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Portrait of Predrag Bakic. Photo

Predrag Bakic

Associate Professor

Portrait of Predrag Bakic. Photo

High-attenuation artifact reduction in breast tomosynthesis using a novel reconstruction algorithm

Author

  • Magnus Dustler
  • Julia Wicklein
  • Hannie Förnvik
  • Joana Boita
  • Predrag Bakic
  • Kristina Lång

Summary, in English

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.

Department/s

  • Diagnostic Radiology, (Lund)
  • Medical Radiation Physics, Malmö
  • BioCARE: Biomarkers in Cancer Medicine improving Health Care, Education and Innovation

Publishing year

2019

Language

English

Pages

21-26

Publication/Series

European Journal of Radiology

Volume

116

Document type

Journal article

Publisher

Elsevier

Topic

  • Radiology, Nuclear Medicine and Medical Imaging

Keywords

  • Artifact reduction
  • Breast imaging
  • Breast tomosynthesis
  • Image reconstruction
  • Mammography

Status

Published

Research group

  • Medical Radiation Physics, Malmö

ISBN/ISSN/Other

  • ISSN: 0720-048X