The required realism of virtual breast phantoms is likely to depend on the imaging modality and the task. This work investigates the extent to which the VICTRE breast models are suitable for the evaluation of synthetic mammography (SM) in terms of statistical texture properties and microcalcification detection performance. First, a power spectrum analysis was performed on digital breast tomosynthesis (DBT) and SM images of patients and virtual phantoms, including all four breast density categories. The fitted power law exponent 𝛽 was used to characterize breast texture. Next, calcification clusters were simulated in patient and phantom backgrounds acquired with three different DBT dose distributions applied over the projections. A human observer detectability study was performed. The power spectrum analysis showed slightly lower power law exponents for patients compared to virtual breast phantoms. The trend of 𝛽 across different density categories is similar for patient and phantom SM images. Additionally, trends in the detectability study with virtual phantoms were similar to those in the patient study, however, the absolute performance values and level of significance between the different dose distributions were not identical. Nevertheless, this suggests that the VICTRE breast phantoms are potentially valuable replacements for patients in system optimization studies for microcalcification detection in SM and DBT.
BackgroundThe accuracy of morphological radiomic features (MRFs) can be affected by various acquisition settings and imaging conditions. To ensure that clinically irrelevant changes do not reduce sensitivity to capture the radiomics changes between successive acquisitions, it is essential to determine the optimal imaging systems and protocols to use.PurposeThe main goal of our study was to optimize CT protocols and minimize the minimum detectable difference (MDD) in successive acquisitions of MRFs.MethodMDDs were derived based on the previous research involving 15 realizations of nodule models at two different sizes. Our study involved simulations of two consecutive acquisitions using 297 different imaging conditions, representing variations in scanners’ reconstruction kernels, dose levels, and slice thicknesses. Parametric polynomial models were developed to establish correlations between imaging system characteristics, lesion size, and MDDs. Additionally, polynomial models were used to model the correlation of the imaging system parameters. Optimization problems were formulated for each MRF to minimize the approximated function. Feature importance was determined for each MRF through permutation feature analysis. The proposed method was compared to the recommended guidelines by the quantitative imaging biomarkers alliance (QIBA).ResultsThe feature importance analysis showed that lesion size is the most influential parameter to estimate the MDDs in most of the MRFs. Our study revealed that thinner slices and higher doses had a measurable impact on reducing the MDDs. Higher spatial resolution and lower noise magnitude were identified as the most suitable or noninferior acquisition settings. Compared to QIBA, the proposed protocol selection guideline demonstrated a reduced coefficient of variation, with values decreasing from 1.49 to 1.11 for large lesions and from 1.68 to 1.12 for small lesions.ConclusionThe protocol optimization framework provides means to assess and optimize protocols to minimize the MDD to increase the sensitivity of the measurements in lung cancer screening.
KEYWORDS: Lung, Data modeling, Computed tomography, Scanners, 3D modeling, Computer simulations, Modulation transfer functions, Chest imaging, Medicine, Medical research
Virtual Imaging Trials, known as VITs, provide a computational substitute for clinical trials. These traditional trials tend to be sluggish, costly, and frequently deficient in definitive evidence, all the while subjecting participants to ionizing radiation. Our VIT platform meticulously mimics essential components of the imaging process, encompassing everything from virtual patients and scanners to simulated readers. Within the scope of this intended research, we aim to authenticate our virtual imaging trial platform by duplicating the results of the National Lung Screening Trial (NLST) for lung cancer screening through the emulation of low-dose computed tomography (CT) and chest radiography (CXR) procedures. The methodology involves creating 66 unique computational phantoms, each with inserted simulated lung nodules. Replicating NLST CT imaging via Duke Legacy W20 scanner matched essential properties. Virtual imaging was done through DukeSim. A LUNA16-trained virtual reader, combining a 3D RetinaNet model (front-end) with a ResNet-10 false positive reduction model (back-end), evaluated the virtually imaged data, ensuring rigorous assessment. The back-end model achieved a sensitivity of over 95% at fewer than 3 false positives per scan for both the clinical and virtual imaged CTs. Notably, nodule diameter-based analysis showcases even higher sensitivity for nodules measuring 10 mm or more. In conclusion, the integration of diverse computational and imaging techniques, culminating in a virtual reader, demonstrates promising sensitivity. To capture both arms of the trial, future research will compare virtual reader performance on CT with CXR. This affirms the transformative potential of virtual imaging trials in advancing evidence-based medicine, offering an efficient and ethically conscious approach to medical research and development.
This work proposes an objective and automated procedure to obtain realistic digital breast tomosynthesis (DBT) images for virtual clinical trials (VCT) using the hybrid approach (simulating lesions in acquired patient images). Based on extensive feedback from a radiologist, we have implemented an automatic selection of an appropriate insertion position that (1) is located in the interior region of the breast, (2) contains sufficient glandular tissue, and (3) has the lowest variance to cope with the presence of prominent background structure and contains no Sobel edge detected blood vessels. Next, the lesion is rotated to align with the breast structures using the histogram of oriented gradient feature descriptor. The spicules of the lesion are extended to improve the fine details of the manually segmented mass models. To reduce the pronounced shadow artefact surrounding the mass, the lesion template is modified with a fitted 2D gaussian to create a softer transition between background and lesion. The realism of 20 simulated lesions using the established automated procedure was scored; 70% of the simulated cases received at least a realism score of 4 out of 5. This means an improvement in realism compared to when lesions without processing are inserted at random locations in the patient background images. Additionally, the automated method eliminates the dependency on the researcher performing the VCT.
PURPOSE: To investigate differences in microcalcification detection performance for different acquisition setups in digital breast tomosynthesis (DBT), a convex dose distribution and sparser number of projections compared to the standard set-up was evaluated via a virtual clinical trial (VCT). METHODS AND MATERIALS: Following the Institutional Review Board (IRB) approval and patient consent, mediolateral oblique (MLO) DBT views were acquired at twice the automatic exposure controlled (AEC) dose level; omitting the craniocaudal (CC) view limited the total examination dose. Microcalcification clusters were simulated into the DBT projections and noise was added to simulate lower dose levels. Three set-ups were evaluated: (1) 25 DBT projections acquired with a fixed dose/projection at the clinically used AEC dose level, (2) 25 DBT projections with dose/projection following a convex dose distribution along the scan arc, and (3) 13 DBT projections at higher dose with the total scan dose equal to the AEC dose level and preserving the angular range of 50° (sparse). For the convex set-up, dose/projection started at 0.035 mGy at the extremes and increased to 0.163 mGy for the central projection. A Siemens prototype algorithm was used for reconstruction. An alternative free-response receiver operating characteristic (AFROC) study was conducted with 6 readers to compare the microcalcification detection between the acquisition set-ups. Sixty cropped VOIs of 50x50x(breast thickness) mm3 per set-up were included, of which 50% contained a microcalcification cluster. In addition to localization of the cluster, the readers were asked to count the individual calcifications. The area under the AFROC curve was used to compare the different acquisition set-ups and a paired t-test was used to test significance. RESULTS: The AUCs for the standard, convex and sparse set-up were 0.97±0.01, 0.95±0.02 and 0.89±0.03, respectively, indicating no significant difference between standard and convex set-up (p=0.309), but a significant decrease in detectability was found for the sparse set-up (p=0.001). The number of detected calcifications per cluster was not significantly different between standard and convex set-ups (p=0.049), with 42%±9% and 40%±8%, respectively. The sparse set-up scored lower with a relative number of detected microcalcifications of 34%±11%, but this decrease was not significant (p=0.031). CONCLUSION: A convex dose distribution that increased dose along the scan arc towards the central projections did not increase detectability of microcalcifications in the DBT planes compared to the current AEC set-up. Conversely, a sparse set of projections acquired over the total scan arc decreased microcalcification detectability compared to the variable dose and current clinical set-up.
Purpose: The relevance of presampling modulation transfer function (MTF) measurements in digital mammography (DM) quality control (QC) is examined. Two studies are presented: a case study on the impact of a reduction in MTF on the technical image quality score and analysis of the robustness of routine QC MTF measurements.
Approach: In the first study, two needle computed radiography (CR) plates with identical sensitivities were used with differences in the 50% point of the MTF (fMTF0.5) larger than the limiting value in the European guidelines (>10 % change between successive measurements). Technical image quality was assessed via threshold gold thickness of the CDMAM phantom and threshold microcalcification diameter of the L1 structured phantom. For the second study, presampling MTF results from 595 half-yearly QC tests of 55 DM systems (16 types, six manufacturers) were analyzed for changes from the baseline value and changes in fMTF0.5 between successive tests.
Results: A reduction of 20% in fMTF0.5 of the two CR plates was observed. There was a tendency to a lower score for task-based metrics, but none were significant. Averaging over 55 systems, the absolute relative change in fMTF0.5 between consecutive tests (with 95% confidence interval) was 3% (2.5% to 3.4%). Analysis of the maximum relative change from baseline revealed changes of up to −10 % for one a-Se based system and −15 % for a group of CsI-based systems.
Conclusions: A limit of 10% is a relevant action level for investigation. If exceeded, then the impact on performance has to be verified with extra metrics.
Aim: Compare an in-house developed hybrid simulation framework and the FDA’s total simulation framework VICTRE in an exercise to simulate realistic DBT images. Methods: Three different set-ups were investigated in increasing order of difficulty: (1) A simple object insert simulated in homogeneous backgrounds. (2) The same simple test object in a breast phantom to investigate the impact of a non-homogeneous background. (3) The simple test object replaced with clinically relevant lesions (spiculated and non-spiculated masses, calcification clusters) to test the frameworks in their entirety. Next to a visual analysis, a quantitative comparison based on contrast and signal-difference-to-noise (SDNR) measurements was performed. Results: Similar contrast and SDNR values in the ‘for processing’ images are obtained for a glandular test object when simulated with VICTRE and the Leuven platform, for both homogeneous as well as structured backgrounds (e.g. structured background; contrast: 0.13 and 0.12, SDNR: 8.99 and 8.56 for the Leuven platform and VICTRE respectively). The reconstruction algorithms of both frameworks differ, but the input of VICTRE images in an offline reconstruction tool like in the Leuven framework leads to similar results. In DBT reconstructed slices, the simulated mass models looked similar to the real lesions from which the model was derived. The simulated calcification clusters are more subtle when using the VICTRE framework, while all clusters appear to be realistic. This illustrates the need of full characterization of the methods. Conclusion: The step-by-step comparison of two very different frameworks was successful. Both frameworks are able to simulate objects with the same characteristics (contrast, SDNR, shape) and can create images with realistic lesions.
KEYWORDS: Digital breast tomosynthesis, Tumor growth modeling, Clinical trials, Breast cancer, Databases, Data modeling, Cancer, Systems modeling, Visual process modeling, Image segmentation
Aim: To develop, validate and apply a pipeline for breast cancer voxel model generation from patient digital breast tomosynthesis (DBT) cases for cancer type specific virtual clinical trials (VCT). Methods: Input cancer cases were retrieved from wide-angle DBT systems. Three aspects of the creation process were investigated: (1) The impact of the limited z-resolution of DBT on the shape of the voxel model using circularity measurements (i.e. ratio of diameters between input and result after simulation test), DICE coefficient and artefact spread function. (2) The possibility to speed up and automate lesion segmentation with a deep learning network. (3) The ultimate realism of the voxel models in a VCT application, visually scored by a radiologist and a medical physicist. Results: Deviations between ground truth and segmented voxel models due to the pseudo-3D characteristics of DBT were limited, with circularity changes smaller than 8%. A 4-layer U-net deep learning network with a multiplication of the DICE loss and the implemented boundary loss as loss function is capable to produce segmentations within the variability of manual segmentations (DICE coefficient = 0.80). A reader study of the VCT application showed an average realism score of 3.4 on a scale of 1 to 5 for the simulated lesion manually segmented, compared to an average of 4.3 for the real lesions. An initial total of 25 invasive cancer models (9 non-spiculated, 16 spiculated masses) was successfully created and validated. Conclusion: Segmentation from an object with limited z-resolution induces an acceptable deformation. Voxel models created from DBT images can be used to mimic realistic DBT cancer cases. The use of AI techniques has facilitated the cumbersome manual segmentation task.
Purpose: To investigate the possibility of evaluating synthetic mammograms (SM) with a 3D structured phantom combined with model observer scoring. Methods: SM images were acquired on the Siemens Mammomat Revelation in order to set up a human observer study with 6 readers. Regions of interest with lesions (microcalcifications and masses) present and absent were selected for use in a four-alternative forced choice study. Image acquisitions and reading was performed at AEC,½ AEC and 2×AEC dose levels. The percentage correct (PC) results were calculated for all readers together with the standard error of the mean (SEM). A two-layer non-biased Channelized Hotelling Observer (CHO) for lesion detection was used: a two Laguerre-Gauss channel CHO applied first for localization and then an eight Gabor channel CHO for classification. Observer PC results were estimated using a bootstrap method, and the standard deviation (SD) was used as a figure of merit for reproducibility. Results: Following tuning steps, good correlation was found between the MO and human observer results for both microcalcifications and masses, at the three dose levels. The CHO predicted the PC values of the human readers, but with better reproducibility than the human readers. The detection threshold trends of the CHO matched those of the human observers. Conclusion: A two-layer CHO, with appropriate tuning and testing steps, could approximate the human observer detection results for microcalcifications and masses in SM images acquired on a Siemens Revelation DBT systems over three dose levels . The model observer developed is a promising candidate to track imaging performance in SM.
KEYWORDS: Visualization, Digital breast tomosynthesis, Modulation transfer functions, Optical spheres, Aluminum, Breast imaging, Image processing, 3D modeling, Photovoltaics, Polymethylmethacrylate
Purpose: The impact of system parameters on signal detectability can be studied with simulation platforms. We describe the steps taken to verify and confirm the accuracy of a local platform developed for the use in virtual clinical trials.
Approach: The platform simulates specific targets into existing two-dimensional full-field digital mammography and digital breast tomosynthesis images acquired on a Siemens Inspiration system. There are three steps: (1) creation of voxel models or analytical objects; (2) generation of a realistic object template with accurate resolution, scatter, and noise properties; and (3) insertion and reconstruction. Four objects were simulated: a 0.5-mm aluminium (Al) sphere and a 0.2-mm-thick Al sheet in a PMMA stack, a 0.8-mm steel edge and a three-dimensional mass model in a structured background phantom. Simulated results were compared to acquired data.
Results: Peak contrast and signal difference-to-noise ratio (SDNR) were in close agreement (<5 % error) for both sphere and sheet. The similarity of pixel value profiles for sphere and sheet in the xy direction and the artifact spread function for real and simulated spheres confirmed accurate geometric modeling. Absolute and relative average deviation between modulation transfer function measured from a real and simulated edges showed accurate sharpness modelling for spatial frequencies up to the Nyquist frequency. Real and simulated objects could not be differentiated visually.
Conclusions: The results indicate that this simulation framework is a strong candidate for use in virtual clinical studies.
Aim: Investigate 3D structured DBT phantoms with lesion models for use in the evaluation of synthetic mammography (SM) imaging performance.
Methods: 4 phantoms were investigated: CDMAM, L1, CIRS BR3D and Modular DBT Phantom (two different inserts). The phantoms were imaged on recent DBT models: Fujifilm Amulet Innovality (ST mode), GE HC Senographe Pristina, Hologic 3Dimensions, IMS Giotto Class and Siemens Mammomat Revelation. Images were acquired at automatic exposure control (AEC) level, half AEC and twice AEC. SM was calculated. The CDMAM and L1 phantom were read by human readers via a 4-Alternative Forced Choice method and thresholds were established. CIRS BR3D and Modular DBT Phantom were analysed by counting visible lesions.
Results: The scores obtained from the phantoms had the same tendencies among systems. The phantoms highlight many specific characteristics of the SM algorithms such as tuning contrast enhancement to a range of sizes. The phantoms confirm, as in 2D and DBT, an impact of dose on detectability of microcalcification-like inserts but not on masses. None of the phantoms evaluate the SM for different glandular tissue or thickness distributions.
Conclusion: For all phantoms, SM found a number of lesion-like targets and an impact of dose as expected. Whether these phantom readings are representative for quality in SM in real practice is not yet proven. More elaborated sensitivity studies should be done prior to the use of the phantoms in routine QC. Ultimately, accurate assessment of SM may have to be done via virtual trials.
Purpose: This work aims to develop an anthropomorphic convolutional neural network (CNN) classifier, based on the ResNet18 deep learning network and validate it for task based image quality evaluation of digital breast tomosynthesis (DBT) using a structured phantom with non-spiculated mass simulating lesions. Methods: The phantom is constructed from an acrylic breast-shaped container, filled with acrylic spheres and water resembling the background. Five 3D printed non-spiculated mass targets are also inserted in the phantom each with differing size from 1.5mm to 5.7mm. The phantom was scanned 530 times on 8 different DBT systems with 3 dose levels. Half of the image dataset was read by human readers in 4-alternative forced choice (4-AFC) paradigm. The 4-AFC human scores were used to label the cropped signal present and signal absent images. A pre-trained ResNet18 neural network was used and modified for binary classification and the labeled images were used to further train the network for the specific non-spiculated mass detection task. With completed 50 training epochs, the resulting ResNet18 classifier was validated wit the second half of the image dataset against human results. During the training process the loss and accuracy were stored, and statistical analysis was performed for the validation of the ResNet18 against human observers. Results and conclusions: The ResNet18 classifier shows good agreement against human observers for most of the DBT systems and reading sessions. The overall correlation was higher than 0.92. The study shows that a CNN can successfully approximate human scores and can be used for future DBT system image quality estimation studies.
Purpose: To develop a deep learning approach for channelization of the Hotelling model observer (DL-CHO) and apply to the task based image quality evaluation of digital breast tomosynthesis (DBT) using a structured phantom. Methods: An acrylic semi-cylindrical container was filled with different sizes of acrylic spheres and water. Five 3D printed non-spiculated mass models were also inserted in the phantom, each with different size (diameter from 1.5mm to 5.7mm). The phantom was scanned on 8 different DBT systems, at 3 dose levels on each system, giving a total of 594 DBT scans. Nearly half of the image dataset was read by human readers using a 4-alternative forced choice (4-AFC) paradigm. From the human results, an anthropomorphic DL-CHO was developed and trained, utilizing a single convolutional layer with five kernels functioning like channels. After 50 training epochs, the convolutional kernels were fixed and then validated with the second half of the image dataset. Statistical analysis of the goodness of the fit between the newly developed DL-CHO and human observers was performed to estimate the appropriateness of the new CHO for multivendor tomosynthesis studies. Results: The DL-CHO shows good agreement with human observers for all 8 DBT systems, with Pearson’s correlation between 0.90 and 0.99; linear regression slope between 0.60 and 1.17; and mean error between -5.6PC and 12PC. The DL-CHO shows better reproducibility compared to human observers for most of the lesion sizes. Conclusions: The DL-CHO offers a robust and efficient means of evaluating DBT test object images, for the purpose of DBT system image quality evaluation.
KEYWORDS: Breast, 3D modeling, Polymethylmethacrylate, Digital breast tomosynthesis, Signal attenuation, Tissues, Target detection, Liquids, Photography, Quality measurement
Purpose: In this work we present equivalent breast thickness and dose sensitivity of a next iteration 3D structured breast phantom with lesion models to demonstrate its potential use for quality assurance measurements in breast imaging. Methods: PMMA equivalent thickness was determined employing the automatic exposure control (AEC) of Siemens Mammomat Inspiration and Siemens Mammomat Revelation. A 2D projection image of the phantom was acquired and the corresponding AEC settings recorded as reference. Equivalent PMMA thickness was found by interpolating between three PMMA thicknesses with mAs values close to the reference settings selected by AEC. Dose sensitivity of the reconstructed digital breast tomosynthesis (DBT) images was assessed by two experienced readers using a four alternative forced choice (4-AFC) study. Three different dose levels for lesion models and microcalcifications were evaluated. Results: PMMA equivalent thickness of the phantom was 46.8 mm and 47.0 mm for measurements on Siemens Mammomat Inspiration and Siemens Mammomat Revelation which equals to a breast equivalent thickness of 55.5 mm and 55.8 mm, respectively, compared to a physical phantom thickness of 53.5 mm. For lesion models dose sensitiviy of the detectability was not obvious. For microcalcification the diameter threshold was found to increase for decreasing dose from high dose to AEC to low dose. Conclusions: We found the measured equivalent breast thickness of our phantom to be close to its physical thickness. It can be concluded that changes in dose can be detected by the presented phantom for the tested dose levels.
This work examined the impact of the presampling Modulation Transfer Function (MTF) on detectability of lesion-like targets in digital mammography. Two needle CR plates (CR1 and CR2) with different MTF curves but identical detector response (sensitivity) were selected. The plates were characterized by MTF, normalized noise power spectrum (NNPS) and detective quantum efficiency (DQE). Three image quality phantoms were applied to study the impact of the difference in MTF: first, the CDMAM contrast-detail phantom to give gold thickness threshold (T); second, a 3D structured phantom with lesion models (calcifications and masses), evaluated via a 4-alternative forced-choice study to give threshold diameter (dtr) and third, a detectability index (d') from a 50 mm PMMA flat field image and an 0.2 mm Al contrast square. MTF coefficient of variation was ~1%, averaged up to 5 mm-1. At 5 mm-1, a significant 24% reduction in MTF was observed. The lower MTF caused a 12% reduction in NNPS for CR2 compared to CR1 (at detector air kerma 117 μGy). At 5 mm-1, there was a drop in DQE of 34% for CR2 compared to CR1. For the test objects, there was a trend to lower detectability for CR2 (lower MTF) for all but one parameter, however none of the changes were significant. The MTF is a sensitive and easily applied means of tracking changes in sharpness before these changes are uncovered using lesion simulating objects in test objects.
Aim: The impact of x-ray system parameters on detectability of specific (clinical) signals can be studied with simulation platforms if these tools are sufficiently accurate and realistic. This work describes the steps taken to verify and confirm the accuracy of a local platform developed for the use in virtual clinical trials of breast tomosynthesis. The (gold standard) reference data will be made available to the community. Materials and methods: Our simulation platform simulates specific targets, including microcalcifications into existing 2D FFDM and DBT background images, a method called partial simulation. There are three steps: (1) creation of a voxel model or 3D analytical object to be inserted into the ‘For Processing’ projections; (2) generation of a realistic object template for the geometry under study and the relevant resolution, scatter and noise properties; (3) insertion of the target into the projections and DBT reconstruction plus image processing. Three objects were simulated as part of the verification: a small high contrast 0.5 mm aluminum (Al) sphere in a poly(methyl methacrylate) (PMMA) stack, a 0.2 mm thick Al sheet in a PMMA stack and a 0.8 mm steel edge. For the small Al sphere, the peak contrast, the signal difference to noise ratio (SDNR), the profile in the (in plane) xy-direction and the artifact spread function (ASF) were compared to results from real acquisitions. Contrast and SDNR were compared to data from a real 0.2 mm Al sheet. Sharpness modelling was verified by comparing the modulation transfer function (MTF) calculated from real and simulated edges. The study was performed for a Siemens Inspiration DBT system. Results: Comparing peak contrast and SDNR for both sphere and sheet showed good agreement (<5% error) in 2D FFDM and DBT. The similarity of the pixel value profiles through the sphere and the sheet in the xy-direction and the ASF for real and simulated Al spheres confirmed accurate geometric modelling. Absolute and relative average deviation between MTF measured from real and simulated edge in the front-back and left-right directions show a good correlation for frequencies up to the Nyquist frequency for 2D FFDM and DBT mode. Real and simulated objects could not be differentiated visually. Conclusion: The close correspondence between simulated and real objects, both visually and quantitatively, indicates that this simulation framework is a strong candidate for use in virtual clinical studies employing 2D FFDM and DBT.
KEYWORDS: Digital breast tomosynthesis, 3D modeling, Target detection, 3D image processing, Imaging systems, Polymethylmethacrylate, Breast, Systems modeling, Breast imaging, Digital mammography
The purpose of this study is comparing the detection performance in 2D full field digital mammography (FFDM) and digital breast tomosynthesis (DBT) using a structured phantom with inserted target objects. The phantom consists of a semi-cylindrical PMMA container, filled with water and PMMA spheres of different diameters. Microcalcifications and 3D printed masses (spiculated and non-spiculated) were inserted. The phantom was imaged ten times in both modes of five systems, using automatic exposure control (AEC) and at half and double the AEC dose. Five readers evaluated target detectability in a four-alternative forced-choice study. The percentage of correct responses (PC) was assessed based on 10 trials of each reader for each object type, size, imaging modality and dose level. Additionally, detection threshold diameters at 62.5 PC were assessed via non-linear regression fitting of the psychometric curve. Evaluation of target detection in FFDM showed that spiculated masses were better detected compared to non-spiculated masses. In DBT, detection of both mass types increased significantly (p=0.0001) compared to FFDM. Microcalcification detection thresholds ranged between 110 and 118 μm and were similar for the five systems in FFDM while larger variations (106-158 μm) were found in DBT. Mass detection was independent of dose in FFDM while weak dependence was seen for DBT. Microcalcification detection increased with increasing dose for both modalities. The phantom was able to show detectability differences between FFDM and DBT mode for five commercial systems in line with the findings from clinical trials. We suggest to use the phantom for task-based assessment methods for acceptance and commissioning testing of DBT systems.
KEYWORDS: Digital breast tomosynthesis, Mammography, Image quality, Quality systems, Visualization, 3D modeling, Reconstruction algorithms, 3D acquisition, Medical imaging
Digital breast tomosynthesis (DBT) is a relatively new 3D mammography technique that promises better detection of low contrast masses than conventional 2D mammography. The parameter space for DBT is large however and finding an optimal balance between dose and image quality remains challenging. Given the large number of conditions and images required in optimization studies, the use of human observers (HO) is time consuming and certainly not feasible for the tuning of all degrees of freedom. Our goal was to develop a model observer (MO) that could predict human detectability for clinically relevant details embedded within a newly developed structured phantom for DBT applications. DBT series were acquired on GE SenoClaire 3D, Giotto Class, Fujifilm AMULET Innovality and Philips MicroDose systems at different dose levels, Siemens Inspiration DBT acquisitions were reconstructed with different algorithms, while a larger set of DBT series was acquired on Hologic Dimensions system for first reproducibility testing. A channelized Hotelling observer (CHO) with Gabor channels was developed The parameters of the Gabor channels were tuned on all systems at standard scanning conditions and the candidate that produced the best fit for all systems was chosen. After tuning, the MO was applied to all systems and conditions. Linear regression lines between MO and HO scores were calculated, giving correlation coefficients between 0.87 and 0.99 for all tested conditions.
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