Modeling the Anisotropic Resolution and Noise Properties of Digital Breast Tomosynthesis

Digital breast tomosynthesis (DBT) is a 3D imaging modality in which a reconstruction of the breast is generated from various x-ray projections. Due to the newness of this technology, the development of an analytical model of image quality has been on-going. In this thesis, a more complete model is developed by addressing the limitations found in the previous linear systems (LS) model [Zhao, Med. Phys. 2008, 35(12): 5219-32]. A central assumption of the LS model is that the angle of x-ray incidence is approximately normal to the detector in each projection. To model the effect of oblique x-ray incidence, this thesis generalizes Swank\u27s calculations of the transfer functions of x-ray fluorescent screens to arbitrary incident angles. In the LS model, it is also assumed that the pixelation in the reconstruction grid is the same as the detector; hence, the highest frequency that can be resolved is the detector alias frequency. This thesis considers reconstruction grids with smaller pixelation to investigate super-resolution, or visibility of higher frequencies. A sine plate is introduced as a conceptual test object to analyze super-resolution. By orienting the long axis of the sine plate at various angles, the feasibility of oblique reconstruction planes is also investigated. This formulation differs from the LS model in which reconstruction planes are parallel to the breast support. It is shown that the transfer functions for arbitrary angles of x-ray incidence can be modeled in closed form. The high frequency modulation transfer function (MTF) and detective quantum efficiency (DQE) are degraded due to oblique x-ray incidence. In addition, using the sine plate, it is demonstrated that a reconstruction can resolve frequencies exceeding the detector alias frequency. Experimental images of bar patterns verified the existence of super-resolution. Anecdotal clinical examples showed that super-resolution improves the visibility of microcalcifications. The feasibility of oblique reconstructions was established theoretically with the sine plate and was validated experimentally with bar patterns. This thesis develops a more complete model of image quality in DBT by addressing the limitations of the LS model. In future studies, this model can be used as a tool for optimizing DBT

Impact of Tomosynthesis Acquisition on 3D Segmentations of Breast Outline and Adipose/Dense Tissue with AI: A Simulation-Based Study

Digital breast tomosynthesis (DBT) reconstructions introduce out-of-plane artifacts and false-tissue boundaries impacting the dense/adipose and breast outline (convex hull) segmentations. A virtual clinical trial method was proposed to segment both the breast tissues and the breast outline in DBT reconstructions. The DBT images of a representative population were simulated using three acquisition geometries: a left–right scan (conventional, I), a two-directional scan in the shape of a “T” (II), and an extra-wide range (XWR, III) left–right scan at a six-times higher dose than I. The nnU-Net was modified including two losses for segmentation: (1) tissues and (2) breast outline. The impact of loss (1) and the combination of loss (1) and (2) was evaluated using models trained with data simulating geometry I. The impact of the geometry was evaluated using the combined loss (1&2). The loss (1&2) improved the convex hull estimates, resolving 22.2% of the false classification of air voxels. Geometry II was superior to I and III, resolving 99.1% and 96.8% of the false classification of air voxels. Geometry III (Dice = (0.98, 0.94)) was superior to I (0.92, 0.78) and II (0.93, 0.74) for the tissue segmentation (adipose, dense, respectively). Thus, the loss (1&2) provided better segmentation, and geometries T and XWR improved the dense/adipose and breast outline segmentations relative to the conventional scan

MaasPenn Radiomics Reproducibility Score:A Novel Quantitative Measure for Evaluating the Reproducibility of CT-Based Handcrafted Radiomic Features

Simple Summary: The reproducibility of handcrafted radiomic features (HRFs) has been reported to be affected by variations in imaging acquisition and reconstruction parameters. However, to date, these effects have not been understood or quantified. In this study, we analyzed a significantly large number of scenarios in an effort to quantify the effects of variations on the reproducibility of HRFs. In addition, we assessed the performance of ComBat harmonization in each of the 31,375 investigated scenarios. We developed a novel score that can be considered the first attempt to objectively assess the number of reproducible HRFs in different scenario. Following further validation, the score could be used to decide on the inclusion of data acquired differently, as well as the assessment of the generalizability of developed radiomic signatures. Abstract: The reproducibility of handcrafted radiomic features (HRFs) has been reported to be affected by variations in imaging parameters, which significantly affect the generalizability of developed signatures and translation to clinical practice. However, the collective effect of the variations in imaging parameters on the reproducibility of HRFs remains unclear, with no objective measure to assess it in the absence of reproducibility analysis. We assessed these effects of variations in a large number of scenarios and developed the first quantitative score to assess the reproducibility of CT-based HRFs without the need for phantom or reproducibility studies. We further assessed the potential of image resampling and ComBat harmonization for removing these effects. Our findings suggest a need for radiomics-specific harmonization methods. Our developed score should be considered as a first attempt to introduce comprehensive metrics to quantify the reproducibility of CT-based handcrafted radiomic features. More research is warranted to demonstrate its validity in clinical contexts and to further improve it, possibly by the incorporation of more realistic situations, which better reflect real patients' situations

Multiclass Segmentation of Breast Tissue and Suspicious Findings: A Simulation-Based Study for the Development of Self-Steering Tomosynthesis

In breast tomosynthesis, multiple low-dose projections are acquired in a single scanning direction over a limited angular range to produce cross-sectional planes through the breast for three-dimensional imaging interpretation. We built a next-generation tomosynthesis system capable of multidirectional source motion with the intent to customize scanning motions around “suspicious findings”. Customized acquisitions can improve the image quality in areas that require increased scrutiny, such as breast cancers, architectural distortions, and dense clusters. In this paper, virtual clinical trial techniques were used to analyze whether a finding or area at high risk of masking cancers can be detected in a single low-dose projection and thus be used for motion planning. This represents a step towards customizing the subsequent low-dose projection acquisitions autonomously, guided by the first low-dose projection; we call this technique “self-steering tomosynthesis.” A U-Net was used to classify the low-dose projections into “risk classes” in simulated breasts with soft-tissue lesions; class probabilities were modified using post hoc Dirichlet calibration (DC). DC improved the multiclass segmentation (Dice = 0.43 vs. 0.28 before DC) and significantly reduced false positives (FPs) from the class of the highest risk of masking (sensitivity = 81.3% at 2 FPs per image vs. 76.0%). This simulation-based study demonstrated the feasibility of identifying suspicious areas using a single low-dose projection for self-steering tomosynthesis

Reply to Orlhac, F.; Buvat, I. Comment on "Ibrahim et al. The Effects of In-Plane Spatial Resolution on CT-Based Radiomic Features' Stability with and without ComBat Harmonization. Cancers 2021, 13, 1848".

We would like to thank Orlhac and Buvat [...]

The Effects of In-Plane Spatial Resolution on CT-Based Radiomic Features' Stability with and without ComBat Harmonization

peer reviewedWhile handcrafted radiomic features (HRFs) have shown promise in the field of personalized medicine, many hurdles hinder its incorporation into clinical practice, including but not limited to their sensitivity to differences in acquisition and reconstruction parameters. In this study, we evaluated the effects of differences in in-plane spatial resolution (IPR) on HRFs, using a phantom dataset (n = 14) acquired on two scanner models. Furthermore, we assessed the effects of interpolation methods (IMs), the choice of a new unified in-plane resolution (NUIR), and ComBat harmonization on the reproducibility of HRFs. The reproducibility of HRFs was significantly affected by variations in IPR, with pairwise concordant HRFs, as measured by the concordance correlation coefficient (CCC), ranging from 42% to 95%. The number of concordant HRFs (CCC > 0.9) after resampling varied depending on (i) the scanner model, (ii) the IM, and (iii) the NUIR. The number of concordant HRFs after ComBat harmonization depended on the variations between the batches harmonized. The majority of IMs resulted in a higher number of concordant HRFs compared to ComBat harmonization, and the combination of IMs and ComBat harmonization did not yield a significant benefit. Our developed framework can be used to assess the reproducibility and harmonizability of RFs

Novel Perlin-based phantoms using 3D models of compressed breast shapes and fractal noise

Virtual clinical trials (VCTs) have been used widely to evaluate digital breast tomosynthesis (DBT) systems. VCTs require realistic simulations of the breast anatomy (phantoms) to characterize lesions and to estimate risk of masking cancers. This study introduces the use of Perlin-based phantoms to optimize the acquisition geometry of a novel DBT prototype. These phantoms were developed using a GPU implementation of a novel library called Perlin-CuPy. The breast anatomy is simulated using 3D models under mammography cranio-caudal compression. In total, 240 phantoms were created using compressed breast thickness, chest-wall to nipple distance, and skin thickness that varied in a {[35, 75], [59, 130), [1.0, 2.0]} mm interval, respectively. DBT projections and reconstructions of the phantoms were simulated using two acquisition geometries of our DBT prototype. The performance of both acquisition geometries was compared using breast volume segmentations of the Perlin phantoms. Results show that breast volume estimates are improved with the introduction of posterior-anterior motion of the x-ray source in DBT acquisitions. The breast volume is overestimated in DBT, varying substantially with the acquisition geometry; segmentation errors are more evident for thicker and larger breasts. These results provide additional evidence and suggest that custom acquisition geometries can improve the performance and accuracy in DBT. Perlin phantoms help to identify limitations in acquisition geometries and to optimize the performance of the DBT prototypes