3D lesion insertion in digital breast tomosynthesis images

Abstract

Digital breast tomosynthesis (DBT) is a new volumetric breast cancer screening modality. It is based on the principles of computed tomography (CT) and shows promise for improving sensitivity and specificity compared to digital mammography, which is the current standard protocol. A barrier to critically evaluating any new modality, including DBT, is the lack of patient data from which statistically significant conclusions can be drawn; such studies require large numbers of images from both diseased and healthy patients. Since the number of detected lesions is low in relation to the entire breast cancer screening population, there is a particular need to acquire or otherwise create diseased patient data. To meet this challenge, we propose a method to insert 3D lesions in the DBT images of healthy patients, such that the resulting images appear qualitatively faithful to the modality and could be used in future clinical trials or virtual clinical trials (VCTs). The method facilitates direct control of lesion placement and lesion-to-background contrast and is agnostic to the DBT reconstruction algorithm employed.