Wide-angle breast tomosynthesis: Initial comparative evaluation

Conventional mammography is largely limited by superimposed anatomy which is alleviated by breast tomosynthesis and CT. Limited acquisition in tomosynthesis can result in significant out of plane artifacts while large angular acquisition span in CT can limit the imaging coverage of the chest wall near the breast. We propose a new breast imaging modality, wide-angle breast tomosynthesis (WBT), aimed to provide a practical compromise between 3D sampling and chest-wall coverage. This study compares lesion detection between conventional digital breast tomosynthesis, WBT, and breast CT (44°, 99°, and 198° total angle range, respectively) under equal patient dose conditions. A Monte Carlo (MC) code based on the Penelope package modeled a virtual flat-panel breast tomosynthesis system. The modalities were simulated at four breast compression levels. Glandular dose to the breast was estimated and the radiation flux was subsequently adjusted to achieve a constant mean glandular dose level of 1.5 mGy, independent of the breast thickness and acquisition geometry. Reconstructed volumes were generated using iterative reconstruction methods. Lesion detectability was estimated using contrast-to-noise-ratio. Results showed improved detection with increased angular span and compression. Evaluations also showed improved performance of WBT over DBT at lower compression levels, therefore highlighting potential for reduced breast compression when using a larger acquisition angle. © 2010 SPIE.

Duke Scholars

Author Ehsan Samei Radiology