the law is changed we will likely again experience

  6. Mammography and Other Screening Tests for Breast Problems

    MedlinePlus

    ... What are the risks of mammography? • What is digital mammography? • What is a clinical breast exam? • How ... mammogram does not increase cancer risk. What is digital mammography? Digital mammography is a type of mammography ...

  7. Mammography and Other Screening Tests for Breast Problems

    MedlinePlus

    ... What are the risks of mammography? • What is digital mammography? • What is a clinical breast exam? • How ... mammogram does not increase cancer risk. What is digital mammography? Digital mammography is a type of mammography ...

  8. Evaluation of clinical image processing algorithms used in digital mammography.

    PubMed

    Zanca, Federica; Jacobs, Jurgen; Van Ongeval, Chantal; Claus, Filip; Celis, Valerie; Geniets, Catherine; Provost, Veerle; Pauwels, Herman; Marchal, Guy; Bosmans, Hilde

    2009-03-01

    Screening is the only proven approach to reduce the mortality of breast cancer, but significant numbers of breast cancers remain undetected even when all quality assurance guidelines are implemented. With the increasing adoption of digital mammography systems, image processing may be a key factor in the imaging chain. Although to our knowledge statistically significant effects of manufacturer-recommended image processings have not been previously demonstrated, the subjective experience of our radiologists, that the apparent image quality can vary considerably between different algorithms, motivated this study. This article addresses the impact of five such algorithms on the detection of clusters of microcalcifications. A database of unprocessed (raw) images of 200 normal digital mammograms, acquired with the Siemens Novation DR, was collected retrospectively. Realistic simulated microcalcification clusters were inserted in half of the unprocessed images. All unprocessed images were subsequently processed with five manufacturer-recommended image processing algorithms (Agfa Musica 1, IMS Raffaello Mammo 1.2, Sectra Mamea AB Sigmoid, Siemens OPVIEW v2, and Siemens OPVIEW v1). Four breast imaging radiologists were asked to locate and score the clusters in each image on a five point rating scale. The free-response data were analyzed by the jackknife free-response receiver operating characteristic (JAFROC) method and, for comparison, also with the receiver operating characteristic (ROC) method. JAFROC analysis revealed highly significant differences between the image processings (F = 8.51, p < 0.0001), suggesting that image processing strongly impacts the detectability of clusters. Siemens OPVIEW2 and Siemens OPVIEW1 yielded the highest and lowest performances, respectively. ROC analysis of the data also revealed significant differences between the processing but at lower significance (F = 3.47, p = 0.0305) than JAFROC. Both statistical analysis methods revealed that the

  9. Digital Tomosynthesis to Evaluate Fracture Healing: Prospective Comparison With Radiography and CT.

    PubMed

    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 < 0.01 between one modality and another). Detection of cortical fracture lines was significantly better with 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.

  10. Threshold contrast visibility of microcalcifications in digital mammography

    NASA Astrophysics Data System (ADS)

    Carton, Ann-Katherine G.; Bosmans, Hilde; Vandenbroucke, Dirk; Van Ongeval, Chantal; Souverijns, Geert; Rogge, Frank; Marchal, Guy

    2004-05-01

    The purpose of this study is to describe a method that allows the calculation of a contrast-detail curve for a particular system configuration using simulated micro calcifications into clinical mammograms. We made use of simulated templates of micro calcifications and adjusted their x-ray transmission coefficients and resolution to the properties of the mammographic system under consideration (4). We expressed the thickness of the simulated micro calcifications in terms of Al equivalence. In a first step we validated that the thickness of very small Al particles with well known size and thickness can be calculated from their x-ray transmission characteristics at a particular X-ray beam energy. Then, micro calcifications with equivalent diameters in the plane of the detector ranging from 300 to 800 μm and thicknesses, expressed in Al equivalent, covering 77 to 800 μm were simulated into the raw data of real clinical images. The procedure was tested on 2 system configurations: the GE Senographe 2000 D and the Se based Agfa Embrace DM1000 system. We adapted the X-ray transmissions and spatial characteristics of the simulated micro calcifications such that the same physical micro calcification could be simulated into images with the specific exposure parameters (Senographe 2000D: 28 kVp-Rh/Rh, Embrace DM1000: 28 kVp-Mo/Rh), compressed breast thickness (42+/-5mm) and detector under consideration. After processing and printing, 3 observers scored the visibility of the micro calcifications. We derived contrast-detail curves. This psychophysical method allows to summarize the performance of a digital mammography detector including processing and visualization.

  11. The effects of gray scale image processing on digital mammography interpretation performance.

    PubMed

    Cole, Elodia B; Pisano, Etta D; Zeng, Donglin; Muller, Keith; Aylward, Stephen R; Park, Sungwook; Kuzmiak, Cherie; Koomen, Marcia; Pavic, Dag; Walsh, Ruth; Baker, Jay; Gimenez, Edgardo I; Freimanis, Rita

    2005-05-01

    To determine the effects of three image-processing algorithms on diagnostic accuracy of digital mammography in comparison with conventional screen-film mammography. A total of 201 cases consisting of nonprocessed soft copy versions of the digital mammograms acquired from GE, Fischer, and Trex digital mammography systems (1997-1999) and conventional screen-film mammograms of the same patients were interpreted by nine radiologists. The raw digital data were processed with each of three different image-processing algorithms creating three presentations-manufacturer's default (applied and laser printed to film by each of the manufacturers), MUSICA, and PLAHE-were presented in soft copy display. There were three radiologists per presentation. Area under the receiver operating characteristic curve for GE digital mass cases was worse than screen-film for all digital presentations. The area under the receiver operating characteristic for Trex digital mass cases was better, but only with images processed with the manufacturer's default algorithm. Sensitivity for GE digital mass cases was worse than screen film for all digital presentations. Specificity for Fischer digital calcifications cases was worse than screen film for images processed in default and PLAHE algorithms. Specificity for Trex digital calcifications cases was worse than screen film for images processed with MUSICA. Specific image-processing algorithms may be necessary for optimal presentation for interpretation based on machine and lesion type.