High-attenuation artifact reduction in breast tomosynthesis using a novel reconstruction algorithm. Issue 116 (July 2019)

• Record Type: Journal Article
• Authors: Dustler, Magnus; Wicklein, Julia; Förnvik, Hannie; Boita, Joana; Bakic, Predrag; Lång, Kristina
• Is Part Of: European journal of radiology. Issue 116(2019)
• Page Start: 21
• Page End: 26
• Publication Date: 2019-07
• Subjects: Breast tomosynthesis -- Mammography -- Image reconstruction -- Artifact reduction -- Breast imaging; Medical radiology -- Periodicals; Radiology -- Periodicals; Radiologie médicale -- Périodiques; Medical radiology; Periodicals; 616.075705
• DOI: 10.1016/j.ejrad.2019.04.014
• Languages: English
• ISSNs: 0720-048X

Abstract

Abstract: Purpose: To assess the effect on reducing the out-of-plane artifacts from metal objects in breast tomosynthesis (BT) using a novel artifact-reducing reconstruction algorithm in specimen radiography. Methods and Materials: The study was approved by the Regional Ethical Review Board. BT images of 18 partial- and whole mastectomy specimens from women with breast cancer were acquired before and after a needle was inserted close to the lesion. The images were reconstructed using both a standard reconstruction algorithm, and a novel algorithm; the latter uses pre-segmentation to remove highly attenuating artifact-inducing objects from projection images before reconstruction. Images were separately reconstructed with and without segmentation, and combined into an artifact-reduced reconstruction. Standard and artifact-reduced BT-algorithms were compared visually and quantitatively using clinical images of mastectomy specimens and a physical anthropomorphic phantom. Six readers independently assessed the visibility of the lesion with and without artifact-reduction in a side-by-side comparison. A quantitative analysis was performed, comparing the signal-difference to background ratio (SDBR) and artifact spread function (ASF) between the two reconstruction methods. Results: The magnitude of out-of-plane artifacts was clearly reduced with the novel reconstruction compared to BT-images without artifact reduction. Lesion masking by artifacts was largely averted; tumour visibility was comparable to standard BT images without a needle. In 76 ± 8% (standard deviation) of cases overall, readers could confidently state needle location. The same figure was 94 ± 6% for whole mastectomy cases, compared to 62 ± 17% for partial mastectomies. With metal artifact reduction, SDBR increased by 97% in the phantom, and by 69% in the mastectomies. The artifact spread function was substantially narrower. Conclusion: Artifact reduction in BT using a novel reconstruction method enables qualitatively and quantitatively improved clinical use of BT when metal artifacts can be a limiting factor such as in tomosynthesis-guided biopsy.