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Register a new userReconstruction Algorithm Design for Mitigating the Orientation Dependent Conspicuity of Fiber-Like signals in Digital Breast Tomosynthesis
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There are a number of clinically relevant tasks in digital breast tomosynthesis (DBT) involving the detection and visual assessment of fiber-like structures such as Coopers ligaments, blood vessels, and spiculated lesions. Such structures can exhibit orientation dependent variations in conspicuity. This study demonstrates the presence of in-plane orientation-dependent signal conspicuity for fiber-like signals in DBT and shows how reconstruction algorithm design can mitigate this phenomenon. We uncover a tradeoff between minimizing orientation-dependence and preserving depth resolution that is dictated by the regularization strength employed in reconstruction.
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Fiber-like features are an important aspect of breast imaging. Vessels and ducts are present in all breast images, and spiculations radiating from a mass can indicate malignancy. Accordingly, fiber objects are one of the three types of signals used in the American College of Radiology digital mammography (ACR-DM) accreditation phantom. This work focuses on the image properties of fiber-like structures in digital breast tomosynthesis (DBT) and how image reconstruction can affect their appearance. The impact of DBT image reconstruction algorithm and regularization strength on the conspicuity of fiber-like signals of various orientations is investigated in simulation. A metric is developed to characterize this orientation dependence and allow for quantitative comparison of algorithms and associated parameters in the context of imaging fiber signals. The imaging properties of fibers, characterized in simulation, are then demonstrated in detail with physical DBT data of the ACR-DM phantom. The characterization of imaging of fiber signals is used to explain features of an actual clinical DBT case. For the algorithms investigated, at low regularization setting, the results show a striking variation in conspicuity as a function of orientation in the viewing plane. In particular, the conspicuity of fibers nearly aligned with the plane of the X-ray source trajectory is decreased relative to more obliquely oriented fibers. Increasing regularization strength mitigates this orientation dependence at the cost of increasing depth blur of these structures.
Simulation-based image quality metrics are adapted and investigated for characterizing the parameter dependences of linear iterative image reconstruction for DBT. Three metrics based on 2D DBT simulation are investigated: (1) a root-mean-square-error (RMSE) between the test phantom and reconstructed image, (2) a gradient RMSE where the comparison is made after taking a spatial gradient of both image and phantom, and (3) a region-of-interest (ROI) Hotelling observer (HO) for signal-known-exactly/background-known-exactly (SKE/BKE) and signal-known-exactly/background-known-statistically (SKE/BKS) detection tasks. Two simulation studies are performed using the aforementioned metrics, varying voxel aspect ratio and regularization strength for two types of Tikhonov regularized least-squares optimization. The RMSE metrics are applied to a 2D test phantom and the ROI-HO metric is applied to two tasks relevant to DBT: large, low contrast lesion detection and small, high contrast microcalcification detection. The RMSE metric trends are compared with visual assessment of the reconstructed test phantom. The ROI-HO metric trends are compared with 3D reconstructed images from ACR phantom data acquired with a Hologic Selenia Dimensions DBT system. Sensitivity of image RMSE to mean pixel value is found to limit its applicability to the assessment of DBT image reconstruction. Image gradient RMSE is insensitive to mean pixel value and appears to track better with subjective visualization of the reconstructed bar-pattern phantom. The ROI-HO metric shows an increasing trend with regularization strength for both forms of Tikhonov-regularized least-squares; however, this metric saturates at intermediate regularization strength indicating a point of diminishing returns for signal detection. Visualization with reconstructed ACR phantom images appears to show a similar dependence with regularization strength.
We present the first evaluation of a recently developed silicon-strip detector for photon-counting dual-energy breast tomosynthesis. The detector is well suited for tomosynthesis with high dose efficiency and intrinsic scatter rejection. A method was developed for measuring the spatial resolution of a system based on the detector in terms of the three-dimensional modulation transfer function (MTF). The measurements agreed well with theoretical expectations, and it was seen that depth resolution was won at the cost of a slightly decreased lateral resolution. This may be a justifiable trade-off as clinical images acquired with the system indicate improved conspicuity of breast lesions. The photon-counting detector enables dual-energy subtraction imaging with electronic spectrumsplitting. This improved the detectability of iodine in phantom measurements, and the detector was found to be stable over typical clinical acquisition times. A model of the energy resolution showed that further improvements are within reach by optimization of the detector.
Automated methods for breast cancer detection have focused on 2D mammography and have largely ignored 3D digital breast tomosynthesis (DBT), which is frequently used in clinical practice. The two key challenges in developing automated methods for DBT classification are handling the variable number of slices and retaining slice-to-slice changes. We propose a novel deep 2D convolutional neural network (CNN) architecture for DBT classification that simultaneously overcomes both challenges. Our approach operates on the full volume, regardless of the number of slices, and allows the use of pre-trained 2D CNNs for feature extraction, which is important given the limited amount of annotated training data. In an extensive evaluation on a real-world clinical dataset, our approach achieves 0.854 auROC, which is 28.80% higher than approaches based on 3D CNNs. We also find that these improvements are stable across a range of model configurations.
Measurements of breast density have the potential to improve the efficiency and reduce the cost of screening mammography through personalized screening. Breast density has traditionally been evaluated from the dense area in a mammogram, but volumetric assessment methods, which measure the volumetric fraction of fibro-glandular tissue in the breast, are potentially more consistent and physically sound. The purpose of the present study is to evaluate a method for measuring the volumetric breast density using photon-counting spectral tomosynthesis. The performance of the method was evaluated using phantom measurements and clinical data from a small population (n=18). The precision was determined to 2.4 percentage points (pp) of volumetric breast density. Strong correlations were observed between contralateral (R^2=0.95) and ipsilateral (R^2=0.96) breast-density measurements. The measured breast density was anti-correlated to breast thickness, as expected, and exhibited a skewed distribution in the range [3.7%, 55%] and with a median of 18%. We conclude that the method yields promising results that are consistent with expectations. The relatively high precision of the method may enable novel applications such as treatment monitoring.
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