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Development and preclinical evaluation of a patient‐specific high energy x‐ray phase sensitive breast tomosynthesis system
Author(s) -
Ghani Muhammad U.,
Wu Xizeng,
Fajardo Laurie L.,
Jing Zhengxue,
Wong Molly D.,
Zheng Bin,
Omoumi Farid,
Li Yuhua,
Yan Aimin,
Jenkins Peter,
Hillis Stephen L.,
Linstroth Laura,
Liu Hong
Publication year - 2021
Publication title -
medical physics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.473
H-Index - 180
eISSN - 2473-4209
pISSN - 0094-2405
DOI - 10.1002/mp.14743
Subject(s) - tomosynthesis , imaging phantom , mammography , breast imaging , quality assurance , image quality , nuclear medicine , contrast to noise ratio , medicine , medical physics , computer science , materials science , breast cancer , artificial intelligence , cancer , pathology , image (mathematics) , external quality assessment
Background This article reports the first x‐ray phase sensitive breast tomosynthesis (PBT) system that is aimed for direct translation to clinical practice for the diagnosis of breast cancer. Purpose To report the preclinical evaluation and comparison of the newly built PBT system with a conventional digital breast tomosynthesis (DBT) system. Methods and materials The PBT system is developed based on a comprehensive inline phase contrast theoretical model. The system consists of a polyenergetic microfocus x‐ray source and a flat panel detector mounted on an arm that is attached to a rotating gantry. It acquires nine projections over a 15° angular span in a stop‐and‐shoot manner. A dedicated phase retrieval algorithm is integrated with a filtered back‐projection method that reconstructs tomographic slices. The American College of Radiology (ACR) accreditation phantom, a contrast detail (CD) phantom and mastectomy tissue samples were imaged at the same glandular dose levels by both the PBT and a standard of care DBT system for image quality characterizations and comparisons. Results The PBT imaging scores with the ACR phantom are in good to excellent range and meet the quality assurance criteria set by the Mammography Quality Standard Act. The CD phantom image comparison and associated statistical analyses from two‐alternative forced‐choice reader studies confirm the improvement offered by the PBT system in terms of contrast resolution, spatial resolution, and conspicuity. The artifact spread function (ASF) analyses revealed a sizable lateral spread of metal artifacts in PBT slices as compared to DBT slices. Signal‐to‐noise ratio values for various inserts of the ACR and CD phantoms further validated the superiority of the PBT system. Mastectomy sample images acquired by the PBT system showed a superior depiction of microcalcifications vs the DBT system. Conclusion The PBT imaging technology can be clinically employed for improving the accuracy of breast cancer screening and diagnosis.