Improved in-plane visibility of tumors using breast tomosynthesis

Abstract

The purpose of this work was to evaluate and compare the visibility of tumors in digital mammography (DM) and breast tomosynthesis (BT) images. Images of the same women were acquired on both a DM system (Mammomat Novation, Siemens) and a BT prototype system adapted from the same type of DM system. Simulated 3D tumors (average dimension: 8.4 mm x 6.6 mm x 5 mm) were projected and added to each DM image as well as each BT projection image prior to 3D reconstruction. The same beam quality and approximately the same total absorbed dose were used for each breast image acquisition on both systems. Two simulated tumors were added to each of thirty breast scans, yielding sixty cases. A series of 4-alternative forced choice (4-AFC) human observer performance experiments were conducted in order to determine what projected tumor signal intensity in the DM images would be needed to achieve the same detectability as in the reconstructed BT images. Nine observers participated. For the BT experiment, when the tumor signal intensity on the central projection was 0.010 the mean percent of correct responses (PC) was measured to be 81.5%, which converted to a detectability index value (d') of 1.96. For the DM experiments, the same detectability was achieved at a signal intensity determined to be 0.038. Equivalent tumor detection in BT images were thus achieved at around four times less projected signal intensity than in DM images, indicating that the use of BT may lead to earlier detection of breast cancer.