Evaluation of scatter effects on image quality for breast tomosynthesis.

Digital breast tomosynthesis uses a limited number (typically 10-20) of low-dose x-ray projections to produce a pseudo-three-dimensional volume tomographic reconstruction of the breast. The purpose of this investigation was to characterize and evaluate the effect of scattered radiation on the image quality for breast tomosynthesis. In a simulation, scatter point spread functions generated by a Monte Carlo simulation method were convolved over the breast projection to estimate the distribution of scatter for each angle of tomosynthesis projection. The results demonstrate that in the absence of scatter reduction techniques, images will be affected by cupping artifacts, and there will be reduced accuracy of attenuation values inferred from the reconstructed images. The effect of x-ray scatter on the contrast, noise, and lesion signal-difference-to-noise ratio (SDNR) in tomosynthesis reconstruction was measured as a function of the tumor size. When a with-scatter reconstruction was compared to one without scatter for a 5 cm compressed breast, the following results were observed. The contrast in the reconstructed central slice image of a tumorlike mass (14 mm in diameter) was reduced by 30%, the voxel value (inferred attenuation coefficient) was reduced by 28%, and the SDNR fell by 60%. The authors have quantified the degree to which scatter degrades the image quality over a wide range of parameters relevant to breast tomosynthesis, including x-ray beam energy, breast thickness, breast diameter, and breast composition. They also demonstrate, though, that even without a scatter rejection device, the contrast and SDNR in the reconstructed tomosynthesis slice are higher than those of conventional mammographic projection images acquired with a grid at an equivalent total exposure.