How does c-view image quality compare with conventional 2D FFDM?

• Published in: Medical physics (Lancaster) 2016-05, Vol.43 (5), p.2538-2547
• Main Authors: Nelson, Jeffrey S., Wells, Jered R., Baker, Jay A., Samei, Ehsan
• Format: Article
• Language: English
• Subjects: 60 APPLIED LIFE SCIENCES; Acoustic noise measurement; Biological material, e.g. blood, urine; Haemocytometers; BIOMEDICAL RADIOGRAPHY; Breast - diagnostic imaging; Breast Diseases - diagnostic imaging; Calcinosis - diagnostic imaging; COMPUTER CODES; Computer software; c‐view; digital breast tomosynthesis; Digital computing or data processing equipment or methods, specially adapted for specific applications; digital mammography; Digital tomosynthesis mammography; FOURIER ANALYSIS; Humans; Image analysis; Image data processing or generation, in general; image reconstruction; image resolution; LIMITING VALUES; MAMMARY GLANDS; mammography; Mammography - instrumentation; mammography image quality; Medical image contrast; Medical image noise; medical image processing; Medical image reconstruction; Models, Anatomic; Pattern Recognition, Automated; PHANTOMS; Phantoms, Imaging; RADIATION DOSES; RADIATION PROTECTION AND DOSIMETRY; radiology; Reconstruction; Software; SPATIAL RESOLUTION; synthesized 2D mammogram; SYSTEMS ANALYSIS; Tomography - instrumentation; Visibility
• ISSN: 0094-2405; 2473-4209
• DOI: 10.1118/1.4947293

Purpose: The FDA approved the use of digital breast tomosynthesis (DBT) in 2011 as an adjunct to 2D full field digital mammography (FFDM) with the constraint that all DBT acquisitions must be paired with a 2D image to assure adequate interpretative information is provided. Recently manufacturers have developed methods to provide a synthesized 2D image generated from the DBT data with the hope of sparing patients the radiation exposure from the FFDM acquisition. While this much needed alternative effectively reduces the total radiation burden, differences in image quality must also be considered. The goal of this study was to compare the intrinsic image quality of synthesized 2D c-view and 2D FFDM images in terms of resolution, contrast, and noise. Methods: Two phantoms were utilized in this study: the American College of Radiology mammography accreditation phantom (ACR phantom) and a novel 3D printed anthropomorphic breast phantom. Both phantoms were imaged using a Hologic Selenia Dimensions 3D system. Analysis of the ACR phantom includes both visual inspection and objective automated analysis using in-house software. Analysis of the 3D anthropomorphic phantom includes visual assessment of resolution and Fourier analysis of the noise. Results: Using ACR-defined scoring criteria for the ACR phantom, the FFDM images scored statistically higher than c-view according to both the average observer and automated scores. In addition, between 50% and 70% of c-view images failed to meet the nominal minimum ACR accreditation requirements—primarily due to fiber breaks. Software analysis demonstrated that c-view provided enhanced visualization of medium and large microcalcification objects; however, the benefits diminished for smaller high contrast objects and all low contrast objects. Visual analysis of the anthropomorphic phantom showed a measureable loss of resolution in the c-view image (11 lp/mm FFDM, 5 lp/mm c-view) and loss in detection of small microcalcification objects. Spectral analysis of the anthropomorphic phantom showed higher total noise magnitude in the FFDM image compared with c-view. Whereas the FFDM image contained approximately white noise texture, the c-view image exhibited marked noise reduction at midfrequency and high frequency with far less noise suppression at low frequencies resulting in a mottled noise appearance. Conclusions: Their analysis demonstrates many instances where the c-view image quality differs from FFDM. Compared to FFDM, c-vi