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

Abstract

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.

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

“…71 A number of publications have summarised and reviewed both the technical and the clinical aspects of DBT and have speculated on its potential application in breast imaging. 23,[25][26][27]61,63,64,72,73 The AETNA policy report, 74 a combined recommendation from the American College of Radiologists, the American Cancer Society and the American College of Obstetrics and Gynaecologists, considers that breast tomosynthesis imaging is experimental and investigational because of insufficient evidence of its effectiveness. An Australian health technology review acknowledged that DBT systems were likely to replace 2D in screening when existing 2D equipment is due for replacement 75 and an overview of the evidence and issues to be considered in relation DBT and breast cancer screening raised concerns regarding additional radiation exposure and the learning curve for radiologists to accurately interpret DBT results.…”

“…25,26 A viewing workstation provides tools that enable the reader to scroll vertically through the tomographic images as well as to compare them with the corresponding 2D images.…”

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

“…Nevertheless, since DBT is a quasi-three-dimensional (3D) imaging technology, the DBT image quality is influenced by the system geometry and reconstruction algorithms (Sechopoulos 2013a(Sechopoulos , 2013b. Therefore, the 3D imaging performance should be evaluated for the CMOS APS detectors.…”

“…Then the filtered back-projection (FBP) reconstruction is used to convert the 2D MTF, NPS and DQE at each θ i to the 3D spatial frequency domain (f x , f y , f z ). The FBP is a standard image reconstruction method currently used for clinically approved Hologic Selenia Dimensions and Siemens MAMMOMAT Inspiration DBT commercial systems (Sechopoulos 2013a). The implemented 3D cascaded system model is used to investigate the impacts of projection angle range, mean glandular dose (MGD), fiber optic plate optical coupling efficiency, focal spot blurring effect, pixel size and scintillator pixilation on the 3D imaging performance of the CMOS APS detector.…”

“…A c c e p t e d M a n u s c r i p t currently used for DBT systems (Sechopoulos 2013a). Then the filtered back-projection (FBP) reconstruction is used to convert the 2D MTF, NPS and DQE at each θ i to the 3D spatial frequency domain (f x , f y , f z ).…”